Food habits, dietary intake and nutritional status during economic crisis among pregnant women in Central Java, Indonesia Th. Ninuk

........................................................................................................................... III ORIGINAL PAPERS .............................................................................................................. V ABBREVIATIONS................................................................................................................VI GLOSSERY AND DEFINITIONS.................................................................................... VIII CONTENTS............................................................................................................................. X INTRODUCTION .................................................................................................................... 1 1. Health and nutrition in Indonesia ......................................................................................... 1 General description of Indonesia........................................................................................ 1 Food and nutritional problems............................................................................................ 2 Nutrition policy and programmes in Indonesia.................................................................. 4 2. Economic development in Indonesia and the current crisis................................................ 5 Economic development ........................................................................................................ 5 Economic crisis .................................................................................................................... 6 Government intervention ..................................................................................................... 8 3. Nutrient needs of pregnant women ...................................................................................... 8 OBJECTIVES OF THE THESIS ..........................................................................................12 CONCEPTUAL MODEL ......................................................................................................13 METHODS .............................................................................................................................17 1. Study site .............................................................................................................................17 2. Subjects................................................................................................................................18 Quantitative study .............................................................................................................. 18 Qualitative study ................................................................................................................20 3. Data collection ....................................................................................................................22 Dietary intake data ............................................................................................................22 Qualitative data collection ................................................................................................25 Anthropometric measurements and blood samples..........................................................26 Socio-economic and other background data ....................................................................26 4. Time periods in the crisis....................................................................................................27 5. Data quality control.............................................................................................................29 6. Analyses ..............................................................................................................................30 Quantitative data analyses ................................................................................................30 Qualitative data analyses ..................................................................................................31 RESULTS................................................................................................................................32 1. Household expenditures before the crisis ..........................................................................32 2. Selection of women ............................................................................................................34 3. Effect of the crisis on food habits and food intake (Paper I, III, IV and V).....................37 4. Effect of the crisis on nutrient intake (Paper I and Paper II) ............................................45 5. Effect of the crisis on nutritional status (Paper I and Paper II).........................................48 MAIN FINDINGS..................................................................................................................51 DISCUSSION.........................................................................................................................53 1. Power and validity ..............................................................................................................53 Quantitative study ..............................................................................................................53 Qualitative study ................................................................................................................55 2. Dietary intake survey..........................................................................................................55 3. Adequacy of nutrient intake ...............................................................................................56 4. Food habits and food intake ...............................................................................................57 5. Nutrient intake.....................................................................................................................61 6. Nutritional status .................................................................................................................62