The Role of Animal Source Foods in Improving Nutritional Health in Urban Informal Settlements: Identification of Knowledge Gaps and Implementation Barriers

Authors

  • Allison E. James Paul G. Allen School for Global Animal Health, Washington State University, PO Box 647040, Pullman, WA 99164-7040, USA
  • Guy H. Palmer Paul G. Allen School for Global Animal Health, Washington State University, PO Box 647040, Pullman, WA 99164-7040, USA

DOI:

https://doi.org/10.6000/1929-4247.2015.04.02.5

Keywords:

Maternal health, Child malnutrition, Undernutrition, Food security, Informal urban settlements.

Abstract

Childhood undernutrition is a health crisis in the rapidly expanding informal settlements of low-income countries worldwide. Nearly half of Kenyan children in the Kibera settlement, in Nairobi, were reported to be stunted, indicating low height-for-age. Stunted children are at greater risk for poor cognitive and physical health outcomes in the long-term, problems that tend to be perpetuated in subsequent generations. Animal-source foods (ASF) supply a calorically dense source of micro- and macronutrients, and supplementation with ASF has been shown to improve linear growth and cognition. Correspondingly, increasing consumption of ASF by pregnant women and children has been proposed as a means to disrupt the intergenerational cycle of undernutrition caused by food insecurity. Household surveys indicate that consumption of ASF is low in urban slums, despite the availability of these foods in local markets. Here we review the studies addressing the role of ASF in the diets of the urban poor and identify knowledge gaps relevant to improving nutrition by increasing consumption of ASF. Based predominantly on studies in Kibera and greater Nairobi, these gaps include determining the minimal amount and frequency of dietary ASF to prevent stunting, defining how consumer preferences, markets, and income interact to impede or promote ASF consumption, and understanding the interaction between diet and both clinical and sub-clinical enteric disease on growth outcomes.

References

United Nations. World urbanization prospects: The 2011 revision. New York: UN-DESA; 2012.

United Nations. The challenge of the slums: Global report on human settlements 2003. Nairobi: UN-HABITAT; 2003.

Mohiddin L, Phelps L, Walter T. Urban malnutrition: A review of food security and nutrition among the urban poor United Kingdom: Nutrition Works; 2012 [cited 12 July 2014]. Available from: http://www.alnap.org/resource/8602.

Kenya National Bureau of Statistics. County population 2010 [cited 11 July 2014]. Available from: https://www.knbs.or.ke/ index.php.

United Nations. Nairobi urban sector profile. Nairobi: UN-HABITAT; 2006.

Mutisya E, Yarime M. Understanding the grassroots dynamics of slums in Nairobi: The dilemma of Kibera informal settlements. Int Trans J Eng Manag Sci Tech 2011; 2: 197-213.

The World Bank. Urban population growth (Kenya) 2012 [cited 11 July 2014]. Available from: http://search.worldbank. org.

Zulu EM, Beguy D, Ezeh AC, et al. Overview of migration, poverty and health dynamics in Nairobi City's slum settlements. J Urban Health 2011; 88 (Suppl 2): S185-99. http://dx.doi.org/10.1007/s11524-011-9595-0

Olack B, Burke H, Cosmas L, et al. Nutritional status of under-five children living in an informal urban settlement in Nairobi, Kenya. J Health Popul Nutr 2011; 29: 357-63. http://dx.doi.org/10.3329/jhpn.v29i4.8451

Kenya National Bureau of Statistics (KNBS), ICF Macro. Kenya demographic and health survey 2008-09. Calverton, MD: KNBS and ICF Macro; 2010. Available from: http://dhsprogram.com/pubs/pdf/fr229/fr229.pdf.

Lewit EM, Kerrebrock N. Population-based growth stunting. Future Child 1997; 7: 149-56. http://dx.doi.org/10.2307/1602393

Black RE, Allen LH, Bhutta ZA, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008; 371: 243-60. http://dx.doi.org/10.1016/S0140-6736(07)61690-0

United Nations. Improving child nutrition: The achievable imperative for global progress. New York: UNICEF; 2013.

Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO estimates of the causes of death in children. Lancet 2005; 365: 1147-52. http://dx.doi.org/10.1016/S0140-6736(05)71877-8

Black RE, Victora CG, Walker SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013; 382: 427-51. http://dx.doi.org/10.1016/S0140-6736(13)60937-X

Moore SE, Jalil F, Ashraf R, Szu SC, Prentice AM, Hanson LA. Birth weight predicts response to vaccination in adults born in an urban slum in Lahore, Pakistan. Am J Clin Nutr 2004; 80: 453-9.

Victora CG, Adair L, Fall C, et al. Maternal and child undernutrition 2 - Maternal and child undernutrition: consequences for adult health and human capital. Lancet 2008; 371: 340-57. http://dx.doi.org/10.1016/S0140-6736(07)61692-4

Gewa CA. Childhood overweight and obesity among Kenyan pre-school children: association with maternal and early child nutritional factors. Public Health Nutr 2010; 13: 496-503. http://dx.doi.org/10.1017/S136898000999187X

Schonfeldt HC, Gibson Hall N. Dietary protein quality and malnutrition in Africa. Br J Nutr 2012; 108 (Suppl 2): S69-76.

Neumann C, Harris DM, Rogers LM. Contribution of animal source foods in improving diet quality and function in children in the developing world. Nutr Res 2002; 22: 193-220. http://dx.doi.org/10.1016/S0271-5317(01)00374-8

Muller O, Krawinkel M. Malnutrition and health in developing countries. Can Med Assoc J 2005; 173: 279-86. http://dx.doi.org/10.1503/cmaj.050342

Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. Lancet 2007; 369: 60-70. http://dx.doi.org/10.1016/S0140-6736(07)60032-4

Alderman H. Long term consequences of early childhood malnutrition. Oxford Econ Pap 2006; 58: 450-74. http://dx.doi.org/10.1093/oep/gpl008

Heltberg R. Malnutrition, poverty, and economic growth. Health Econ 2009; 18 (Suppl 1): S77-88.

Strauss J, Thomas D. Health, nutrition, and economic development. J Econ Lit 1998; 36: 766-817.

Fogel RW. Health, nutrition, and economic growth. Econ Dev Cult Change 2004; 52: 643-58. http://dx.doi.org/10.1086/383450

World Health Organization. Food security [cited 26 June 2014]. Available from: http://www.who.int/trade/glossary/ story028/en/.

Kamau M, Githuku J, Olwande J. Food security in urban households: An analysis of the prevalence and depth of hunger in Nairobi and its relationship to food expenditure (WPS 41/2011b) Nairobi, Kenya: Tegemeo Institute of Agricultural Policy and Development; 2011. Available from: http://tegemeo.org/.

Kamau M, Olwande J, Githuku J. Consumption and expenditures on key food commodities in urban households: The case of Nairobi (WPS 41/2011a) Nairobi, Kenya: Tegemeo Institute of Agricultural Policy and Development; 2011. Available from: http://tegemeo.org/.

Allen LH. Nutritional influences on linear growth: a general review. Eur J Clin Nutr 1994; 48 (Suppl 1): S75-89.

Neumann CG, Bwibo NO, Murphy SP, 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 2003; 133(Suppl 2): 3941S-9S.

Neumann CG, Murphy SP, Gewa C, Grillenberger M, Bwibo NO. Meat supplementation improves growth, cognitive, and behavioral outcomes in Kenyan children. J Nutr 2007; 137: 1119-23.

Whaley SE, Sigman M, Neumann C, et al. The impact of dietary intervention on the cognitive development of Kenyan school children. J Nutr 2003; 133: 3965s-71s.

Grillenberger M, Neumann CG, Murphy SP, et al. Food supplements have a positive impact on weight gain and the addition of animal source foods increases lean body mass of Kenyan schoolchildren. J Nutr 2003; 133: 3957s-64s. http://dx.doi.org/10.1079/BJN20051641

Grillenberger M, Neumann CG, Murphy SP, et al. Intake of micronutrients high in animal-source foods is associated with better growth in rural Kenyan school children. Br J Nutr 2006; 95: 379-90.

