ABSTRACT:

Introduction: Stunting, a form of chronic malnutrition, remains a significant public health issue in Indonesia, with high prevalence rates among young children. Dietary diversity has been identified as a crucial factor influencing the nutritional status and risk of stunting in this population. This study aimed to investigate the relationship between dietary diversity and the risk of stunting in young children in Indonesia.
Materials & Methods: Literature searches were conducted on electronic databases such as PubMed, Embase, and the Cochrane Library. Articles that meet the inclusion criteria will be analyzed narratively.
Results: The findings demonstrate a significant inverse relationship between dietary diversity and the risk of stunting. Children with higher dietary diversity were found to have a lower likelihood of being stunted compared to those with lower dietary diversity. The results also suggest that dietary diversity can serve as a proxy indicator for nutrient adequacy in this context.
Conclusions: Promoting increased dietary diversity among young children and their mothers emerges as a key strategy to address the high prevalence of stunting in Indonesia. Interventions focusing on improving access to and consumption of a diverse range of nutritious foods, such as nutrition education, food production diversification, and food distribution programs, are recommended to contribute to the reduction of stunting in the country.

KEYWORDS:

Dietary Diversity, Stunting, Young Children, Indonesia

REFERENCES :

1) Spending Better to Reduce Stunting in Indonesia. Spending Better to Reduce Stunting in Indonesia. 2020 Jul 2;
2) Ramli, Agho KE, Inder KJ, Bowe SJ, Jacobs J, Dibley MJ. Prevalence and risk factors for stunting and severe stunting among under-fives in North Maluku province of Indonesia. BMC Pediatr [Internet]. 2009 Sep 6 [cited 2024 Jun 5];9(1):64. Available from: https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-9-64
3) Louis SL, Mirania AN, Yuniarti E, Diii P, Kebidanan I, Kesehatan U, et al. The Relationship Between Exclusive Breastfeeding with Stunting on Toddles Children Hubungan Pemberian ASI Eksklusif dengan Kejadian Stunting pada Anak Balita. [cited 2024 Jun 5]; Available from: https://journal.neolectura.com/index.php/mnhj
4) SJMJ SrAS, Toban RC, Madi MA. Hubungan Pemberian ASI Eksklusif Dengan Kejadian Stunting Pada Balita. Jurnal Ilmiah Kesehatan Sandi Husada [Internet]. 2020 Jun 30 [cited 2024 Jun 5];9(1):448–55. Available from: 

https://akper-sandikarsa.e-journal.id/JIKSH/article/view/314
5) Laksono AD, Sukoco NEW, Rachmawati T, Wulandari RD. Factors Related to Stunting Incidence in Toddlers with Working Mothers in Indonesia. Int J Environ Res Public Health [Internet]. 2022 Sep 1 [cited 2024 Jun 5];19(17). 

Available from: /pmc/articles/PMC9518173/
6) Mertens A, Benjamin-Chung J, Colford JM, Hubbard AE, van der Laan MJ, Coyle J, et al. Child wasting and concurrent stunting in low- and middle-income countries. Nature 2023 621:7979 [Internet]. 2023 Sep 13 [cited 2024 Jun 5];621(7979):558–67. Available from: https://www.nature.com/articles/s41586-023-06480-z
7) Mawaddah S. Hubungan Pemberian ASI Eksklusif dengan Kejadian Stunting pada Balita Usia 24-36 Bulan. Jurnal Berkala Kesehatan [Internet]. 2019 Dec 31 [cited 2024 Jun 5];5(2):60–6. Available from: https://ppjp.ulm.ac.id/journal/index.php/berkala-kesehatan/article/view/7340
8) Purnamasari M, Rahmawati T, Sarjana Keperawatan P, Tinggi Ilmu Kesehatan Jayakarta S, Komunitas D. Hubungan Pemberian Asi Eksklusif dengan Kejadian Stunting Pada Balita Umur 24-59 Bulan. Jurnal Ilmiah Kesehatan Sandi Husada [Internet]. 2021 Jun 30 [cited 2024 Jun 5];10(1):290–9. Available from: 

https://akper-sandikarsa.e-journal.id/JIKSH/article/view/490
9) Ashar H, Laksono AD, Supadmi S, Kusumawardani HD, Yunitawati D, Purwoko S, et al. Factors related to stunting in children under 2 years old in the Papua, Indonesia. Saudi Med J [Internet]. 2024 Mar 1 [cited 2024 Jun 5];45(3):273–8. 

