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Energy intake during economic crisis depends on initial wealth and access to rice fields: the case of pregnant Indonesian women
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
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2002 (English)In: Health Policy, ISSN 0168-8510, Vol. 61, no 1, 57-71 p.Article in journal (Refereed) Published
Abstract [en]

Starting in August 1997, Indonesia experienced a radical and rapid deterioration in its economy. Between 1996 and 1998, dietary intake during the second trimester was measured in 450 pregnant women in Purworejo, Central Java, Indonesia. Using six 24 h recalls we describe the consequences of the economic crisis on the energy intake of pregnant Indonesian women. Depending on the date of data collection, women were grouped into 'before crisis', 'transition' and 'during crisis'. Mean energy intake among groups was compared using ANOVA and Student's t-test. All groups of pregnant women already had a mean energy intake before the emerging crisis that was lower than the Indonesian recommended dietary allowances (RDA). Nevertheless, energy intake differed significantly among women with different education levels (P = 0.00) and from different socio-economic groups (P = 0.00). 'During transition', a significant decrease in energy intake was experienced by urban poor women (P = 0.01). Poor women with access to rice fields had a higher rice consumption than other groups throughout the period. Our results most likely reflect the effect of higher rice price on income and welfare. 'During crisis', energy intake improved among vulnerable groups, perhaps reflecting government intervention.

Place, publisher, year, edition, pages
2002. Vol. 61, no 1, 57-71 p.
Keyword [en]
Energy intake, Economic crisis, Initial wealth, Pregnancy, Indonesia
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-3790DOI: 10.1016/S0168-8510(01)00210-XPubMedID: 12173497OAI: oai:DiVA.org:umu-3790DiVA: diva2:142663
Available from: 2004-03-15 Created: 2004-03-15 Last updated: 2010-05-06Bibliographically approved
In thesis
1. Food habits, dietary intake and nutritional status during economic crisis among pregnant women in Central Java, Indonesia
Open this publication in new window or tab >>Food habits, dietary intake and nutritional status during economic crisis among pregnant women in Central Java, Indonesia
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

FOOD HABITS, DIETARY INTAKE AND NUTRITIONAL STATUS DURING ECONOMIC CRISIS AMONG PREGNANT WOMEN IN CENTRAL JAVA, INDONESIA

Th. Ninuk Sri Hartini, Epidemiology and Public Health Sciences, Dept. of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Community Health and Nutrition Research Laboratories, Gadjah Mada University, Jogjakarta, Indonesia; Nutrition Academy, Ministry of Health, Jogjakarta, Indonesia

ABSTRACT

Objectives: The overall objective of this thesis was to study the effect of the economic crisis on food habits, dietary intake and nutritional status among pregnant women in Purworejo District, Central Java, Indonesia.

Subjects and methods: Since 1994, the Community Health and Nutrition Research Laboratories (CHN-RL), Gadjah Mada University, Jogjakarta, Indonesia have operated a surveillance system in Purworejo District, Central Java, Indonesia. Between 1996 and 1998, a monthly monitoring of new pregnancies took place within the surveillance system. This project included a detailed evaluation of dietary intake during pregnancy. Each trimester six repeated 24-hour recalls were conducted on 450 pregnant women. Weight and mid-upper arm circumference (MUAC) were measured monthly, height and serum ferritin concentration was measured once. Here, the dietary intake and nutritional status of the women during the second trimester are evaluated in relation to the emergence of the economic crisis, that started in 1997. Women were classified into four socio-economic groups. A computer program (Inafood) was developed to calculate nutrient intake. To support the quantitative results, a qualitative study was carried out between January and June 1999. Focus group discussions were held with four groups of women, in-depth interviews with 16 women, three traditional birth attendants and four midwives, and observations were carried out with four women. Here, food habits and coping strategies in relation to the economic crisis were explored.

Results: Before the crisis, more than 80% of the pregnant women had inadequate energy and 40% had inadequate protein and vitamin A intake. All women had inadequate calcium and iron intake. The food intake consisted of rice, nuts and pulses and vegetables, meaning that it was mainly plant-based food. Rice behaved as a strongly inferior good in economic term, meaning that its consumption increased in spite of its price increase. Rice remained an important supplier of energy, protein and carbohydrates also during the crisis. Especially, rural, poor women with access to rice fields increased their rice intake and decreased their intake of non-rice staple foods. Reasons for the continued rice intake included the women had been accustomed to eating rice since they were born and that cooking methods for non-rice staple foods were difficult. The intake of animal food was low initially and decreased further during the economic crisis. Rich women decreased their intake of fat. The intake of nuts and pulses and vegetables increased for most groups. Nuts and pulses were an important supplier of calcium and iron, and vegetables were an important supplier of vitamin A. The rural, poor women with access to rice fields kept their food taboos also during the crisis. Rich women were able to maintain a good nutrient intake during the crisis, although fat intake decreased. Also, urban poor and rural, poor, landless women had an increased intake “during crisis” because relatives and neighbour provided some foods and perhaps also because of the government support programme.

Conclusion: Before the crisis, energy and nutrient intake of pregnant women were inadequate. The food pattern of the women was predominately plant-based. Rich women were able to maintain a good nutrient intake during the crisis, although fat intake decreased. Rural poor women with access to rice fields had a higher rice intake than other groups throughout the crisis. Urban poor and rural poor, landless women experienced a decreased intake of most nutrients in the transition period but an increased intake during the crisis, reflecting government intervention and support from relatives and neighbours. The latter, however, is not sustainable. Thus, vulnerable groups are at risk of developing nutritional deficiencies without food support programmes.

Key words: Food intake, nutrient intake, nutritional status, food pattern, pregnancy, food habits, coping strategies, economic crisis, Indonesia.

Publisher
80 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 885
Keyword
Public health, Folkhälsomedicin
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-212 (URN)91-7305-590-5 (ISBN)
Public defence
2004-03-26, D, Tandläkarhögskolan, Norrlands Universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2004-03-15 Created: 2004-03-15 Last updated: 2010-01-22Bibliographically approved

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Hartini, TNSStenlund, Hans

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