Micronutrient deficiencies account for an estimated one million premature deaths annually, and for some nations can reduce gross domestic product
by up to 11%, highlighting the need for food policies ...that focus on improving nutrition rather than simply increasing the volume of food produced
. People gain nutrients from a varied diet, although fish-which are a rich source of bioavailable micronutrients that are essential to human health
-are often overlooked. A lack of understanding of the nutrient composition of most fish
and how nutrient yields vary among fisheries has hindered the policy shifts that are needed to effectively harness the potential of fisheries for food and nutrition security
. Here, using the concentration of 7 nutrients in more than 350 species of marine fish, we estimate how environmental and ecological traits predict nutrient content of marine finfish species. We use this predictive model to quantify the global spatial patterns of the concentrations of nutrients in marine fisheries and compare nutrient yields to the prevalence of micronutrient deficiencies in human populations. We find that species from tropical thermal regimes contain higher concentrations of calcium, iron and zinc; smaller species contain higher concentrations of calcium, iron and omega-3 fatty acids; and species from cold thermal regimes or those with a pelagic feeding pathway contain higher concentrations of omega-3 fatty acids. There is no relationship between nutrient concentrations and total fishery yield, highlighting that the nutrient quality of a fishery is determined by the species composition. For a number of countries in which nutrient intakes are inadequate, nutrients available in marine finfish catches exceed the dietary requirements for populations that live within 100 km of the coast, and a fraction of current landings could be particularly impactful for children under 5 years of age. Our analyses suggest that fish-based food strategies have the potential to substantially contribute to global food and nutrition security.
Global and local food system transformation is necessary in order to ensure the delivery of healthy, safe, and nutritious foods in both sustainable and equitable ways. Food systems are complex ...entities that affect diets, human health, and a range of other outcomes including economic growth, natural resource and environmental resiliency, and sociocultural factors. However, food systems contribute to and are vulnerable to ongoing climate and environmental changes that threaten their sustainability. Although there has been increased focus on this topic in recent years, many gaps in our knowledge persist on the relation between environmental factors, food systems, and nutritional outcomes. In this article, we summarize this emerging field and describe what innovative nutrition research is needed in order to bring about food policy changes in the era of climate disruption and environmental degradation.
Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to ...evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity.
By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction) among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome.
In 2017, 11 million (95% uncertainty interval UI 10–12) deaths and 255 million (234–274) DALYs were attributable to dietary risk factors. High intake of sodium (3 million 1–5 deaths and 70 million 34–118 DALYs), low intake of whole grains (3 million 2–4 deaths and 82 million 59–109 DALYs), and low intake of fruits (2 million 1–4 deaths and 65 million 41–92 DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates.
This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually.
Bill & Melinda Gates Foundation.
Achieving Sustainable Development Goal 2 of zero hunger and malnutrition by 2030 will require dietary shifts that include increasing the consumption of nutrient dense foods by populations in low- and ...middle-income countries. Animal source foods are known to be rich in a number of highly bioavailable nutrients that otherwise are not often consumed in the staple-food based diets of poorer populations throughout the world. Fish is the dominant animal source food in many low- and middle-income countries in the global south and is available from both fisheries and aquaculture. Consumers often perceive that wild caught fish have higher nutritional value than fish produced through aquaculture, and this may be true for some nutrients, for example omega-3 fatty acid content. However, there is potential to modify the nutritional value of farmed fish through feeds and through production systems, illustrated by the common practice of supplementing omega-3 fatty acids in fish diets to optimize their fatty acid profile. This manuscript reviews the evidence related to fish feeds and the nutritional composition of fish with respect to a number of nutrients of interest to human health, including iron, zinc, vitamins A and D, selenium, calcium, and omega-3 fatty acids, with low- and middle-income country populations in mind. In general, we find that the research on fortification of fish diet particularly with vitamins and minerals has not been directed toward human health but rather toward improvement of fish growth and health performance. We were unable to identify any studies directly exploring the impact of fish feed modification on the health of human consumers of fish, but as nutrition and health rises in the development agenda and consumer attention, the topic requires more urgent attention in future feed formulations.
