Assessment of nutrient adequacy and associated factors among lactating women of rural Bangladesh using observed intake: Findings from Bangladesh Integrated Household Survey 2018–2019

Abstract

Lactating women of low‐ and middle‐income countries are prone to develop deficiencies in essential nutrients due to various demographic and socioeconomic components. This study aimed to estimate the adequacy of dietary intake and the determinants of diet quality of lactating women in rural Bangladesh. One‐day dietary recall (24‐Hour recall) data of 973 lactating women were obtained from the Bangladesh Integrated Household Survey (BIHS) 2018–2019. Nutrient adequacy was determined using the Estimated Average Requirement (EAR) cut‐point approach. The molar ratios of phytate to zinc, calcium, and iron were calculated. Mean Adequacy Ratio (MAR) was calculated to measure diet quality, and multiple linear regression analysis was performed to assess the sociodemographic determinants of MAR. While the intakes of protein and carbohydrate were equal to/above the Acceptable Macronutrient Distribution Range (AMDR) among most of the subjects, intakes of total energy and fat were below the reference intakes for 74.4% and 98.3%, respectively. Nutrient adequacy remained unmet for riboflavin, calcium, vitamin A, and folate among most (87.2%–97.6%) of the study population, and the mean (SD) MAR was 0.72 (0.12). Cereals were the major contributor of energy and B vitamins, while protein and iron mainly came from plant‐based sources. The molar ratio of phytate to iron was greater than the critical limit among most respondents. Maternal Body Mass Index (BMI) (beta = 0.003, p = .014) and education level (beta = 0.017, p = .038) were associated with their diet quality. The diet of most lactating women in rural Bangladesh indicates the inadequacy of several micronutrients. This can lead to a worsening of the double burden of malnutrition in women. Lactating women should be given special consideration when designing food and nutrition programs for reproductive women in rural Bangladesh.

Micronutrient inadequacy among lactating mothers in rural areas of North Mecha District, Amhara Region, Ethiopia

“…Vitamin A intake inadequacy was prevalent among 86.7% of lactating mothers, according to this study. This is comparable to studies conducted in Ethiopia ( 13 ), Niger ( 12 ), and Bangladesh ( 8 ). In contrast, this study finding is lower than studies conducted in Bahir Dar City, Ethiopia ( 14 ), Zambia ( 11 ), China ( 45 ), and California ( 10 ), and higher than reports from studies conducted in Nigeria ( 46 ), Indonesia ( 41 ), Thailand ( 44 ) and Iran ( 43 ).…”

“…This study revealed that the prevalence of micronutrient intake inadequacy among selected B vitamins (vitamin B1, vitamin B2, vitamin B3, vitamin B6, vitamin B9, and vitamin B12) ranges from 18.1 to 82.3%. Among lactating mothers, 33.7% of them had inadequate intake for vitamin B1 (Thiamin), which is higher than studies in Ethiopia ( 13 , 14 ), Iran ( 43 ), and California ( 10 ), and lower than findings from Zambia ( 11 ), Niger ( 12 ), Bangladesh ( 8 ), Thailand ( 44 ), China ( 45 ), and Indonesia ( 41 ). Dietary practices and mandatory fortification of staple foods have a major impact on thiamin intake; areas high in meat, whole grains, and legume production and consumption experience lower rates of inadequacy ( 48 ).…”

“…The difference between using RDA or EAR is apparent in the calculation of NAR and determining the prevalence of nutrient inadequacy for each specific nutrient. Other researchers have reported disparities between studies using RDA ( 14 , 43 , 44 ) and EAR ( 8 , 10–12 , 41 , 45 ).…”

“…The majority of lactating mothers had inadequacy for many of the micronutrients, with a global prevalence of micronutrient inadequacy reaching over 50%. Most lactating mothers (87.2–97.6%) in rural Bangladesh did not meet the recommended levels of riboflavin, calcium, vitamin A, and folate ( 8 ). Lactating mothers in Brazil had a high prevalence of micronutrient inadequacy, even more so than mothers of reproductive age, for vitamin A (95% versus 72%), vitamin C (56% versus 37%), vitamin B6 (75% versus 33%), folate (72% versus 40%), and zinc (64% versus 20%) ( 9 ).…”

Inadequate intake of energy and nutrients: A comparative cross‐sectional study between sport and nonsport science university students of southern Ethiopia

“…A (581-643 μg vs. 321-328 μg) by adults greater than 18 years old was far higher than we had found in our present study (Fulgoni Iii & Agarwal, 2021), whereas the protein intake by Bangladesh lactating women was consistent with our findings, in which the median protein intake was 67.84 g (Islam et al, 2023).…”