Available from: https://smj.org.sa/content/45/3/273
10) Laksono AD, Wulandari RD, Amaliah N, Wisnuwardani RW. Stunting among children under two years in Indonesia: Does maternal education matter? PLoS One [Internet]. 2022 Jul 1 [cited 2024 Jun 5];17(7). Available from: /pmc/articles/PMC9312392/
11) Permatasari TAE, Chadirin Y, Ernirita, Elvira F, Putri BA. The association of sociodemographic, nutrition, and sanitation on stunting in children under five in rural area of West Java Province in Indonesia. J Public Health Res [Internet]. 2023 Jul 1 [cited 2024 Jun 5];12(3). Available from: /pmc/articles/PMC10469257/
12) Kusumajaya AAN, Mubasyiroh R, Sudikno S, Nainggolan O, Nursanyoto H, Sutiari NK, et al. Sociodemographic and Healthcare Factors Associated with Stunting in Children Aged 6–59 Months in the Urban Area of Bali Province, Indonesia 2018. Nutrients [Internet]. 2023 Jan 1 [cited 2024 Jun 5];15(2). 

Available from: /pmc/articles/PMC9863855/
13) Fikadu T, Assegid S, Dube L. Factors associated with stunting among children of age 24 to 59 months in Meskan district, Gurage Zone, South Ethiopia: A case-control study. BMC Public Health. 2014 Aug 7;14(1).
14) Paramashanti BA, Paratmanitya Y, Marsiswati M. Individual dietary diversity is strongly associated with stunting in infants and young children. Jurnal Gizi Klinik Indonesia [Internet]. 2017 Jul 30 [cited 2024 Jun 5];14(1):19–26. Available from: https://journal.ugm.ac.id/jgki/article/view/15989
15) Rathnayake KM, Madushani P, Silva K. Use of dietary diversity score as a proxy indicator of nutrient adequacy of rural elderly people in Sri Lanka. BMC Res Notes [Internet]. 2012 [cited 2024 Jun 5];5. 

Available from: https://pubmed.ncbi.nlm.nih.gov/22931957/
16) Saaka M. Maternal Dietary Diversity and Infant Outcome of Pregnant Women in Northern Ghana. Int J Child Health Nutr. 2012;1:148.
17) Dewey KG, Adu-Afarwuah S. Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries. Matern Child Nutr [Internet]. 2008 Apr [cited 2024 Jun 6];4 Suppl 1(Suppl 1):24–85. Available from: 

https://pubmed.ncbi.nlm.nih.gov/18289157/
18) Arimond M, Ruel MT. Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr [Internet]. 2004 [cited 2024 Jun 6];134(10):2579–85. Available from: https://pubmed.ncbi.nlm.nih.gov/15465751/
19) Moursi MM, Arimond M, Dewey KG, Trèche S, Ruel MT, Delpeuch F. Dietary diversity is a good predictor of the micronutrient density of the diet of 6- to 23-month-old children in Madagascar. J Nutr [Internet]. 2008 Dec [cited 2024 Jun 6];138(12):2448–53. Available from: https://pubmed.ncbi.nlm.nih.gov/19022971/
20) Sié A, Tapsoba C, Dah C, Ouermi L, Zabre P, Bärnighausen T, et al. Dietary diversity and nutritional status among children in rural Burkina Faso. Int Health [Internet]. 2018 May 1 [cited 2024 Jun 6];10(3):157–62. 

Available from: https://pubmed.ncbi.nlm.nih.gov/29579204/
21) Sununtnasuk C, Fiedler JL. Can household-based food consumption surveys be used to make inferences about nutrient intakes and inadequacies? A Bangladesh case study. Food Policy. 2017 Oct 1;72:121–31.
22) Nguyen PH, Avula R, Ruel MT, Saha KK, Ali D, Tran LM, et al. Maternal and child dietary diversity are associated in Bangladesh, Vietnam, and Ethiopia. J Nutr [Internet]. 2013 Jul 1 [cited 2024 Jun 6];143(7):1176–83. 

Available from: https://pubmed.ncbi.nlm.nih.gov/23658424/
23) Khamis AG, Mwanri AW, Ntwenya JE, Kreppel K. The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania. BMC Pediatr [Internet]. 2019 Dec 28 [cited 2024 Jun 6];19(1).

 Available from: https://pubmed.ncbi.nlm.nih.gov/31881999/
24) NP S, JH N, G N, G K, D L. Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy? Public Health Nutr [Internet]. 2006 Aug [cited 2024 Jun 6];9(5):644–50. Available from: https://pubmed.ncbi.nlm.nih.gov/16923296/
25) Campbell RK, Aguayo V, Kang Y, Dzed L, Joshi V, Waid J, et al. Infant and young child feeding practices and nutritional status in Bhutan. Matern Child Nutr [Internet]. 2018 Jul 1 [cited 2024 Jun 6];14(3). Available from: https://pubmed.ncbi.nlm.nih.gov/29266829/