Developing Feasible Healthy Diets for Ethiopian Women of Reproductive Age - A linear goal programming approach

Objective: To develop a healthy diet for Ethiopian women closely resembling their current diet and taking fasting periods into account while tracking the cost difference. Design: Linear goal programming models were built for three scenarios (non-fasting, continuous fasting, and intermittent fasting). Each model minimized a function of deviations from nutrient reference values for 11 nutrients (protein, calcium, iron, zinc, folate, and the vitamins A, B1, B2, B3, B6, and B12). The energy intake in optimized diets could only deviate 5% from the current diet. Settings: Five regions are included in the urban and rural areas of Ethiopia. Participants: Two non-consecutive 24-hour dietary recalls (24HDR) were collected from 494 Ethiopian women of reproductive age from November-December 2019. Results: Women's mean energy intake was well above 2000 kcal across all socio-demographic sub-groups. Compared to the current diet, the estimated intake of several food groups was considerably higher in the optimized modelled diets, i.e., milk and dairy foods (396 versus 30 g/day), nuts and seeds (20 versus 1 g/day), and fruits (200 versus 7 g/day). Except for calcium and vitamin B12 intake in the continuous fasting diet, the proposed diets provide an adequate intake of the targeted micronutrients. The proposed diets had a maximum cost of 120 Ethiopian birrs ($3.5) per day, twice the current diet's cost. Conclusion: The modelled diets may be feasible for women of reproductive age as they are close to their current diets and fulfill their energy and nutrient demands. However, the costs may be a barrier to implementation.