Dietary diversity determinants and contribution of fish to maternal and under-five nutritional status in Zambia.

BACKGROUND: This study examines socio-economic determinants of food consumption patterns amongst women of reproductive age and children aged 6-59 months from urban poor settlements of Lusaka and their implications for nutritional status. Particular emphasis was placed on the role of fish in their diets and nutritional status. METHODS: A cross-sectional survey design was applied, in which 714 mother-child dyads, with children aged 6-59 months were enrolled. A three-stage randomized cluster sampling approach was applied. RESULTS: The mean dietary diversity score among children aged 6-23 and 24-59 months was 2.98 (±1.27) and 3.478 (±1.07), respectively. In children aged 6-23 months, there was a significant difference in their nutritional status, based on fish consumption (χ2 = 10.979, df = 2, p = 0.004). Children from poorer households consumed mostly small fish (Kapenta). The quantity of fish consumed by children was significantly associated with stunting in both age groups, odds ratio = 0.947 (95% CI: 0.896, 1.000) for children aged 6-23 months and odds ratio = 1.038 (95% CI: 1.006, 1.072) for children aged 24-59 months old. Other significant risk factors for stunting in children aged 6-23 months were the child's age, mother's body mass index, access to treated water and child morbidity. Child's age, mother's educational level and wealth status were determinants of dietary diversity in children aged 6-59 months as shown by the Poisson regression. CONCLUSION: Nutritional status of children aged 6-23 months is associated with fish consumption, with children consuming fish less likely to be stunted. Small fish (Kapenta) is an animal-source food that is particularly important in the diet of children in urban poor households in Zambia and contributes to better nutritional outcomes. As all small fish stem from capture fisheries, sustainable one health environmental integration, monitoring and management strategies are desirable.

Fish and Meat Are Often Withheld From the Diets of Infants 6 to 12 Months in Fish-Farming Households in Rural Bangladesh.

BACKGROUND: Fish is a widely available animal-source food in Bangladesh and a rich source of nutrients, yet little is known about practices related to incorporating fish into the diets of infants and young children. OBJECTIVE: Use dietary diversity data to explore consumption patterns of fish and high-quality food items within the household and examine factors associated with delayed introduction of fish to infants and young children. METHODS: Cross-sectional survey of 496 households with children <36 months participating in the Aquaculture for Income and Nutrition project in Bangladesh. Data collected included household characteristics, women's dietary diversity score, and minimum dietary diversity score along with data on Infant and Young Child Feeding practices. RESULTS: Most children (63.4%) met the threshold for minimum dietary diversity. Despite having received extensive nutrition education related to including fish in complementary foods, only half of the caretakers introduced fish at 6 months and the mean age of introduction of small fish was 8.7 months. Meat and fish were not common in infant diets but increased with child age. Concerns about bones were a major barrier to incorporating fish into infant diets. CONCLUSION: Given its nutrient profile and widespread availability in certain contexts, fish could be an underutilized opportunity to improve nutrition and health outcomes of infants and young children. Further research, including utilizing food processing technologies, is needed to develop appropriate responses to overcome these barriers.