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

PLoS One. 2018 Sep 24;13(9):e0204009. doi: 10.1371/journal.pone.0204009. eCollection 2018.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Child Nutritional Physiological Phenomena
  • Child, Preschool
  • Cross-Sectional Studies
  • Diet*
  • Eating
  • Female
  • Fishes*
  • Growth Disorders / epidemiology
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena
  • Male
  • Maternal Nutritional Physiological Phenomena
  • Mothers
  • Nutrition Surveys
  • Nutritional Status*
  • Poverty
  • Socioeconomic Factors
  • Urban Population
  • Zambia / epidemiology

Grants and funding

This study was made possible with financial support from the Federal Ministry for Economic Cooperation and Development, Germany. Funding for this study was provided to WorldFish by the German Federal Ministry for Economic Cooperation and Development (BMZ) through the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ). The funding contract number is 81170271.