**Background:** The paper addresses the critical role of food preparation and food choice in determining the nutritional growth of children under 5 years of age in Nigeria. It highlights that while nutrition science aims to maintain normal growth, the ultimate utilization of food by the body depends on how food is prepared and selected. The authors note that poor food practices and choices by mothers are established causes of childhood malnutrition, including stunting, wasting, and overweight/obesity. Stunting affects lifelong linear growth and cognitive capacity, while wasting increases infection risk and mortality. The paper emphasizes that Nigeria has few registered nutritionists and dietitians, leaving most nutrition education to nurses, doctors, and international programs sponsored by UNICEF and WHO. This creates a gap in specialized knowledge about food preparation and choice from the dietetic perspective.
**Methods:** This is a narrative review article. The authors synthesized existing literature on food safety, food security, food preparation methods, and food choice determinants as they relate to under-5 children in Nigeria. They describe two categories of food preparation: pre-preparation (cleaning, peeling, grating, sieving, grinding, blanching, washing) and preparation methods involving heat (boiling, frying, steaming, stewing, roasting, etc.). The paper also discusses moist heat (140–212°F), dry heat (160–2300°C), fat-based cooking (350–375°F), and microwave methods. The authors note that food preparation methods significantly affect the concentration and availability of minerals, vitamins, and essential compounds.
**Key Results:** The paper reports that globally, about 420,000 people die and 6,000,000 become ill annually from contaminated food, with the majority of foodborne illness sufferers being children under 5. Africa has the highest prevalence of foodborne illness. The 2020 Global Report on Food Crises indicated approximately 135 million people in 55 countries face acute food insecurity, with 73 million from 36 African countries. Nigeria's under-5 mortality rate is 11.7%. The economic burden of foodborne illnesses is approximately USD 3.6 billion per annum. In Nigeria specifically, 29% of children under 5 are underweight, 18% are wasting, and 37% are stunted. Marasmus is the most prevalent protein-energy malnutrition type in South-Eastern Nigeria. Children aged 13–24 months are most likely to have stunted growth (81.8%) and are less likely to be underweight (45.5%), while wasting (18.2%) is highest among children 37–48 months old. More than 33% of all child fatalities worldwide are attributed directly or indirectly to inadequate food choices and poor food preparation.
**Clinical Implications:** The authors recommend that Nigerian nutritionists and dietitians intensify advocacy and awareness campaigns on appropriate diets and food preparation methods for under-5 children. They propose adopting multiple health promotion frameworks including The Staged Approach to Health Promotion, The Five-Stage Community Organization Model, A Planning Framework for Community Empowerment Goals Within Health Promotion, The ABC Planning Model, The Proceed Planning Framework for Health Promotion, and The Red Lotus Health Promotion Model. They advocate for a One Health approach involving interdisciplinary collaboration with pediatricians, food-technology experts, chefs, and environmentalists. The paper recommends periodic assessment of nutritional habits, growth parameters, and nutritional status as part of pediatric check-ups, using primary measures (stature, weight, head circumference) and secondary measures (triceps skinfold thickness, subscapular skinfold thickness, mid-upper arm circumference). They note that atypical growth is suspected when height or weight for age is below the 5th percentile or above the 95th percentile, or when BMI is below the 10th or above the 90th percentile. The authors also call for policy-level work to improve environmental opportunities for healthy eating and for enhanced training of public health nutritionists in communication and behavioral strategies.