Fish-based products to
improve nutrition in the
first 1,000 days of life
By Anne-Louise Hother, Manika Saha, Jessica Bogar...
Outline
1. State of nutrition of women and children in Bangladesh
2. Why focus on the first 1,000 days of life?
3. Nutriti...
State of nutrition in women in Bangladesh
women of reproductive age (14-49 y)
• 1 out of 4 are underweight (BMI <18.5)
• 1...
State of nutrition in children in Bangladesh
Children 0-59 months
• 36% are underweight
• 17% are wasted (thin)
• 41% are ...
State of nutrition in children in Bangladesh
Children 0-59 months
• 36% are underweight
• 17% are wasted (thin)
• 41% are ...
State of nutrition in children in Bangladesh
Children 0-59 months
• 36% are underweight
• 17% are wasted (thin)
• 41% are ...
0
10
20
30
40
50
60
-9 <6 6-8 9-11 12-17 18-23 24-35 36-47 48-59
%children
Age in months
stunting
severe stunting
wasting
...
0
10
20
30
40
50
60
-9 <6 6-8 9-11 12-17 18-23 24-35 36-47 48-59
%children
Age in months
stunting
severe stunting
wasting
...
0
10
20
30
40
50
60
-9 <6 6-8 9-11 12-17 18-23 24-35 36-47 48-59
%children
Age in months
stunting
severe stunting
wasting
...
Why focus on the first 1,000 days of life?
Pregnancy Breastfeeding Complementary feeding
1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8...
Complementary feeding
in 6-23 months old breastfed children
1. Exclusive breastfeeding from 0-6 months
>1 in 3 children ar...
Nutritional challenges in the first 1,000
days
• Predominantly plant based diet (>70% of energy from rice)
• Low in micron...
• Inclusion of small amounts of animal-source foods in a
plant-based diet can substantially increase nutrient
adequacy. It...
• Inclusion of small amounts of animal-source foods in a
plant-based diet can substantially increase nutrient
adequacy. It...
Fish-based products developed by
WorldFish
1. Fish-based CF product for infants and young children
2. Fish chutney for pre...
Fish-based complementary food product
• Made from local
ingredients
• High content of MN (iron,
zinc, vit A, calcium)
• Hi...
Selection of ingredients - Rice
Selection of ingredients - Fish
“Mache bhate Bengali” Fish and rice make a Bengali
Fish most commonly eaten animal-source ...
Selection of ingredients - Fish
0
2
4
6
8
10
12
14
Chanda Chapila Chikra Darkina Kaski Mola Puti Taki
Fe (mg/100g)
Zn (mg/...
Selection of ingredients - Orange Sweet
Potato
Vitamin A
Fructose (natural sweetener)
Low in anti-nutrients
Homestead
production of
sweet potato
Parboil
Sun-dry
Oven-dry
Blanch
Oven-dry
Slice into chips
Mill
Polish
GrindGrind Grind
Darkina fish Rice paddyOSP roots So...
Mix in specified proportions
Oven-dry
Grind
Package
15% Fish 45% Rice flour30% OSP flour 10% Soybean oil
Nutrient composition of the fish-based
CF compared to other CFs in Bangladesh
Fish-based
CF
SUPER
CEREAL plus
Pushti Packe...
Contribution to nutrient needs from CFs
[1] Desired nutrient needs from CFs are calculated from desired nutrient densities...
Fish chutney for pregnant and lactating
women
• Rich in
micronutrients
(especially iron)
• Animal protein
• Essential fats...
Ingredients: 37% dried small fish, 15% oil, 37% onion,
7% garlic and 4% red chili
Fish chutney for pregnant and lactating
...
Increased consumption of fish
= 60 g of raw fish
Nutrient composition of fish chutney
A supplement to the diet
Content
per 100 g*
Content per
serve (30 g)*
% Contribution ...