Murphy SP, Allen LH. Nutritional importance of animal source foods. J Nutr 2003; 133: 3932s-5s.

Hurrell RF. Influence of vegetable protein sources on trace element and mineral bioavailability. J Nutr 2003; 133: 2973s-7s.

Gibson RS. Content and bioavailability of trace-elements in vegetarian diets. Am J Clin Nutr 1994; 59: S1223-S32.

Ettarh R, Van de Vijver S, Oti S, Kyobutungi C. Overweight, obesity, and perception of body image among slum residents in Nairobi, Kenya, 2008-2009. Prev Chronic Dis 2013; 10: E212.

Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr 2006; 84: 289-98.

Ziraba AK, Fotso JC, Ochako R. Overweight and obesity in urban Africa: A problem of the rich or the poor? BMC Public Health 2009; 9: 465. http://dx.doi.org/10.1186/1471-2458-9-465

van 't Riet H, den Hartog AP, Mwangi AM, Mwadime RK, Foeken DW, van Staveren WA. The role of street foods in the dietary pattern of two low-income groups in Nairobi. Eur J Clin Nutr 2001; 55: 562-70. http://dx.doi.org/10.1038/sj.ejcn.1601183

Steyn NP, Nel JH, Parker WA, Ayah R, Mbithe D. Dietary, social, and environmental determinants of obesity in Kenyan women. Scand J Public Health 2011; 39: 88-97. http://dx.doi.org/10.1177/1403494810384426

Gamba P. Urban domestic consumption patterns for meat: Trends and policy implications (WP 17/2005) Nairobi, Kenya: Tegemeo Institute of Agricultural Policy and Development; 2005. Available from: http://tegemeo.org/.

Argwings-Kodhek G, M'mboyi G, Muyanga M, Gamba P. Consumption patterns of dairy products in Kenya's urban centres: Report from an urban household survey (WP 18/2005) Nairobi, Kenya: Tegemeo Institute of Agricultural Policy and Development; 2005. Available from: http://tegemeo.org/.

Food and Agriculture Organization of the United Nations. Meat consumption [cited 31 July 2013]. Available from: http://www.fao.org/ag/againfo/themes/en/meat/background.html.

Michelson H, Lentz EC, Mulwa R, et al. Cash, food, or vouchers in urban and rural Kenya? An application of the market information and food insecurity response analysis framework: SSRN; 2011. http://dx.doi.org/10.2139/ssrn.1844594

Kenya Food Security Steering Group (KFSSG). The 2008/'09 short-rains season assessment report: KFSSG; 2009. Available from: http://reliefweb.int/sites/reliefweb.int/files/ resources/828585AE5D12C0CF492575800027F6AA-Full_Report.pdf.

Andreyeva T, Long MW, Brownell KD. The impact of food prices on consumption: a systematic review of research on the price elasticity of demand for food. Am J Public Health 2010; 100: 216-22. http://dx.doi.org/10.2105/AJPH.2008.151415

Musyoka MP, Lagat JK, Ouma DE, Wambua T, Gamba P. Structure and properties of urban household food demand in Nairobi, Kenya: implications for urban food security. Food Sec 2010; 2: 179-93. http://dx.doi.org/10.1007/s12571-010-0063-6

Pinstrup-Anderson P. Food prices and the poor in developing countries. Euro R Agr Eco 1985; : 69-85.

Food and Agriculture Organization of the United Nations. The state of food insecurity in the world, 2008. Rome: FAO, 2008. http://dx.doi.org/10.1007/s11524-011-9594-1

Bett HK, Musyoka MP, Peters KJ, Bokelmann W. Demand for meat in the rural and urban areas of Kenya: A focus on the indigenous chicken. Economics Res Int [Internet]. 2012; Article ID 401472:[10 p.]. http://dx.doi.org/10.1155/2012/401472

Juma GP, Ngigi M, Baltenweck I, Drucker AG. Consumer demand for sheep and goat meat in Kenya. Small Ruminant Res 2010; 90: 135-8. http://dx.doi.org/10.1016/j.smallrumres.2009.12.002

Emina J, Beguy D, Zulu EM, et al. Monitoring of health and demographic outcomes in poor urban settlements: evidence from the Nairobi Urban Health and Demographic Surveillance System. J Urban Health 2011; 88 (Suppl 2): S200-18.

