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ARS Home » Pacific West Area » Davis, California » Western Human Nutrition Research Center » Immunity and Disease Prevention Research » Research » Publications at this Location » Publication #407359
Research Project: Impact of Diet on Intestinal Microbiota, Gut Health and Immune Function

Location: Immunity and Disease Prevention Research

Title: Associations of fish and meat intake with iron and anemia in malawian children

Author
item WERNER, E ROCHELLE - University Of California, Davis
item ARNOLD, CHARLES - University Of California, Davis
item Caswell, Bess
item IANNOTTI, LORA - Washington University
item MALETA, KENNETH - University Of Malawi
item STEWART, CHRISTINE - University Of California, Davis

Submitted to: Maternal and Child Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/21/2023
Publication Date: 1/12/2024
Citation: Werner, E., Arnold, C.D., Caswell, B.L., Iannotti, L.L., Maleta, K.M., Stewart, C.P. 2024. Associations of fish and meat intake with iron and anemia in malawian children. Maternal and Child Nutrition. 2024;20:e13622. https://doi.org/10.1111/mcn.13622.
DOI: https://doi.org/10.1111/mcn.13622

Interpretive Summary: Anemia, iron deficiency and other forms of malnutrition are common among children in rural Malawi, where consumption of animal source foods is limited. Meat and fish provide bioavailable iron and other nutrients that may improve iron and anemia status. We measured iron and anemia status and studied the diets of rural Malawian children from when they were 6 to 9 months old until they were 12 to 15 months old. Over the six month study, children consumed small fish on 25% of days. Large fish and meat were consumed on less than 10% of days. The amounts of fish or meat consumed averaged less than 5g (about one teaspoon) per day. Fish and meat were important sources of bioavailable iron in children's diets, and frequency of small fish consumption showed slight associations with iron status. Greater intakes of fish among infants and young children in rural Malawi and similar settings could improve iron status and reduce the burden of anemia.

Technical Abstract: Flesh foods are rich in bioavailable iron but infrequently consumed by young children. We aimed to determine whether flesh food intake was associated with iron and anemia status in a cohort of 585 Malawian infants enrolled in a 6mo egg feeding trial. Percent of days of small fish, large fish, and meat consumption were assessed through weekly 7-day animal-source food screeners. Grams of intake were assessed through 24-hr recalls conducted at 6-9mo, 9-12mo, and 12-15mo of age. Plasma ferritin, sTfR, and hemoglobin (Hb) were measured at 6-9mo and 12-15mo of age. At enrollment, each flesh food category was consumed by <5% of children in the past 24-hours. Over the next 6mo, small fish, large fish, and meat were consumed on 25%, 8%, and 6% of days, respectively, with mean usual intakes of <5g/d. More frequent small fish consumption was associated with lower sTfR [geometric mean ratio (95%CI): 0.98mg/L (0.96, 1.00) per 10-percentage-point difference] but not with ferritin (1.03µg/L (0.98, 1.07)) or Hb (1.01g/dL (1.00, 1.01)), and large fish was associated with higher anemia (Prevalence ratio (95%CI): 1.09 (1.01, 1.19)) and lower iron deficiency (ID; 0.96 (0.93, 1.00)) prevalence. Gram intakes of any flesh food category were not associated with any indicator of iron or anemia. Small fish were a primary contributor to flesh food intake in this cohort of Malawian children, although usual portions were small. Fish was associated with modest improvements to iron status, but meat intake was likely too infrequent to be associated with anemia and ID.