Acceptability of fish chutney
Fish powder to be added to family foods
Preparation of fish powder
Nutrient composition per 100 g of fish powder
Energy Protein Fat Iron Zinc Calcium
317 kcal 19 ...
Acceptability trial
• Well-liked by mothers and
children in Sunamganj
• Regular introduction of fish
powder to the child w...
Future plans for fish-based products
• Food distribution programmes
• Community business plan
• Commercial sale including ...
Thank you
Draw attention to that you can taste the
products at the table by the door
1. Fish-based CF product for infants and young ...
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Fish-based products to improve nutrition in the first 1,000 days of life

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By Anne-Louise Hother, Manika Saha, Jessica Bogard and Shakuntala Haraksingh Thilsted.

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Fish-based products to improve nutrition in the first 1,000 days of life

  1. 1. Fish-based products to improve nutrition in the first 1,000 days of life By Anne-Louise Hother, Manika Saha, Jessica Bogard and Shakuntala Haraksingh Thilsted
  2. 2. Outline 1. State of nutrition of women and children in Bangladesh 2. Why focus on the first 1,000 days of life? 3. Nutritional challenges in the 1,000 days 4. Why should fish consumption be increased in the 1,000 days? 5. Fish-based products for improved nutrition and health • Fish-based CF product for infants and young children • Fish chutney for pregnant and lactating women • Fish powder to be added to family foods
  3. 3. State of nutrition in women in Bangladesh women of reproductive age (14-49 y) • 1 out of 4 are underweight (BMI <18.5) • 1 out of 10 are moderately of severely thin (BMI <17) • >1 out of 10 have a short stature (height <145 cm) • 4 out of 10 women are anaemic • 1 out of 20 children are VERY small at birth • 1 out of 10 children are SMALLER THAN AVERAGE at birth Source: BDHS 2011 - National Institute of Population, Research and Training (NIPORT), Mitra and Associates, ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA; 2011.
  4. 4. State of nutrition in children in Bangladesh Children 0-59 months • 36% are underweight • 17% are wasted (thin) • 41% are stunted Source: BDHS 2011 - National Institute of Population, Research and Training (NIPORT), Mitra and Associates, ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA; 2011.
  5. 5. State of nutrition in children in Bangladesh Children 0-59 months • 36% are underweight • 17% are wasted (thin) • 41% are stunted 26 months 52 months Source: BDHS 2011 - National Institute of Population, Research and Training (NIPORT), Mitra and Associates, ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA; 2011.
  6. 6. State of nutrition in children in Bangladesh Children 0-59 months • 36% are underweight • 17% are wasted (thin) • 41% are stunted 26 months 52 months The damages done early in life are irrevesible BUT can be prevented by eating a nutritious diet rich in micronutrient rich foods Source: BDHS 2011 - National Institute of Population, Research and Training (NIPORT), Mitra and Associates, ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA; 2011.
  7. 7. 0 10 20 30 40 50 60 -9 <6 6-8 9-11 12-17 18-23 24-35 36-47 48-59 %children Age in months stunting severe stunting wasting severe wasting Child malnutrition in Bangladesh 0–59 months Source BDHS 2011 - National Institute of Population, Research and Training (NIPORT), Mitra and Associates, ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA; 2011.
  8. 8. 0 10 20 30 40 50 60 -9 <6 6-8 9-11 12-17 18-23 24-35 36-47 48-59 %children Age in months stunting severe stunting wasting severe wasting Child malnutrition in Bangladesh 0–59 months Window of opportunity Source BDHS 2011 - National Institute of Population, Research and Training (NIPORT), Mitra and Associates, ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA; 2011.
  9. 9. 0 10 20 30 40 50 60 -9 <6 6-8 9-11 12-17 18-23 24-35 36-47 48-59 %children Age in months stunting severe stunting wasting severe wasting Child malnutrition in Bangladesh 0–59 months Source BDHS 2011 - National Institute of Population, Research and Training (NIPORT), Mitra and Associates, ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA; 2011. The period from the start of a woman’s pregnancy to the child’s 2nd birthday offers a unique window of opportunity to shape healthier and more prosperous futures
  10. 10. Why focus on the first 1,000 days of life? Pregnancy Breastfeeding Complementary feeding 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Improve nutrition for mothers and young children during the critical 1,000 days from pregnancy to the child’s second birthday, when better nutrition can have a lifelong impact on a child’s future and help break the cycle of poverty.
