Malnutrition in Rural Highland Ecuador: The Importance of Intrahousehold Food Distribution,Diet Composition,and Nutrient Requirements

Abstract

Our objectives were to quantify the intrahousehold distribution of food in an Andean community and to relate this distribution to dietary adequacy. Dietary information was collected using the 24-hour-recall method (n = 155 in 35 households; two or more recalls per subject). We found that food was served equitably (according to energy and protein requirements), yet the risk of inadequate intakes of four micronutrients was age-related. This was largely a function of age-based differences in micronutrient requirements per unit of energy, rather than variations in composition of the diet. A simple reallotment of food to those with higher requirements will not solve this problem, since the micronutrient density of the average diet is relatively low. Targeting of nutrient-dense foods would be difficult in this and other similar developing-world communities that are accustomed to a common pot from which foods of homogeneous composition are served. Feasible alternatives include nutrition education programmes and fortification of foods (salt, sugar, and oil) with micronutrients.