The aim of this study was to explore United States (U.S.) seafood consumption patterns, food sourcing, expenditures, and geography of consumption. We analyzed seafood intake and food sourcing using ...the National Health and Nutrition Examination Survey (NHANES) cycles 2007-2008 to 2015-2016 for US adults ≥19 years old (
= 26,743 total respondents;
= 4957 respondents consumed seafood in the past 24 h). Seafood expenditures were extrapolated by combining NHANES with three other public datasets. U.S. adults consumed 63% of seafood (by weight) at home. The top sources of seafood (by weight) were food retail (56%), restaurants (31%), and caught by the respondent or someone they know (5%). Sixty-five percent of consumer expenditures for seafood were at restaurants and other "away from home" sources while 35% were at retail and other "at home" sources. Slightly less than half of overall U.S. food expenditures are "away from home," which is much lower than for seafood, suggesting that consumers have very different spending habits for seafood than for an aggregate of all foods.
Little is known of the usual food intakes of rural adolescents in South Asia. This study describes dietary patterns, based on >91,000 7‐day food frequencies among 30,702 girls and boys, aged 9–15 ...years in rural northwest Bangladesh. Three intake assessments per child, taken across a calendar year, were averaged to represent individual annual intake patterns for 22 food groups. Latent class analysis was used to assign individuals to dietary patterns based on class membership probabilities. The following five dietary patterns (class membership probabilities) were identified: (1) “least diverse” (0.20); (2) “traditional” (0.28); (3) “low vegetable/low fish” (0.23), (4) “moderately high meat” (0.20); and (5) “most diverse” (0.09). The least diverse pattern had the lowest median consumption of most foods and traditional had a relatively higher intake of most vegetables and fish. The most diverse pattern consumed both healthy and processed foods much more often than other patterns. The two most diverse patterns (4 and 5) were associated with higher socioeconomic status, body mass index, height‐for‐age Z‐score, and male gender, and the least diverse pattern showed inverse associations with these characteristics. The most diverse pattern may represent an early wave of the nutrition transition in rural Bangladesh.
This study describes dietary patterns, based on >91,000 7‐day food frequencies among 30,702 girls and boys, aged 9–15 years in rural northwest Bangladesh. Three intake assessments per child, taken across a calendar year, were averaged to represent individual annual intake patterns for 22 food groups. These were then used to generate dietary patterns.
The 2015 earthquake in Nepal caused massive damages and triggered relief activities to minimize human suffering. The post-earthquake nutrition and food security situation in the hardest hit areas ...remains uncertain.
Two national cross-sectional surveys were conducted in 2014 and 2016 among households (HH) with pre-school aged children or newly married women. Of the 21 village development committees (VDCs) included in this sample, 7 fell within "earthquake-affected" areas. This paper presents data from 982 HH, 1015 women, and 883 children from 2014 and 1056 HH, 1083 women, and 998 children from 2016 living in these areas, with longitudinal overlap of about 55%. Prevalence estimates and 95% confidence intervals were calculated, and logistic regression was used to calculate p-values, both using robust estimates of standard errors to account for clustering.
From 2014 to 2016, child wasting (weight-for-height z score <-2) fell from 4.5% (95% CI 3.3%- 6.1%) to 2.1% (1.4%- 3.1%) and food insecurity (assessed using the household food insecurity access scale) dropped from 17.6% (11.7%- 25.6%) to 12.4% (6.9%- 21.2%). Child stunting prevalence remained similar at both time-points. Improvements were also evident in dietary diversity and breastfeeding indicators.
Nutrition and food security conditions remained comparable or improved one year after the earthquake despite evidence of structural and other damage. Livelihood resilience to shocks and/or effective nutrition, food or health interventions may have helped buffer the impact on nutrition, although this hypothesis requires further exploration.
The COVID-19 pandemic and subsequent lockdowns are creating health and economic crises that threaten food and nutrition security. The seafood sector provides important sources of nutrition and ...employment, especially in low-income countries, and is highly globalized allowing shocks to propagate. We studied COVID-19-related disruptions, impacts, and responses to the seafood sector from January through May 2020, using a food system resilience ‘action cycle’ framework as a guide. We find that some supply chains, market segments, companies, small-scale actors and civil society have shown initial signs of greater resilience than others. COVID-19 has also highlighted the vulnerability of certain groups working in- or dependent on the seafood sector. We discuss early coping and adaptive responses combined with lessons from past shocks that could be considered when building resilience in the sector. We end with strategic research needs to support learning from COVID-19 impacts and responses.