  11. 11. Complementary feeding in 6-23 months old breastfed children 1. Exclusive breastfeeding from 0-6 months >1 in 3 children are NOT exclusively breastfed 2. Meal frequency (2/day at 6-8 months, 3/day at 9-23 months) >1 in 3 are NOT fed the minimum number of meals per day 3. Dietary diversity >3 in 4 are NOT fed with appropriate dietary diversity 4. Adequate diet (Meal freq. AND dietary diversity) Only 21% have an adequate diet Source: BDHS 2011 - National Institute of Population, Research and Training (NIPORT), Mitra and Associates, ICF International. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh and Calverton, Maryland, USA; 2011.
  12. 12. Nutritional challenges in the first 1,000 days • Predominantly plant based diet (>70% of energy from rice) • Low in micronutrients • High in antinutrients • Limited food diversity (<6% of energy from animal-source foods) • CFs rarely provide adequate energy and micronutrients • Thin rice porrigde • Suji – wheat porrigde • Time • Safe storage
  13. 13. • Inclusion of small amounts of animal-source foods in a plant-based diet can substantially increase nutrient adequacy. It is therefore recommended that infants and young children and pregnant and lactating women are fed animal-source foods every day • Most commonly consumed animal-source food • Small indigenous fish are particularly nutritious as they are eaten whole, with head, bones and viscera, and provide a rich source of animal protein, iron, zinc, calcium and vitamin A Why should fish consumption be increased in the first 1,000 days?
  14. 14. • Inclusion of small amounts of animal-source foods in a plant-based diet can substantially increase nutrient adequacy. It is therefore recommended that infants and young children and pregnant and lactating women are fed animal-source foods every day. • Most commonly consumed animal-source food • Small indigenous fish are particularly nutritious as they are eaten whole, with head, bones and viscera, and provide a rich source of animal protein, iron, zinc, calcium and vitamin A BUT • Amounts consumed by the poor are low • Even if available in the household, fish are often introduced to the child only after 9 months of age Why should fish consumption be increased in the first 1,000 days?
  15. 15. Fish-based products developed by WorldFish 1. Fish-based CF product for infants and young children 2. Fish chutney for pregnant and lactating women 3. Fish powder to be added to family foods
  16. 16. Fish-based complementary food product • Made from local ingredients • High content of MN (iron, zinc, vit A, calcium) • High energy density • Low content of anti- nutrients • Include animal-source food • Culturally acceptable • Acceptable taste, texture and colour • Easy to prepare • Hygenically safe
  17. 17. Selection of ingredients - Rice
  18. 18. Selection of ingredients - Fish “Mache bhate Bengali” Fish and rice make a Bengali Fish most commonly eaten animal-source food across all income groups Small indigenous fish are highly nutritious
  19. 19. Selection of ingredients - Fish 0 2 4 6 8 10 12 14 Chanda Chapila Chikra Darkina Kaski Mola Puti Taki Fe (mg/100g) Zn (mg/100g) Calcium (g/100g)
  20. 20. Selection of ingredients - Orange Sweet Potato Vitamin A Fructose (natural sweetener) Low in anti-nutrients
  21. 21. Homestead production of sweet potato
  22. 22. Parboil Sun-dry Oven-dry Blanch Oven-dry Slice into chips Mill Polish GrindGrind Grind Darkina fish Rice paddyOSP roots Soybean oil Wash Wash Wash SoakPeel and trim
  23. 23. Mix in specified proportions Oven-dry Grind Package 15% Fish 45% Rice flour30% OSP flour 10% Soybean oil