Fiszbein A, Schady N. Conditional cash transfers; Reducing present and future poverty. Washington, D.C.: The World Bank, 2009. http://dx.doi.org/10.1596/978-0-8213-7352-1

Allen LH. The nutrition Crsp: What is marginal malnutrition, and does it affect human function? Nutr Rev 1993; 51: 255-67. http://dx.doi.org/10.1111/j.1753-4887.1993.tb03117.x

Satterthwaite D. The under-estimation of urban poverty in low and middle-income nations (WP 14) London, UK: UK Department for International Development; 2004. Available from: http://pubs.iied.org/9322IIED.html.

Brown KH. Diarrhea and malnutrition. J Nutr 2003; 133: 328s-32s.

Guerrant RL, Oria RB, Moore SR, Oria MO, Lima AA. Malnutrition as an enteric infectious disease with long-term effects on child development. Nutr Rev 2008; 66: 487-505. http://dx.doi.org/10.1111/j.1753-4887.2008.00082.x

Dewey KG, Mayers DR. Early child growth: How do nutrition and infection interact? Matern Child Nutr 2011; 7 (Suppl 3): 129-42. http://dx.doi.org/10.1111/j.1740-8709.2011.00357.x

African Population and Health Research Center (APHRC). Population and health dynamics in Nairobi's informal settlements: Report of the Nairobi Cross-sectional Slums Survey (NCSS) 2012 Nairobi: APHRC; 2014. Available from: http://aphrc.org/wp-content/uploads/2014/08/NCSS2-FINAL-Report.pdf.

Rice AL, Sacco L, Hyder A, Black RE. Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries. B World Health Organ 2000; 78: 1207-21.

Moore SR, Lima AA, Conaway MR, Schorling JB, Soares AM, Guerrant RL. Early childhood diarrhoea and helminthiases associate with long-term linear growth faltering. Int J Epidemiol 2001; 30: 1457-64. http://dx.doi.org/10.1093/ije/30.6.1457

Richard SA, Black RE, Gilman RH, et al. Diarrhea in early childhood: short-term association with weight and long-term association with length. Am J Epidemiol 2013; 178: 1129-38. http://dx.doi.org/10.1093/aje/kwt094

Korpe PS, Petri WA, Jr. Environmental enteropathy: critical implications of a poorly understood condition. Trends Mol Med 2012; 18: 328-36. http://dx.doi.org/10.1016/j.molmed.2012.04.007

Keusch GT, Rosenberg IH, Denno DM, et al. Implications of acquired environmental enteric dysfunction for growth and stunting in infants and children living in low- and middle-income countries. Food Nutr Bull 2013; 34: 357-64.

Bhutta ZA, Ahmed T, Black RE, et al. What works? Interventions for maternal and child undernutrition and survival. Lancet 2008; 371: 417-40. http://dx.doi.org/10.1016/S0140-6736(07)61693-6

Darapheak C, Takano T, Kizuki M, Nakamura K, Seino K. Consumption of animal source foods and dietary diversity reduce stunting in children in Cambodia. Int Arch Med 2013; 6: 29. http://dx.doi.org/10.1186/1755-7682-6-29

Krebs NF, Mazariegos M, Tshefu A, et al. Meat consumption is associated with less stunting among toddlers in four diverse low-income settings. Food Nutr Bull 2011; 32: 185-91.

McKay S, Gaudier E, Campbell DI, Prentice AM, Albers R. Environmental enteropathy: new targets for nutritional interventions. Int Health 2010; 2: 172-80. http://dx.doi.org/10.1016/j.inhe.2010.07.006

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Published

2015-06-01

How to Cite

James, A. E., & Palmer, G. H. (2015). The Role of Animal Source Foods in Improving Nutritional Health in Urban Informal Settlements: Identification of Knowledge Gaps and Implementation Barriers. International Journal of Child Health and Nutrition, 4(2), 94–102. https://doi.org/10.6000/1929-4247.2015.04.02.5

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General Articles