Fish and Fish-Based Products for Nutrition and Health in the First 1000 Days: A Systematic Review of the Evidence from Low and Middle-Income Countries.

Fish provide essential nutrients for the critical window of growth and development in the first 1000 d of life and are thus an attractive option for inclusion in nutrition-sensitive and nutrition-specific programming. We conducted a systematic review of the evidence for fish and fish-based products for nutrition and health outcomes during the first 1000 d of life in low- and middle-income countries, searching the peer-reviewed and gray literature from 1999 to 2020. Databases included PubMed, Web of Science, Embase, ProQuest, and the Clinical Trials repository. Our search returned 1135 articles, 39 of which met the inclusion criteria. All studies were dual evaluated for risk of bias. Of the included studies, 18 measured maternal health and nutrition outcomes and 24 measured infant/child outcomes (3 measured both). Our search uncovered 10 impact evaluations, all of which measured consumption of fish or fish-based complementary food products in children aged 6-24 mo. We did not find strong evidence for fish consumption in children improving child growth from the impact evaluations; however, the studies were highly heterogeneous in their design and likely underpowered to detect an effect. Results from observational studies were mixed but provided evidence that adding fish to maternal and child diets is associated with improved nutrition outcomes, such as reducing the risk of anemia and improving vitamin D status. Given the nutrient richness of fish and the fact that production is often more environmentally friendly as compared with other animal source foods, more robust evidence is needed on the role of fish consumption in nutrition interventions to inform policy and programming recommendations in low- and middle-income countries.

Multiple impact pathways of the 2015-2016 El Niño in coastal Kenya.

The 2015-2016 El Niño had large impacts globally. The effects were not as great as anticipated in Kenya, however, leading some commentators to call it a 'non-event'. Our study uses a novel combination of participatory Climate Vulnerability and Capacity Analysis tools, and new and existing social and biophysical data, to analyse vulnerability to, and the multidimensional impacts of, the 2015-2016 El Niño episode in southern coastal Kenya. Using a social-ecological systems lens and a unique dataset, our study reveals impacts overlooked by conventional analysis. We show how El Niño stressors interact with and amplify existing vulnerabilities to differentially impact local ecosystems and people. The policy significance of this finding is that the development of specific national capacities to deal with El Niño events is insufficient; it will be necessary to also address local vulnerabilities to everyday and recurrent stressors and shocks to build resilience to the effects of El Niño and other extremes in climate and weather.