LAUSR

Objectives Nutrient requirements are defined for individuals, but meals are often shared and food consumption is typically measured at the household level. Prior studies of nutrient adequacy using household data have estimated requirements in terms of adult equivalents. We introduced a nutrient-by-nutrient approach to capture differences in household composition, and used this measure to test whether a household's nutrient adequacy was associated with the market cost of nutritionally adequate diets. Methods We used panel data on food consumption from 1398 rural Malawian households from the Malawi Integrated Household Survey Panel with monthly prices for 53 foods at the nearest market. Both datasets are collected by the National Statistics Office (NSO), matched at the market-month level. We defined household nutrient needs as the highest density of each nutrient (quantity per kilocalorie) required by any household member over 6 months, summed over daily energy requirements for each individual in the household. From local prices and food composition data we calculated a least-cost, nutritionally adequate diet for the mean household, and computed its level at each location. From observed consumption and nutrient needs we calculated household nutrient adequacy ratios (HNARs) and mean adequacy ratios (HMAR), and tested their association with the local market cost of nutrient adequacy (CoNA), controlling for seasonality, volatility of diet cost, and household size. Results In each round of the survey, between 36% and 59% of households reached their nutrient requirements (HMAR = 1). We found no significant association with the level, seasonality or volatility in market costs, but found that greater household size is associated with lower odds of meeting nutrient adequacy. Conclusions Our novel approach recognizes food sharing at the household level, typical in developing countries, thereby advancing the potential to conduct nutrition-related analyses with existing household survey data. Our initial application found no association with market prices suggesting that other factors may be more important predictors of nutrient adequacy. Future analyses will investigate dietary patterns and cost of individual nutrients to further explain the odds of meeting household needs. Funding Sources Bill & Melinda Gates Foundation via the CANDASA project. Supporting Tables Images and/or Graphs