  24. 24. Nutrient composition of the fish-based CF compared to other CFs in Bangladesh Fish-based CF SUPER CEREAL plus Pushti Packet Energy (kcal) 423 410 395 Protein (g) 12 16 NA Iron (mg) 15 6.5 2.1 Zinc (mg) 4.5 5 4.4 Calcium (mg) 895 130 300 Vitamin A (RAE) 418 499 197 Daily recommended ration: 6-11 months: 1 serve (30 g) 12-23 months: 2 serves (60 g)
  25. 25. Contribution to nutrient needs from CFs [1] Desired nutrient needs from CFs are calculated from desired nutrient densities of CFs, assuming energy required from complementary foods is 202, 307 and 548 kcal/day for infants and young children, aged 6-8, 9-11 and 12-23 months, respectively as per US longitudinal data. % contribution of the daily ration of fish-based CF to desired nutrient needs from CFs 6-8 months 9-11 months 12-23 months (1 serve/day) (1 serve/day) (2 serves/day) Energy (kcal) 63 41 46 Protein (g) 179 118 147 Iron (mg) 50 49 164 Zinc (mg) 42 40 82 Calcium (mg) 127 118 156 Vitamin A (RAE) 401 272 398
  26. 26. Fish chutney for pregnant and lactating women • Rich in micronutrients (especially iron) • Animal protein • Essential fats • Energy
  27. 27. Ingredients: 37% dried small fish, 15% oil, 37% onion, 7% garlic and 4% red chili Fish chutney for pregnant and lactating women Protein, Fe, Zn, Ca Energy density, EFA Texture and flavour Taste enhancer
  28. 28. Increased consumption of fish = 60 g of raw fish
  29. 29. Nutrient composition of fish chutney A supplement to the diet Content per 100 g* Content per serve (30 g)* % Contribution to RNI for pregnant women from 1 serve % Contribution to RNI for lactating women from 1 serve 1st trimester 2nd trimester 3rd trimester 0-2 months 3-6 months 7-12 months Energy (kcal)^ 432.8 129.8 153 46 27 19 19 26 Protein (g)^ 38.5 11.5 1150 128 37 61 61 92 Iron (mg)# 9 2.7 - - - 18 18 18 Zinc (mg) 7.8 2.4 71 57 40 41 45 56 Calcium (mg) 1879.4 563.8 75 75 70 75 75 75 * Content is estimated based on analysed nutrient composition values for individual ingredients ^ Recommended additional energy and protein requirements during pregnancy and lactation Joint FAO/WHO/UNU 2004; WHO/FAO/UNU, 2007). Base energy requirements dependant on body weight and physical activity level # It is recommended that iron supplements be given to all pregnant women because of difficulties in correctly assessing iron status in pregnancy. Using RNI for iron assuming a dietary iron bioavailability of 10% Source mineral requirements: WHO, 2004 (assuming 10% availability of iron; high availability of zinc)
  30. 30. Acceptability of fish chutney
  31. 31. Fish powder to be added to family foods
  32. 32. Preparation of fish powder Nutrient composition per 100 g of fish powder Energy Protein Fat Iron Zinc Calcium 317 kcal 19 g 22 g 22 g 4.5 mg 1669 mg Fish powder added to different types of family foods
  33. 33. Acceptability trial • Well-liked by mothers and children in Sunamganj • Regular introduction of fish powder to the child will help familiarise the child with the new product • Mothers expressed interest in including the fish powder in their own meal
  34. 34. Future plans for fish-based products • Food distribution programmes • Community business plan • Commercial sale including rural sales programmes • Emergency response food rations • School feeding programmes • Moderate and severe acute malnutrition • A business model to determine the feasibility of distribution of the fish-based products through the various channels and production scalability
  35. 35. Thank you
  36. 36. Draw attention to that you can taste the products at the table by the door 1. Fish-based CF product for infants and young children 2. Fish chutney for pregnant and lactating women 3. Fish powder to be added to family foods
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