Abstract
The value of animal-sourced foods (ASFs) in providing key nutrients, particularly for child growth and where diets are of low quality, is understood mainly from cross-sectional assessment of current consumption. Longitudinal panel data from Nepal, Bangladesh and Uganda were used here to assess associations among previous (lagged) and contemporaneous ASF intake with linear growth of children aged 6–24 months. Lagged ASF consumption was significantly correlated with a 10% decline in stunting in Nepali children who consumed any ASF in the previous year, while current intake was associated with a 9% decline in stunting in Uganda. Previous consumption of two or more ASFs showed a stronger association, ranging from a 10% decline in stunting in Bangladesh to a 16% decline in Nepal. This novel lagged analysis emphasizes the need for regular and appropriate levels of ASF intake by young children to support healthy growth in resource-constrained settings.
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Data availability
The data that support the findings of this study are available from https://tufts.box.com/s/xeh9fioghz9ng4q00tn62c1new1xv9zx. Source data are provided with this paper.
Code availability
The code used to generate the results presented in this study is available from https://tufts.box.com/s/xeh9fioghz9ng4q00tn62c1new1xv9zx.
References
Kinyoki, D. K. et al. Mapping child growth failure across low- and middle-income countries. Nature 577, 231–234 (2020).
Aguayo, V. M. & Menon, P. Stop stunting: improving child feeding, women’s nutrition and household sanitation in South Asia. Matern. Child Nutr. 12, 3–11 (2016).
Black, R. E. et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 382, 427–451 (2013).
Ahmed, T. et al. in Hunter’s Tropical Medicine and Emerging Infectious Diseases (eds Ryan, E. T. et al.) 1034–1041 (2020).
Jeffery, K., Chatterjee, I., Lavin, T. & Li, I. W. Young lives and wealthy minds: the nexus between household consumption capacity and childhood cognitive ability. Econ. Anal. Policy 65, 89–104 (2020).
Ghosh, S., Suri, D. & Uauy, R. Assessment of protein adequacy in developing countries: quality matters. Br. J. Nutr. 108, S77–S87 (2012).
Krasevec, J., An, X., Kumapley, R., Begin, F. & Frongillo, E. A.Diet quality and risk of stunting among infants and young children in low- and middle-income countries. Matern. Child Nutr. 13, e12430 (2017).
Headey, D., Hirvonen, K. & Hoddinott, J. Animal sourced foods and child stunting. Am. J. Agric. Econ. 100, 1302–1319 (2018).
Hoppe, C., Molgaard, C. & Michaelsen, K. F. Cow’s milk and linear growth in industrialized and developing countries. Annu. Rev. Nutr. 26, 131–173 (2006).
Ghosh, S., Suri, D. & Griffiths, J. Dairy consumption is associated with a lower risk of stunting in Ethiopian children 6–24 months of age (620.10). FASEB J. 28, abstr. 620.610 (2014).
Dror, D. K. & Allen, L. H. Dairy product intake in children and adolescents in developed countries: trends, nutritional contribution, and a review of association with health outcomes. Nutr. Rev. 72, 68–81 (2014).
Mahmudiono, T., Sumarmi, S. & Rosenkranz, R. R. Household dietary diversity and child stunting in East Java, Indonesia. Asia Pac. J. Clin. Nutr. 26, 317–325 (2017).
Krebs, N. F. et al. Meat consumption is associated with less stunting among toddlers in four diverse low-income settings. Food Nutr. Bull. 32, 185–191 (2011).
Marinda, P. A., Genschick, S., Khayeka-Wandabwa, C., Kiwanuka-Lubinda, R. & Thilsted, S. H. Dietary diversity determinants and contribution of fish to maternal and under-five nutritional status in Zambia. PLoS ONE 13, e0204009 (2018).
Kaimila, Y. et al. Consumption of animal-source protein is associated with improved height-for-age z scores in rural Malawian children aged 12–36 months. Nutrients 11, 480 (2019).
Shivakumar, N. et al. Protein-quality evaluation of complementary foods in Indian children. Am. J. Clin. Nutr. 109, 1319–1327 (2019).
Neumann, C. G. et al. Animal source foods improve dietary quality, micronutrient status, growth and cognitive function in Kenyan school children: background, study design and baseline findings. J. Nutr. 133, 3941S–3949S (2003).
Iannotti, L. L. et al. Eggs in early complementary feeding and child growth: a randomized controlled trial. Pediatrics 140, e20163459 (2017).
Iannotti, L. L. et al. Egg intervention effect on linear growth no longer present after two years. Matern. Child Nutr. 16, e12925 (2020).
Stewart, C. P. et al. The effect of eggs on early child growth in rural Malawi: the Mazira Project randomized controlled trial. Am. J. Clin. Nutr. 110, 1026–1033 (2019).
Mahfuz, M. et al. Daily supplementation with egg, cow milk, and multiple micronutrients increases linear growth of young children with short stature. J. Nutr. 150, 394–403 (2019).
Willett, W. et al. Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems. Lancet 393, 447–492 (2019).