•We studied COVID-19 related disruptions, impacts, and responses to the seafood sector•COVID-19 is showing the vulnerability of groups that work in- or dependent on the seafood sector•Current responses combined with lessons from past shocks can help building resilience•Strategic research is needs to support learning from COVID-19 impacts and responses
Dietary diversity can play an important role in providing essential nutrients for both mother and fetus during pregnancy. This study aimed to assess the factors associated with dietary diversity ...during pregnancy in the western hill region of Nepal.
A cross-sectional study of 327 pregnant women was conducted in an urban municipality of Baglung district in the western hill region of Nepal. A semi-structured questionnaire was used to collect information on household demographic and socioeconomic status, food taboos, household food security status, nutrition-related knowledge in pregnancy, and women's empowerment. Women consuming ≥5 of 10 food groups in the past 24 hours were defined as consuming a diverse diet using the Minimum Dietary Diversity Score for Women (MDD-W) tool. Bivariate and multivariate logistic regression was used to estimate crude odds ratio (cOR) and adjusted odds ratios (aOR) and 95% confidence intervals (CIs) to understand factors associated with dietary diversity.
Almost 45% (95% CI: 39.6-50.4) of the participants did not consume a diverse diet and the mean dietary diversity score was 4.76 ± 1.23. Multivariable analysis revealed that women with greater empowerment (aOR = 4.3, 95% CI: 1.9-9.9), from wealthier households (aOR = 5.1, 95% CI: 2.7-9.3), joint families (aOR = 2.7, 95% CI: 1.4-5.1), employment (aOR = 2.2, 95% CI: 1.2-4.1), and had adequate nutrition knowledge (aOR: 1.9, 95% CI 1.1-3.4) had higher odds of dietary diversity.
Along with socioeconomic status, women's empowerment and nutrition knowledge were modifiable risk factors that should be considered as targets for programs to improve women's health during pregnancy.
Vitamin A (VA) deficiency during pregnancy is common in low‐income countries and a growing number of intervention trials have examined the effects of supplementation during pregnancy on maternal, ...perinatal and infant health outcomes. We systematically reviewed the literature to identify trials isolating the effects of VA or carotenoid supplementation during pregnancy on maternal, fetal, neonatal and early infant health outcomes. Meta‐analysis was used to pool effect estimates for outcomes with more than one comparable study. We used GRADE criteria to assess the quality of individual studies and the level of evidence available for each outcome. We identified 23 eligible trials of which 17 had suitable quality for inclusion in meta‐analyses. VA or beta‐carotene (βC) supplementation during pregnancy did not have a significant overall effect on birthweight indicators, preterm birth, stillbirth, miscarriage or fetal loss. Among HIV‐positive women, supplementation was protective against low birthweight (<2.5 kg) risk ratio (RR) = 0.79 95% confidence interval (CI) 0.64, 0.99, but no significant effects on preterm delivery or small‐for‐gestational age were observed. Pooled analysis of the results of three large randomised trials found no effects of VA supplementation on neonatal/infant mortality, or pregnancy‐related maternal mortality (random‐effects RR = 0.86 0.60, 1.24) although high heterogeneity was observed in the maternal mortality estimate (I2 = 74%, P = 0.02). VA supplementation during pregnancy was found to improve haemoglobin levels and reduce anaemia risk (<11.0 g/dL) during pregnancy (random‐effects RR = 0.81 0.69, 0.94), also with high heterogeneity (I2 = 52%, P = 0.04). We found no effect of VA/βC supplementation on mother‐to‐child HIV transmission in pooled analysis, although some evidence suggests that it may increase transmission. There is little consistent evidence of benefit of maternal supplementation with VA or βC during pregnancy on maternal or infant mortality. While there may be beneficial effects for certain outcomes, there may also be potential for harm through increased HIV transmission in some populations.
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