Temporal Trends in Available Energy and Macronutrient Distribution in The Indonesian Diet: A Joinpoint Analysis of Food Balance Sheet Data

Background/Aims: The aim of this study was to analyze the temporal trends and changes in available energy and macronutrient distribution in the Indonesian diet from 1961 to 2013. Methods: Due to the lack of long-term dietary intake dataset, this study used dataset derived from the FAO's food balance sheets. We used joinpoint regression analysis for the temporal trends. Results: The annual percentage change (APC) was computed for each segment of the trends. Energy availability in the Indonesian diet increased by 52.2% with an average annual percent change (AAPC) of 0.8% from 1961 to 2013. The availability of carbohydrate energy decreased by only 8.3% (AAPC= –0.2), while available energy from fat increased by 39.8% (AAPC = 0.6). Carbohydrate energy in the diet increased from 1961 to 1974 (APC = 0.10) and thereafter decreased significantly (APC= –0.44) until the year of 1988 and after a stagnant phase decreased again from 1998 to 2013 (APC= –0.32). Available energy from fat showed a zigzag upward trend. The temporal trends in the available energy from protein changed but within a very narrow limit (7.72% to 9.02%) over the last 53 years (AAPC = 0.30). Conclusion: The availability of energy from carbohydrate decreased in the Indonesian diet while available protein energy was grossly inadequate in the diet for the last 53 years. During the first half 1970s (1982–1988) there was a shift in the availability of carbohydrate and fat in the diet and was characterized by increased fat energy while reduced carbohydrate energy in the Indonesian diet.