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

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.

Automated summary

Lactating women in rural Bangladesh have inadequate dietary intake, especially for micronutrients. The study found that most subjects had low intake of total energy and fat, and there were deficiencies in riboflavin, calcium, vitamin A, and folate. Maternal BMI and education level were associated with diet quality.