Swinburn, B. A. et al. The global syndemic of obesity, undernutrition, and climate change: the Lancet Commission report. Lancet 393, 791–846 (2019).
Michaelsen, K. F. Effect of protein intake from 6 to 24 months on insulin-like growth factor 1 (IGF-1) levels, body composition, linear growth velocity, and linear growth acceleration: what are the implications for stunting and wasting? Food Nutr. Bull. 34, 268–271 (2013).
Milward, D. Nutrition, infection and stunting: the roles of deficiencies of individual nutrients and foods, and of inflammation, as determinants of reduced linear growth of children. Nutr. Res. Rev. 30, 50–72 (2017).
Murphy, S. P. & Allen, L. H. Nutritional importance of animal source foods. J. Nutr. 133, 3932S–3935S (2003).
Hoppe, C. et al. Animal protein intake, serum insulin-like growth factor I, and growth in healthy 2.5-y-old Danish children. Am. J. Clin. Nutr. 80, 447–452 (2004).
Choudhury, S. & Headey, D. D. Household dairy production and child growth: evidence from Bangladesh. Econ. Hum. Biol. 30, 150–161 (2018).
Kabunga, N., Ghosh, S. & Webb, P. Does ownership of improved dairy cow breeds improve child nutrition? A pathway analysis for Uganda. PLoS ONE 12, e0187816 (2017).
Hoddinott, J., Headey, D. & Dereje, M. Cows, missing milk markets, and nutrition in rural Ethiopia. J. Dev. Stud. 51, 958–975 (2015).
Rawlins, R., Pimkina, S., Barrett, C. B., Pedersen, S. & Wydick, B. Got milk? The impact of Heifer International’s livestock donation programs in Rwanda on nutritional outcomes. Food Policy 44, 202–213 (2014).
Thorne‐Lyman, A., Spiegelman, D. & Fawzi, W. W.Is the strength of association between indicators of dietary quality and the nutritional status of children being underestimated? Matern. Child Nutr. 10, 159–160 (2014).
Klemm, R. et al. Pathways from agriculture-to-nutrition: design and conduct of the national PoSHAN surveys of Nepal. J. Food Secur. 6, 79–89 (2018).
Akter, R. et al. Household engagement in both aquaculture and horticulture is associated with higher diet quality than either alone. Nutrients 12, 2705 (2020).
Bashaasha, B., Namulondo, R., Emegu, R.I., Webb, P., Ghosh, S. & Agaba, E. Association between bio-fortification and child nutrition among smallholder households in Uganda. J. Agri. Econ. Rural Dev. 6, 744–751 (2020).
WHO Anthro v.3.1 (WHO, 2010); http://www.who.int/childgrowth/software/en/
WHO Child Growth Standards. Methods and Development: Length/Height-for-Age, Weight-for-Age, Weight-for-Length, Weight-for-Height and Body Mass Index-for-Age (WHO, 2007); http://www.who.int/childgrowth/publications/technical_report_pub/en/index.html
Leroy, J. L., Ruel, M., Habicht, J.-P. & Frongillo, E. A. Using height-for-age differences (HAD) instead of height-for-age z-scores (HAZ) for the meaningful measurement of population-level catch-up in linear growth in children less than 5 years of age. BMC Pediatrics 15, 145 (2015).
Greene, W. Estimating Econometric Models with Fixed Effects (New York Univ., 2001).
Acknowledgements
We express gratitude to the United States Agency for International Development’s (USAID’s) Bureau of Resilience and Food Security, the US Missions in each country included in this study, as well as USAID staff involved with the Feed the Future Innovation Lab for Nutrition over its lifetime, including M. Mack, A. Kablan, D. Adhikari and O. Aimiuwu. We also thank the study participants without whom this research would not have been possible. Support for this research was provided by USAID (award AID-OAA-L-10-00006 (P.W., S.Z., S.Ghosh, R.S., S.M., A.T.L., B.B., N.K., G.N. and L.L.) and award AID-OAA-LA-14-00012 (K.A. and S.Ghosh)) to the Friedman School of Nutrition Science and Policy at Tufts University. The opinions expressed herein are solely those of the authors.
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P.W. conceived of the study. S.Z., P.W. and S.Ghosh developed the methodology. S.Z. conducted the analyses. P.W., S.Ghosh and R.S. helped to refine the methodology and analytical methods. S.Z., P.W. and S.Ghosh interpreted the results. S.Z., P.W. and S.Ghosh developed early drafts of the paper. R.S. contributed to writing, reviewing and editing early drafts. P.W., S.Ghosh, R.S., S.Gurung, B.B., N.K., A.L.T.-L. and S.M. designed the surveys and oversaw data collection. S.M., A.L.T.-L., N.K., K.H.A., G.N. and L.L. performed the data curation. All authors reviewed the final manuscript.
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Zaharia, S., Ghosh, S., Shrestha, R. et al. Sustained intake of animal-sourced foods is associated with less stunting in young children. Nat Food 2, 246–254 (2021). https://doi.org/10.1038/s43016-021-00259-z
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DOI: https://doi.org/10.1038/s43016-021-00259-z
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