Effect of enhanced homestead food production and aquaculture on dietary intakes of women and children in rural Cambodia: A cluster randomized controlled trial

Abstract

The Cambodian diet is low in nutrient-dense animal-source foods. Enhanced homestead food production (EHFP) and aquaculture, which increase availability of nutrient-dense foods, are promising interventions to improve dietary intake. This study examined the effect of EHFP with or without aquaculture on dietary intake and prevalence of inadequate intake of select nutrients among women and children living in rural Cambodia, compared to controls. In a registered, cluster randomized controlled trial in Prey Veng, Cambodia, 10 households in each of 90 villages (n = 900) were randomized by village to receive EHFP, EHFP plus aquaculture, or control. After 22-month intervention, 24-hr dietary recalls (24HRs) were collected from mothers aged 18-50 years (n = 429) and their children aged 6 months-7 years (n = 421), reported by their mothers. Usual intake distributions (generated using 24HRs and repeat 24HRs on a subsample) were used to estimate prevalence of inadequate intake. Compared to controls, women in the EHFP group had significantly higher zinc (+1.0 mg/d) and Vitamin A (+139 retinol activity equivalents/d) intakes, and women in the EHFP plus aquaculture group had significantly higher iron (+2.7 mg/d), Vitamin A (+191 retinol activity equivalents/d), and riboflavin (+0.17 mg/d) intakes. Women in the EHFP plus aquaculture group also had significantly lower prevalence of inadequate iron (-7%, at 10% bioavailability), Vitamin A (-19%), and riboflavin (-17%) intakes, compared to controls. No significant differences in intakes or nutrient adequacy were observed among children or between EHFP and EHFP plus aquaculture groups. The biological importance of the small differences in nutrient intakes among women remains to be established.

Effect of enhanced homestead food production on anaemia among Cambodian women and children: A cluster randomized controlled trial

“…Details of village and household selection have been reported elsewhere (Karakochuk et al, ; Verbowski et al, ). In summary, through key stakeholder consultation, HKI created a list of villages ( n = 190) in Prey Veng that were not participating in any other food and nutrition interventions related to home gardening, poultry production, fish production, fruit production, infant and young child feeding education, or maternal nutrition activities.…”

“…Households that were randomized to the EHFP + F group received assistance from the project to build new ponds or refurbish existing ponds, technical assistance for polyculture activities, and were provided with simple fish raising inputs such as fish nets, fish fry, and fingerlings. Additional details of the intervention packages can be found in Verbowski et al, .…”

“…Additionally, dietary intake data were collected from a subsample of n = 450 women and children. Details of dietary data collection procedures, assessment, and results are published elsewhere (Verbowski et al, ).…”

Micronutrient intake and prevalence of micronutrient inadequacy among women (15-49 y) and children (6-59 mo) in South Kivu and Kongo Central, Democratic Republic of the Congo (DRC)

“…Similar results were found in a study conducted by Verbowski et al where dietary intake data contradicted biochemical indicators. (22) In this study, iron deficiency anemia was only attributable to 1.5% of women in their sample, while prevalence of inadequacy was estimated to be 50%. As was highlighted by Verbowski et al, the reason for the discrepancy may be due to the use of nutrient reference values that are not suitable to the Congolese population where starchy roots and tubers contribute roughly 40% of dietary energy intake.…”

Integrating nutrition outcomes into agriculture development for impact at scale: Highlights from the Canadian International Food Security Research Fund

“…While Helen Keller International, the local implementing partner, has implemented their homestead food production programme in Asia and Africa for over 20 years, the project in Cambodia was novel in that it included the addition of small‐scale polyculture (the raising of small and large indigenous fish together) to their standard programme of diversified home gardens instead of traditional small‐scale poultry production. This research team previously reported significant improvements in dietary intake in women and children among the study sample (Verbowski et al, ). However, as reported in the paper Effect of enhanced homestead food production on anaemia among Cambodia women and children: A cluster randomized controlled trial , although significant improvements were observed in anaemia rates among children in one of the intervention groups, no improvements were seen in women (Michaux et al, ).…”