title: Methods of using household consumption and expenditures survey (HCES) data to estimate the potential nutritional impact of fortified staple foods.
abstract: BACKGROUND
  Micronutrient malnutrition, caused largely by inadequate dietary intake, is a global public health problem that adversely affects health, child growth and development, work capacity, and quality of life. Mass fortification of widely consumed edible products has the potential to increase micronutrient intakes and thus alleviate some nutritional deficiencies. Although individual-level data about food consumption patterns are ideal for informing the design of food fortification programs, they are often unavailable. Household Consumption and Expenditures Surveys (HCES) are nationally representative cross-sectional surveys conducted over a 12-month period every 2 to 5 years, primarily to characterize household expenditures.
  
  
  OBJECTIVE
  We describe how expenditure data from HCES can serve as a proxy for household food consumption and thus aid in choosing which foods to fortify and in determining how much of a micronutrient to add to that food.
  
  
  METHODS
  We describe methods of using HCES data to characterize apparent food consumption patterns among different strata within a population.
  
  
  RESULTS
  There are several limitations of using HCES data to describe apparent food consumption. HCES do not directly capture information about true food intake, but rather describe food expenditures. We assume that purchased foods are not shared with guests, wasted, fed to animals, gifted, or stockpiled for later use. We also assume that foods are allocated within each household based on energy needs.
  
  
  CONCLUSIONS
  Despite the limitations of using HCES data to estimate apparent food consumption, the dearth of individual-level data about food intake renders HCES data useful in designing food fortification programs.
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1599 Clifton Road, N.E. - GHI Rm 6.431, Atlanta, GA 30322, USA. beth.imhoffkunsch@gmail.com
authors.forename: Beth
authors.initials: B
authors.lastname: Imhoff-Kunsch
authors.forename: Rafael
authors.initials: R
authors.lastname: Flores
authors.forename: Omar
authors.initials: O
authors.lastname: Dary
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Martorell
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004034:Diet Surveys; D002149:Energy Intake; D004734:Energy Metabolism; D005191:Family Characteristics; D005247:Feeding Behavior; D005260:Female; D063427:Food Quality; D005523:Food Supply / Q000592:standards; D005527:Food, Fortified; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000503:physiopathology; D018977:Micronutrients / Q000008:administration & dosage / Q000172:deficiency; D009752:Nutritional Status; D055815:Young Adult
chemical_list: D018977:Micronutrients