the contribution of small indigenous fish to global nutritionabstract sis fish nutrition, compare...
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The Contribution of Small Indigenous Fish to Global Nutrition
Asha Belsan, MPH-PHP Candidate, University of Massachusetts Amherst
Final Report: Cornell University Research Practicum Experience
Site Supervisor: Katie Fiorella, Postdoctoral Fellow, Cornell University
August 2016
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Abstract:
This summer, I chose to participate in a research practicum studying the impact of small
indigenous fish on global nutrition. This practicum aligns well with my overarching goal of
completing my MPH-PHP degree and Global Health Graduate Certificate, in that I want be
equipped with the skills to identify and improve health and nutrition outcomes of people on the
community and population level. Specifically for this research-based practicum, my goal was to
understand how small indigenous fish contribute to global nutrition, and how they can be utilized
in new ways to improve nutrition deficits. My practicum was done remotely in conjunction with
Cornell University and I was fortunate to be able to work on the project with two other Cornell
undergraduate students, Santana Silver and Ismini Ethridge, as well as my site supervisor, Katie
Fiorella, a Postdoctoral Fellow at Cornell. Our team performed an extensive literature review
using several databases and search terms, abstracted the data in all articles found, and is currently
in the process of analyzing the results of the collated nutrition and fishery data. This report will
serve as an update to inform our processes and methods thus far, as well as an outline for our
plan for future publication of our findings.
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Update of Aims and Rationale:
It goes without saying that there are many under-researched and under-addressed public
health issues in our world today, but one of the most significant and ongoing problems is that of
malnutrition, especially in developing countries. Approximately 13% of the population in
developing countries are malnourished, and 1 in 6 children are classified as underweight (World
Food Program, 2016). People living in poverty often consume small indigenous species (SIS)
fish, which are usually widely available and generally do not grow longer than 25 cm (9 inches)
(Galib, 2009). Despite their popularity in many countries, there is minimal information and
analysis available on the current and potential nutritive properties of these fish (Puwastien et al.
1999). Thus, the goals of this research project were to perform a literature review, identify and
abstract SIS fish nutrition, compare our data findings to the data found in the Food and
Agriculture Organization’s InFoods Database, identify gaps in the research, collate the data for
analysis, and determine how these locally available fish can be used to address nutrition issues in
developing countries. Our goals remained the same throughout the project, with the exception of
triangulating with the InFoods Database, which will be discussed in the following section.
This experience most definitely expanded my knowledge about fish nutrition in the
developing world. Though I am very interested in global nutrition, I was not very well educated
about small-scale fisheries and the consumption of SIS fish in developing countries. The
practicum has allowed me to delve into this area of research and has brought to light the
importance of identifying areas of nutritional deficit, and understanding how locally-available
SIS can be used to reduce these deficits. One of my main career goals is to be able to improve
population health outcomes while utilizing readily-available resources in an area, as opposed to
coming in with “Westernized” ideas that do not take into consideration the history and deeply
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rooted culture of a people group. Thus, I feel this research project has allowed me to learn the
foundation of information that I can now use to build my Capstone upon.
Update of Approach, Methods and Findings:
My original approaches and methods included the completion of three things: literature
review, triangulation with InFood Database, and summarizing fish nutrition. For the literature
review, we used specific words, phrases, and cabicodes to discover relevant articles on small fish
nutrient composition information and use of small fish as food in developing regions. I contacted
a librarian from UMass Amherst, who was very helpful and gave me advice on how to use
additional search tools such as Agricola to locate relevant fish nutrition information. Initially, my
goal was to find all available articles through a literature review, abstract the data, analyze the
data, and be able to report my findings and offer suggestions for nutrition improvement, all by
the end of the practicum time period. However, I soon realized that while the topic of SIS fish is
not widely researched or reported, there are still a significant number of articles available from
many databases, dating back to 1987. In addition, since the literature review is the foundation of
this project, it must be done methodically to allow for easy replication. During the literature
review, we kept an updated Google Drive spreadsheet of databases, search terms, and articles
that yielded relevant results.
