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The effect of plant-based homestead food production with and without small-scale aquaculture on dietary intake of women farmers and their children in Prey Veng, Cambodia

University of British Columbia

In 2011-2013, 15.4% of the Cambodian population was undernourished, compared to <5% in Canada. The Cambodian diet is rice-based and low in nutrient-dense animal-source foods. Homestead food production (HFP) and aquaculture are potential interventions to improve dietary intake. However, we lack comprehensive evidence that these interventions improve intake. Using a cluster randomized control trial, I aimed to determine whether women and children receiving HFP with or without aquaculture have higher intakes or lower prevalence of inadequate intakes of select nutrients, compared to controls in Prey Veng, Cambodia. Ninety villages of ten households each (n=900) were randomized to: HFP, HFP plus aquaculture, or control. After 22-months of intervention, interviewers collected 24-hour dietary recalls (24HRs) from women 18-50 y (n=429) and children 6 m-7 y (n=421). Repeat 24HRs were collected (n=139) to allow for adjustment of within-person variation in intake (using PC-SIDE software). Mean nutrient intakes were compared using generalized estimating equations (GEE) models. Prevalence of nutrient inadequacy was compared by applying the Estimated Average Requirement cut-point method or probability approach and using GEE models. After intervention, women in the HFP group had higher mean intakes of zinc (+1.0 mg) and vitamin A (+139 Retinol Activity Equivalent (RAE)), compared to controls (p<0.05). Women in the HFP plus aquaculture group had higher mean intakes of vitamin A (+191 RAE) and iron (+2.7 mg), and lower prevalence of inadequate vitamin A intake (-19%) and iron intake at 10% bioavailability (-7%) and 5% bioavailability (-2%) levels, compared to controls (p<0.05). Among groups of children and between the HFP and HFP plus aquaculture groups for both women and children, there were no significant differences in nutrient intakes or prevalence of nutrient inadequacy. This research provides evidence that intervention with HFP in Cambodia results in higher zinc and vitamin A intakes, and intervention with HFP plus aquaculture results in higher vitamin A and iron intakes and reduced prevalence of inadequate vitamin A and iron intakes among women, compared to controls. Future research should assess the impact of these changes on clinical outcomes, the effect of seasonal changes on intake, and the feeding relationship between women and children.

Text

2015-10-24

Attribution-NonCommercial-NoDerivs 2.5 Canada

http://hdl.handle.net/2429/55088

Human Nutrition

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/2.5/ca/