The socioeconomics of fish consumption and child health: An observational cohort study from Bangladesh

Abstract Malnutrition is a lead contributor to the global burden of disease, with undernutrition accounting for nearly half of all deaths in children under five in Asia and Africa. Given the health benefits of fish-intensive diets, this study investigates the potential of fish consumption for alleviating malnutrition. This observational cohort study is from Bangladesh, where child malnutrition exceeds the World Health Organization’s threshold for public-health emergencies. More than 36,000 records from successive Bangladesh Demographic and Health Surveys are analyzed to explore the socioeconomic determinants of household consumption of all animal-source foods and fish consumption specifically, as well as the impact of observed consumption patterns on mortality and childhood resistance to infectious diseases. Child health outcomes are studied using regression models adjusted for annual fish price fluctuations, household income, maternal education, and gender. The results indicate that increased animal-source food intake is significantly associated with maternal education and family economic status; however, these variables are associated with a lower share of fish intake. This suggests that increased income and education impart a “status bias” toward eggs and meat, even though fish is less expensive and more beneficial for child health. Also, mothers’ animal-source food preferences and the seasonal availability of fish during pre- and post-partum periods significantly affect child mortality and resistance to several common childhood illnesses. Overall, the findings highlight the importance of programs to increase fish supply to poor households and expand appropriate nutrition education.