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BMC Public Health
Published in: BMC Public Health 1/2023

Open Access 01-12-2023 | Research

Adolescent girls in aquaculture ecozones at risk of nutrient deficiency in Bangladesh development and validation of an integrated metric

Authors: Eleanor Grieve, Abdullah-Al Mamun, Baukje de Roos, Benoy K. Barman, Gulshan Ara, Nanna Roos, Alexandra Pounds, Alan A. Sneddon, Francis Murray, Tahmeed Ahmed, David C. Little

Published in: BMC Public Health | Issue 1/2023

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Abstract

Background

This study developed and validated an integrated metric that enhances understanding of linkages between agro-ecological and socio-economic factors that are important for explaining nutritional wellbeing in relation to fish consumption; especially among adolescent girls who are at risk of nutritional deficiency in Bangladesh. Currently, there is no metric that takes account of environmental, cultural and economic contexts when considering fish consumption and dietary health from a policy perspective.

Methods

The study was designed as a bi-seasonal survey, repeated in the same population of adolescent girls recruited during the dry and wet seasons. Sampling was stratified by five settings (four aqua-agroecological zones and one processing plant community), with 60 girls recruited in each. Associations between candidate predictors (salinity, diet diversity, religion, socio-economic status and women’s autonomy score) and dependent variables representing nutritional outcomes (anthropometry, omega-3 index and micronutrient levels) were explored in multivariable regressions. The fitted model with its predictors was validated, and a risk score derived from responses to a few short questions on religion, salinity zone, female autonomy, diet diversity and tilapia consumption.

Results

The omega-3 index showed the clearest distinction between seasons, by salinity and religion. Higher female autonomy, religion (being Hindu rather than Muslim), geographical location (living in a high or mid-saline area), and a higher dietary diversity were the strongest predictors of whole blood omega-3 index. The c-index for the prognostic model was 0.83 and 0.76 in the wet and dry season respectively, indicating good predictive accuracy. There appeared to be a clear trend in risk scores differentiating between those ‘chronically at risk’ and those ‘never at risk’.

Conclusions

Observational data on different aquaculture-ecozones defined by salinity enabled us to establish linkages between seasonal fish intake, religion, diet diversity, female autonomy and nutritional wellbeing. The purpose of the metric is to reveal these specific linkages in practice. This tool should improve targeting of timely, preventative and cost-effective nutritional interventions to adolescent girls most at-risk from low omega-3 levels in communities where seafood is produced.
Appendix
Available only for authorised users
Footnotes
1
See Box 3.7.
 
2
from -2SD under-and + 2SD overweight.
 
3
Note this is a population cut off value.
 
4
A manuscript is currently under review, reporting the investigation of the status and risk of deficiencies for iron, iodine, vitamin D and vitamin A separately.
 
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Metadata
Title
Adolescent girls in aquaculture ecozones at risk of nutrient deficiency in Bangladesh development and validation of an integrated metric
Authors
Eleanor Grieve
Abdullah-Al Mamun
Baukje de Roos
Benoy K. Barman
Gulshan Ara
Nanna Roos
Alexandra Pounds
Alan A. Sneddon
Francis Murray
Tahmeed Ahmed
David C. Little
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2023
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-023-15175-z

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