One of the main factors causing the incidence of stunting is the inadequacy of children's nutrients that should be consumed by children based on the RDA standard from the Indonesian Ministry of Health. The inadequacy of the child's nutrition is influenced by 2 factors, namely the quality and quantity of children's food. In the section on the quality of children's food, it includes the diversity of food or the Dietary Diversity Score, while the quantity section of food includes the Dietary Pattern, which will show the frequency of children consuming various foods or foods that can support children's intake needs. Diversity has long been recognized as a key element of a high-quality diet and can be assessed using simple tools such as the dietary diversity score (DDS).1 The phase of children under 5 years of age desperately needs appropriate intake where the growth and development phases require a balance of micronutrients and macronutrients. Therefore, this research will look at the relationship between Food diversity, Food pattern, and Food intake on the incidence of stunting in children.

This study design is a follow-up of previous research, namely nutrition intervention in pregnant and lactating women using the RCT-DB design. This study was conducted in 6 districts (Tamalatea, Bangkala, Bontoramba, Binamu, Tarowang, and Kelara) in Jeneponto district, South Sulawesi, Indonesia.2 At this time, the children born were 2 years old and the number of samples obtained was 340 children scattered in each sub-district. In this study, stunting was defined as <−2 SD height for age z score according to WHO rules.3 The determination of the z score was using the application of the WHO Anthro 2005 to maintain the accuracy of stunting determination in children. In the analysis phase, HAZ will be divided into 2 categories, namely stunted and normal. This study received Ethical Approval from the Ethics Commission of the Faculty of Public Health, Hasanuddin University with Protocol Number: 5111993028 signed on letter number 10153/UN4.14.7/TP.01.02/2019. This study is conducted since 28 November 2019 until 10 January 2020.

The independent variables consist of children's dietary diversity, children's diet, and children's dietary intake. The diversity of children's diets aims to see variations in the amount of children's food based on food genetics from the Ministry of Agriculture and FAO. The number of types of food is 9 consisting of grains, tubers, animal food, oils and fats, coconut oil or oil from plants, sugar, nuts, vegetables and fruit, and other foods.4 It is defined to be various when consuming children's food more than 6 types of food consumed in the last 1 month. The food pattern is defined to be good when the frequency of food is at least 4 times a week in consuming this type of food. Measurement of food diversity and children's dietary patterns using the FFQ (Food Frequency Questioner) method which has been tested previously on several samples.5,6 The amount of children's nutritional intake is determined based on the RDA 2020 value by the Indonesian Ministry of Health.7 Collecting food intake data using the 24-hour Recall method and calculated using the Nutrisurvey 2007 application. All tests were analyzed using SPSS 25 for mac when use chi-square test to measure difference of proportion between stunting and normal on food pattern and nutrients adequate. Measuring of food diversity use independet t-test and Mann–Whitney test because data scale in numeric form.

The results showed that the highest frequency was at the level of mother's education, namely in the low category as many as 232 (68.2%), the same thing at the level of education of the father was at the most in the low category, namely 233 (68.5%) (see Table 1). The total score of the food diversity of children who were stunted got an average dietary diversity of 7.51±0.87, which was lower than normal children, 7.63±0.67 (p=0.040). So that it is found that there is a relationship between the diversity of children's diets with the incidence of stunted children in Jeneponto district (see Table 2).

In the consumption of nuts for children who were stunted, the consumption pattern of nuts in the low category was 135 (45.3%) and the consumption pattern of nuts in the moderate category was 43 (35.8%) (p=0.019). As for the category of sugar consumption, children who were stunted and lacked sugar consumption were 103 (46.8%), while children who were stunted but their sugar consumption was fulfilled only reached 43 (35.8%) with a value of p=0.05 (see Table 3). The results showed that there was a relationship between lack of energy and fat on the incidence of stunted children. More children were stunted who experienced insufficient energy consumption 132 (44.9%) than those who were stunted, but energy adequacy was met 14 (30.4%) which was significant at p=0.050. Similarly, in the category of child fat intake, were children who were stunted were more likely to have 125 (45.6%) deficient amounts of fat intake compared to children who were stunted but their nutritional fat was only 21 (31.8%) with p-value=0.042 (see Table 4).

The incidence of stunting in food factors is influenced by the quality and quantity of food. The quality of food is related to the variety of children's food, and the quantity of food is related to the child's diet, while both the quality and quantity of children are determined by the amount of food intake of the child. Children who eat a variety of foods accompanied by a more dietary pattern according to the recommendations will automatically increase the amount of food intake and will avoid deficiencies of micro and macronutrients.

The authors declare no conflict of interest.