Dietary assessment using a novel image-voice-based system indicates nutrient inadequacies in Cambodian women’s dietary intake

Women and children are priority populations in Cambodia, however no dietary intake information exists on breastfeeding women for informing nutritional intervention. The aim was to assess nutritional adequacy of dietary intakes of Cambodian women, by breastfeeding status and locality. A cross-sectional assessment of dietary intake was conducted with non-pregnant women ≥18 years of age with at least one child under 5 years in rural, semi-rural and urban locations in Siem Reap province, Cambodia. Women used a bespoke smartphone application to capture three-day image-voice records on two occasions. Data were analysed using a semi-automated web platform incorporating a tailored Cambodian food composition database. Estimated Average Requirements were used to assess adequacy of nutrient intakes. Of 119 women included in the analysis, 58% were breastfeeding, and 63% were rural or semi-rural. Protein, carbohydrate, vitamin B₁₂, iron, and sodium were adequate for over 65% of women. Less than 10% of women had adequate vitamin A, vitamin C, thiamine, calcium, and zinc intakes, in contrast to low deficiency rates reported for Cambodian women. Despite breastfeeding women recording higher dietary intakes, adequate intakes of protein, carbohydrate, vitamin A, thiamine, and zinc were lower than non-breastfeeding women due to higher requirements. Rural women generally had higher nutrient intakes, and urban women had inadequate folate intake. This study indicates dietary intakes of Cambodian women in Siem Reap province, particularly breastfeeding women, are not nutritionally adequate. Data collected using image-voice dietary assessment could inform nutrition interventions and policies in Cambodia to improve dietary intakes and nutrition-related health outcomes.