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

Abstract

BackgroundThis 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.MethodsA 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.ResultsThe 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.ConclusionNutritional 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.

Determinants of age‐appropriate breastfeeding, dietary diversity, and consumption of animal source foods among Indonesian children

“…Studies have shown that dietary diversity was positively associated with the child's age (Iqbal, Zakar, Zakar, & Fischer, ), maternal education, socio‐economic status (Marinda, Genschick, Khayeka‐Wandabwa, Kiwanuka‐Lubinda, & Thilsted, ; Patel et al, ; Senarath et al, ; Solomon, Aderaw, & Tegegne, ), mother's working status (Solomon et al, ), women's empowerment (Ickes, Wu, Mandel, & Roberts, ), and the number of antenatal care (ANC) visits (Patel et al, ). There are reports of differences in consumption of ASF by residence and wealth status and child's age (J. M. White et al, ).…”

The Effect of Maternal Depressive Symptoms on Infant Feeding Practices in Rural Ethiopia: Community Based Birth Cohort Study

“…Systematic reviews in 2019 and 2015concluded that depressed women breastfed their child for shorter duration than nondepressed women [23,41]. Other previous studies also reported a negative association between maternal depression and early initiation of breastfeeding [42], complementary feeding initiation [43] and infants' dietary diversity [44,45].…”

Healthy pregnancies and essential fats: focus group discussions with Zambian women on dietary need and acceptability of a novel RUSF containing fish oil DHA

“…A major goal of this work was to develop and assess an RUSF to contain fish oil as a method to deliver macronutrient and micronutrient supplements and DHA to women at risk for food insecurity and malnutrition during pregnancy and lactation since this is a concern in Zambia [ 5,29]. The lipid based nutrient supplements are deemed a valid delivery vehicle for DHA as the oils are miscible in the nut paste, low in water, as well as air and light tight, which helps to maintain the integrity of the highly unsaturated fatty acids to prevent or reduce oxidation [30].…”

“…Improving maternal and infant nutrition and health is a major focus of the Zambian Government to ensure the population reaches its full potential [1,4]. However, the dietary diversity for women and children in Zambia is highly dependent upon socioeconomic status, such that a low diversity index correlates with malnutrition and food insufficiency [5,6]. Animal-source foods are limited and the diet is highly dependent on starchy staples such as the corn-based porridge, nshima.…”

“…Therefore, the basic diet of the very low income population has limited diversity, contributing to insufficient daily protein and micronutrient intake, and minimal consumption of long chain polyunsaturated n-3 fatty acids [1]. Fish is an important staple in the Zambian diet and fish intake correlates with dietary diversity and lower levels of stunting [2,5,7]. The small sardine-like fish species, kapenta, are a rich source of DHA and native to Zambia [7].…”