Background: Inadequate intake of micronutrients in adolescence leads to high risk of nutritional anemia contributing to the intergenerational cycle of malnutrition. Objective: To compare problem nutrients in diet of girls with anemia and nonanemic girls and develop food-based recommendation (FBR) to prevent anemia (hemoglobin <12.0 g/dL) and micronutrient deficiencies among adolescent schoolgirls. Methods: Screening for anemia was conducted among 355 adolescent schoolgirls aged 15 to 18 years in East Java, Indonesia. Food consumption patterns were assessed from 69 girls with anemia and 78 nonanemic girls aged 15 to 18 years using two 24-hour dietary recalls and 5-day food records. Weighing is used to obtain food portion sizes. Linear Programming (LP) approach using Optifood was used to identify problem nutrient(s) and formulate FBRs. Results: Iron and calcium were problem nutrients among nonanemic girls, while iron, calcium, folate, and vitamin A were problem nutrients among anemic girls. Milk and liver were potential nutrient-dense foods identified to fill the nutrient gaps. Six FBRs would ensure the dietary adequacy for 9 of 12 nutrients except for iron, folate, and calcium. Conclusions: Anemic girls had more problem nutrients compared to their nonanemic counterparts. The FBRs developed using LP can meet adequacy of most nutrients except iron, folate, and calcium. Nutrient gap identified from LP analysis suggests that it is advisable to add a mixture of weekly iron and folate supplement for adolescent girls in order to meet adequacy of iron and folate to prevent anemia.

Nutrition is a major determinant of health throughout all stages of life and together with smoking is the most important risk factor for morbidity and mortality in the Asia Pacific Region. The workshop participants examined Dietary Guidelines and Food Guides that are in use in our region, together with additional materials from the World Health Organization, UNICEF and the World Cancer Research Foundation. The resulting set of guidelines is meant as a reminder of the main issues to be covered in a general public health education program. It may also be of value in reminding public health practitioners, educators, administrators, and policy makers of current nutrition issues. It may additionally be useful as a checklist of the issues to be considered in public health programs and regulations. The main areas of nutrition that are included in the Guidelines are eating a variety of foods, including vegetables, fruits, whole grain cereals, and nuts. Choose fish, poultry, and meats grown in a sustainable way. Appropriate growth, including avoiding obesity, and physical activity are important. Breastfeeding is the basis of infant nutrition and nutrition of mothers is an important public health measure. Negative factors in the Asian diet include salt, refined sugar, alcohol and fats. The APACPH Dietary Guidelines will need to be kept under review and modified to meet regional differences in food supply. The Guidelines will be useful as a checklist of the issues to be considered in public health programs, addressing both acute and chronic diseases.