Increased Availability of Micronutrient Rich Foods and Income among Women Farmers Participating in a Cluster Randomized Control Trial of Homestead Food Production (HFP) in Cambodia.

Objectives: Household food insecurity and under-nutrition are prevalent in Cambodia where there is a lack of dietary diversity and reliance on rice. To address these issues, HKI has implemented HFP to increase the availability and consumption of micronutrient-rich foods. We are currently integrating household level fishponds to enhance plant-based HFP; small nutrient-rich fish, consumed whole, are raised together with large fish, which can be eaten or sold. We aim to improve household food security, micronutrient intake and status. To report on the progress of our 24-month cluster RCT after one year intervention in Prey Veng Province. Methods: 90 clusters were established each consisting of a village model farm and 10 families headed by women farmers (n=990). Each cluster was randomly assigned to either: 1) HFP, 2) HFP plus aquaculture, or 3) control. A baseline survey was completed and process monitoring onging with production, and income data among other variables. Results: Median vegetable and fruit production increased by 8 kg and 4 kg, respectively in households receiving any HFP. Income generation from the sale of fruit and vegetables in HFP farms increased by 55%. Small and large fish production increased by 1 and 5 kg, respectively. Conclusions: Early in the intervention we are observing increased fish, fruit and vegetables production as well as income generation. We hope that this will translate into an improvement in nutritional and in in particular micronutrient status.

Suboptimal Thiamin Status is Common in Women of Childbearing Age in Rural and Urban Cambodia.

Objectives: Thiamin deficiency causes beriberi, which is often fatal in infants who do not receive rapid treatment. Infantile beriberi appears to be common in Cambodia, likely because thiamin deficient mothers produce breast milk low in thiamin. Strategies may be needed to improve thiamin status; however, population representative thiamin data is required. Therefore, we measured erythrocyte thiamin diphosphate (TDP) concentration to assess thiamin status in Cambodian women of childbearing age. Methods: A representative sample of non-pregnant and non-lactating women of childbearing age (20-45 y) in urban Phnom Penh (n=146) and rural Prey Veng (n=156), and for comparison purposes, a convenience sample of urban women in Vancouver, Canada (n=49) were recruited. TDP was measured using HPLC. Results: The response rates were 91% in Phnom Penh and 98% in Prey Veng. Mean ± SD erythrocyte TDP was 100±38 and 87±26 nmol/L in Phnom Penh and Prey Veng, respectively; which were lower than in Canadian women, [128±38 nmol/L (P<0.001)]. Among Cambodian women, thiamin deficiency (TDP < 70 nmol/L) was more prevalent in Prey Veng (24%) than Phnom Penh (12%). Similarly, insufficient thiamin status (TDP < 90 nmol/L) was more prevalent among women living in Prey Veng (59%) than Phnom Penh (39%). Of Canadian women, 84% were thiamin sufficient (TDP > 90 nmol/L). Conclusions: We found a high prevalence of suboptimal thiamin status in Cambodian women of childbearing age, particularly in rural Prey Veng. Supplementation, fortification, and/or food-based strategies may be required to improve thiamin intake in Cambodian women. Funding: UBC Vitamin Research Fund.