Getting the Food List “Right”: Leveraging Household Consumption and Expenditure Surveys for Food Security and Nutrition

Background                     There is growing interest in leveraging the consumption data collected in Household Consumption and Expenditure Surveys (HCES) to inform food and nutrition policies. However many HCES food lists lack sufficient detail on food items and necessary disaggregation of food groups to construct indicators of interest, including dietary quality indicators and estimates of household‐level nutrient adequacy.                                                           Objective                     This research explored whether and how changes to the food list could result in significant benefits for those interested in using HCES for food security and nutrition related analyses. Using two unique nationally representative datasets from Bangladesh, this analysis sought to determine the most parsimonious set of food list items needed to derive a core set of maximally accurate food security and nutrition indicators while balancing concerns about cost, respondent burden, and trade‐offs with data needs for poverty estimation.                                                           Methods                     Food security and nutrition indicators constructed from the food consumption module of the 2011–2012 Bangladesh Integrated Household Survey (BIHS) were compared to the same indicators constructed from the ‘gold standard’ 24‐hour recall module in the same data set. The recommended food list from the gold standard BIHS was then compared to the 2010–2011 Bangladesh Household Income and Expenditure Survey (B‐HIES) food list to quantify the accuracy of food security and nutrition indicators. The 2013 Bangladesh Nutrient Database was linked to both the BIHS and B‐HIES to construct indicators of nutrient adequacy. Sensitivity and specificity analyses were conducted in order to determine how well the indicators from the consumption module compared to those from the 24‐hour recall, allowing for assessment of accuracy and precision with different configurations of the food list. Bland‐Altman plots were used to assess the degree of agreement between indicators derived from each data source.                                                           Results                     Indicators were compared across the 24‐hour recall and the household food consumption module in both the BIHS and the B‐HIES. The indicators that were evaluated included 1) energy adequacy; 2) macronutrient adequacy (fat, protein, carbohydrate, alcohol); 3) micronutrient adequacy (vitamin A, calcium, folate, iron, and zinc); 4) percentage of calories from individual foods and food groups; 5) quantities consumed of individual foods and food groups including animal source foods, select processed foods, staple and non‐staple foods; and 6) dietary diversity.                                                           Conclusion                     Findings from this research contribute to guidance and recommendations for National Statistics Offices and the international community to enable the development of food lists that serve multiple purposes, including poverty estimation and the derivation of key food security and nutrition metrics.                                            Support or Funding Information                                                                 Funding:                       This research was conducted as part of the International Dietary Data Expansion (INDDEX) Project, which is implemented by Tufts University's Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy with funding from the Bill &amp; Melinda Gates Foundation.