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.

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 Presentation Transcript

  • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. • 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. • 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. 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. 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. Selection of ingredients - Rice
  • 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. 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. Selection of ingredients - Orange Sweet Potato Vitamin A Fructose (natural sweetener) Low in anti-nutrients
  • 21. Homestead production of sweet potato
  • 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. Mix in specified proportions Oven-dry Grind Package 15% Fish 45% Rice flour30% OSP flour 10% Soybean oil
  • 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. 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. Fish chutney for pregnant and lactating women • Rich in micronutrients (especially iron) • Animal protein • Essential fats • Energy
  • 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. Increased consumption of fish = 60 g of raw fish
  • 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. Acceptability of fish chutney
  • 31. Fish powder to be added to family foods
  • 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. 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. 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. Thank you
  • 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