Inclusion of Small Indigenous Fish Improves Nutritional Quality During the First 1000 Days

Abstract

Background: Within food-based approaches to improve nutrition during the first 1000 days of life, improved formulations of food products and the use of animal source foods, such as fish, are 2 widely cited strategies; however, there are few examples where the 2 strategies are combined. Furthermore, although small indigenous fish are highly nutritious and available to the poor in many regions of the world, their importance is often overlooked. Objective: To document the development of 2 nutritious fish-based food products in Bangladesh: a chutney for pregnant and lactating women (PLW) and a complementary food (CF) for infants and young children (6-23 months), including potential contributions to recommended or desirable nutrient intakes in the first 1000 days, processing methods, and nutrient composition. Methods: Local nutrient-rich ingredients and simple processing methods based on traditional knowledge (for the chutney), and a literature review (for the CF), were selected and trial batches produced. Products were analyzed for nutrient composition using standard analytical procedures and results compared with recommended or desirable nutrient intakes for women and children. Results: Both products could contribute significantly to micronutrient intakes of PLW (24% of iron and 35% of calcium recommended intakes) and macro-and micronutrient intake of infants and young children (65% of vitamin A, 61% of zinc, and 41% of iron desirable intakes) when consumed in the proposed serving size. Conclusion: Inclusion of small indigenous fish as an underutilized animal source food in combination with other local nutrient-rich ingredients in food products represents a promising food-based strategy to improve nutrition, with many additional potential benefits for communities involved in production, and therefore warrants further investigation.

The contribution of fish to nutrition and food security: informing the evidence base for agricultural policy in Bangladesh

“…Guidelines within relevant Codex Alimentarius Commission standards 21,22 , the WHO/UNICEF review of complementary feeding in low-income countries 23 and updates to this review 24 were also considered for the CF; however to the authors' knowledge, no such equivalent guidelines for food products specifically for PLW are available.…”

“…These serving sizes were selected to be consistent with recommended quantities of CFs and to provide nutrients consistent with CODEX guidelines. 22,47 These serving sizes are specifically designed as a supplement to the local diet and to be given in addition to family foods, with continued breastfeeding. In the home, the premixed product is to be mixed with boiled water and served as a porridge.…”

“…In terms of micronutrient content, the proposed serve sizes exceeded 100% of desirable calcium intakes for all age groups; and vitamin A, iron and zinc intakes for children 12-23 months. A tolerable upper intake level (the highest average daily intake level that is likely to pose no risk of adverse health outcomes) for calcium for infants aged 7-11 months has not been established, however, the proposed serving for infants [12][13][14][15][16][17][18][19][20][21][22][23] months is well within acceptable limits (2500 mg/day 41), assuming average breast milk intake. Proposed serving sizes for vitamin A (600 µg RAE), iron (40 mg) and zinc (7 mg) are also well within tolerable upper intake levels, assuming average breast milk intake.…”

“…This formulation is consistent with Codex Alimentarius Commission guidelines for macro nutrient composition of formulated CFs for older infants and young children (energy density of ≥ 17kJ/g, protein content of 6-15% energy, fat content of ≥ 20% energy). 22 24(footnote) , and using the above total energy requirements from CFs. 24 d Assuming 10% dietary bioavailability.…”

“…The scale of this transition has given rise to concerns over the implications for nutrient supply and associated nutrition outcomes [22,23], but its effects have never been examined empirically. Given how many people depend on fish as a food source and are also at risk of malnutrition, this is an important omission in the literature.…”