The next step we planned to take was to triangulate with the InFoods Database. This is a
cumulative, ever-growing database run by the Food and Agriculture Organization that documents
nutrition information of foods from all over the world. Anyone is encouraged to contribute to the
database in order to have the most recent and thorough information available. Our original plan
was to determine whether the information we found during the literature review was present in
the InFoods databases, but upon examining the databases, this task it proved to be time-
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consuming and difficult, primarily due to some language barriers and the way the data was
presented and referenced in the tables. Thus, in the interest of time, we collectively decided to
eliminate this step and focus on data abstraction.
When relevant articles were found, we abstracted the data and categorized it into tabs
labeled “Nutrition Composition” and “Fishery and Use”. For the “Nutrition Composition”, we
extracted nutrient information from relevant tables reported within the article. Each type of fish,
processing method, and nutrient info was listed on a separate line. All relevant nutrient
composition information was entered, and the units were recorded as they were presented in the
articles. We decided to record 5 different polyunsaturated fatty acids of interest: ALA, LA,
DHA, EPA, and ARA, and decided to forgo amino acids. For “Fishery and Use”, we recorded
information about the location of the fisheries, the size of the fish, and the way they are
processed, perceived, and valued in the fisheries and communities. The conclusions of the
articles were also recorded in this document.
We came up with a total of 75 relevant articles (93 total) and listed them in a Progress
document in the Google Drive. Since there are multiple people working on this project, the
Progress document allowed everyone to view in “real time” which articles were abstracted and
which articles were not. We did find several articles that we initially though had relevant
nutrition data, but after careful reading, it was decided to omit the articles due to irrelevant
information. I was surprised at how long the data abstraction actually took, but I know it was
imperative to record the data correctly in order to conclude accurate results.
At the time this report is being written, we are finishing up the data abstraction and
entering into the data analysis stage. Our plan going forward is to write a report which will
include an abstract, introduction, methods, and results sections. We will also create summary
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tables organized by continent which will present the number of studies, fisheries, types of fish,
and nutrition content. We also plan to submit our collated findings to the WorldFish organization
for use by researchers and other interested parties. Furthermore, and what will be different
because of this practicum, is that I plan to use the practicum project as a starting point for my
capstone project next semester. Using our research as a foundation, I plan to focus on a particular
country and create a culturally-appropriate health education program to encourage consumption
of SIS fish using various cooking methods or consumption of other parts of the fish (i.e. eyes or
bones) to reduce nutrition problems such as Vitamin A deficiency and calcium deficiency. So
far, this research practicum has evolved very similarly to how I anticipated it would, and I would
not change anything about our research approach or progression.
At the beginning of this course, I chose five competencies as goals for my practicum
experience. Below is an update on my progress towards meeting those goals:
1) Describe origins of current public health and health care dilemmas: I have met this
competency. Wild, indigenous fish serve as essential nutrition to many populations across the
globe, especially in developing regions. However, the exact nutrition these fish provide is not
fully understood, due to poor and inconsistent data collection and recording. Throughout this
practicum, I was able to understand how small scale fisheries provide fish to developing regions,
and the type of nutrition these fish offer. Malnutrition is a significant issue in developing
countries, and fish can be used to address these issues with proper cooking and processing
methods.
2) Research and propose an innovative new approach to health promotion: This
competency is one of my goals for next semester. I plan to use this research project as a starting
point, and develop a culturally-appropriate health promotion program focused on improving
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major nutrition deficits in South Asia. This program will educate and encourage populations to
adopt various cooking methods and processing using under-utilized parts of these locally
available fish to improve nutrition.
3) Interpret study findings from research literature and apply that knowledge to a
public health or health care problem: I have met this goal. As part of a team, we were able to
search various databases for relevant articles related to SIS nutrition and small-scale fisheries.
We kept track of search terms, which helps us understand how fish nutrition is represented in
research.
