The Asia-Pacific region is home to more than half of the world’s undernourished children. It also has the fastest growing prevalence of overweight children and childhood obesity: in Southeast Asia between 2000 and 2017, the proportion of overweight and obese children under five more than doubled.
Micronutrient deficiencies add a further layer, leading to a ‘triple burden of malnutrition’. This phenomenon is particularly stark in Indonesia. Unhealthy diets and highly processed foods are partly to blame. Efforts to change behaviour, particularly among children and young people, are being stepped up.
Using food diaries to understand food choices
There is very little data about what Indonesian people eat and why. A study conducted by Hivos, IIED, the University of Jember and the community-based organisation Tanoker tried to plug this knowledge gap. The study was conducted as part of the Sustainable Diets for All (SD4ALL) programme implemented in partnership with the Dutch government.
The study analysed data generated with and by the local community in Jember seeking to better understand what drives people’s food choices. Ninety-seven households (328 individuals) in six sub-districts participated in the study. Each household filled out a food diary, detailing meals and beverages they consumed in a seven-day period.
The study found that a sizeable proportion of respondents did not meet minimum daily dietary diversity targets. This can lead to nutritional problems such as obesity. Food costs, lack of time, habits, taste preferences and the increasing appetite for fast food are leading to the wider consumption of cheaper, ultra-processed foods, sweets and food additives and flavourings such as monosodium glutamate (MSG). In fact, almost four in 10 children aged five to 18 have insufficiently diverse diets.
Children: championing healthy diets
Tanoker is helping to tackle the issue by working with local communities and policymakers to get children and their families to make healthy food choices. In Indonesian culture, women are mainly in charge of buying and preparing food for the family. Tanoker began working with them and also reached out to men – fathers – recognising that change will only happen if they are involved.
But their work prioritised children and young people as agents of change. More than 30 locals between nine and 18 have been trained as ‘healthy diets champions’ who come together in a ‘Children Forum’. Here, the children learn about health and nutrition and are also trained to talk about healthy choices to their families and peers.
Representatives of the forum have also engaged with policymakers in the Ledokombo subdistrict, contributing their views to a government consultation on healthy diets.
Mutiara – or Tiara, as she is nicknamed – is a senior high school student from Ledokombo and leads the Children Forum. She works tirelessly to change eating habits in her community. It was Tiara’s own unhealthy eating that made her realise she had to change her ways.
She recalls a particular occasion when she realised the effects of drinks that contained chemical flavouring: “Sometimes after drinking cold drinks from street vendors my throat would hurt and I’d start coughing.” One day she read a story about the dangers of unhealthy food. It made her anxious: “I was afraid when I read the article. It described how people were getting sick after eating food with too many preservatives”.
Tiara’s first attempts to change her habits on her own failed. But everything changed when she joined Tanoker’s programme and learned more about healthy eating and nutrition. She was determined to get people to switch to healthy food, starting with her own family. She knew it may take time.
The first step was to help her mother reduce the amount of chemical flavouring agents in the family’s food. “My mum and dad used to say that food is not complete unless you add flavours – it is just too plain,” said Tiara. “But when my mum saw me coughing after eating unhealthy food she realised that this was not a good habit. Although the food tasted plain in the beginning, we got used to it. And now it is my mum who tells others to use fewer flavouring agents”. Eventually, Tiara convinced her family to stop using flavouring agents altogether.
From family, to friends – and beyond
Tiara began bringing what she’d learnt into all her choices around food. She started to think more carefully when buying snacks and she worked hard to inspire her friends to start eating healthy food. And she hasn’t stopped there. Taking her learning beyond her circle of family and friends, she has become a model for other local children and families, and a vocal advocate for healthy diets at the subdistrict level.
The study’s findings highlight that concrete action is needed to improve diets in Jember. Tanoker’s valuable work with children and young people can be extended to improving the food culture in schools, engaging local food vendors to market healthy snacks and drinks, developing a whole-family approach to providing healthy foods at home, and supporting healthy cooking using the wealth of diversity in local food.
All these initiatives need healthy diets champions like Tiara to encourage her generation to choose a healthy future for themselves.