4) Employ appropriate quantitative or qualitative methods to analyze data on a public
health or health care issue: I am in the process of meeting this goal. At the time of this report,
we are finishing up the data abstraction and moving into the data analysis phase. This analysis
will be useful to help us gain a more well-rounded understanding of the changes occurring in the
utilization of various fish species in human diets.
5) Explain the influence of environmental factors on the public’s health: This
competency is another goal for next semester. As part of my Capstone project, I plan to examine
the impact of climate, pollution, and environmental changes on fish populations, and how these
changes consequently impact fish health and reproduction.
Reflection on the Practicum:
I am pleased with the progression of my practicum experience. Given the nature of this
research project, I am planning to continue working on it to provide a foundation for my
Capstone project next semester. In addition, though the practicum time period has nearly ended,
the project’s work has not, so I feel it is only fair to continue remaining on the research team
until the project is complete. One of the best parts about this practicum was working with my
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supervisor, Katie, as well as the other students, Santana and Ismini. It was very helpful to have
them assist with the research, abstraction, and analysis, as they all have backgrounds in global
health and nutrition. It was especially beneficial to have Katie leading the team, as she provided
guidance and expertise, and facilitated communication regarding all aspects of the project.
One challenge that I encountered in this process was getting into the groove of working
remotely with other people. In the past, I have done research projects independently and have
been able to organize my articles, findings, and final report in a way that works well for me.
Working with others and seeing different approaches to even simple things such as naming a
document or creating an article citation has been challenging at times. I do not feel as organized
as I would if I were doing this project independently, but I think I have improved in being able to
identify concerns and raise questions as they come. Another challenge that became evident
during my actual research was that I had difficulty knowing when to include articles and when to
exclude articles. For the first several weeks of this project, I was using specific search terms to
find articles that gave nutrition information on small indigenous fish. I noticed the line became
gray at times when I would find articles that may (or may not) be outside of our scope of interest.
I ended up including the articles in question, with the plan that we could always throw them out
when doing data abstraction if the information was determined not to be relevant. Finally, the
timeline of the research project was challenging only because it did not completely align with the
timeline of the practicum course. Research is usually very difficult to constrain to a time frame,
as it almost always involves “charting new waters”. Thus, the research project was not completed
at the same time this course final report was due. I was hoping the data would be analyzed and I
would be able to explain our conclusions, but I dealt with this issue by working ahead on the
conclusion of a small area of our focus.
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The person that had the most impact on my practicum experience was my site supervisor,
Katie Fiorella. From the very beginning, Katie was extremely involved, and never seemed
deterred by the fact that we live in different states or that I was attending a different university.
She implemented weekly Skype meetings which began with the two of us, and then expanded to
include Santana and Ismini when they joined the project. This was very helpful to ensure
everyone was on the same page and to address issues that arose with our research, abstraction,
and data analysis. I am aware that not all site supervisors are as involved as Katie is, so I
consider myself fortunate to have her guidance and supervision on this project. In particular, I
think her open communication via weekly calls and emails have made my practicum a very
efficient and enjoyable experience.
Overall, though this practicum experience was remote and not in-person as I had
originally planned, it proved to be a rewarding and challenging experience that allowed me to
expand my knowledge in global health and nutrition.
Future Directions:
As we finish up data abstraction and move into data analysis, we will be looking for
relationships between nutrition present in locally-available fish and the types of malnutrition
present in various continents and regions. We hope to be able to address these malnutrition issues
by understanding which SIS offer high vitamin and mineral contents that address malnutrition
issues, and recommending increased production and consumption of these particular fish. To
illustrate, here is a small-scale example using the country of Bangladesh:
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Common SIS fish present in Bangladesh: (references: Bogard et al. 2015; Roos et al. 2003; Roos et al. 2007)
Common Name Scientific Name
Mola Amblypharyngodon mola
Darkina Esomus danricus
Rui Labeo rohita
Chanda Parambassis baculis
Koi Anabas testudineus
Chikra Macrognathus aculeatus
Puti Puntius sophore
Taki Channa punctuatus
Tengra Mystus vittatus
Najari Icha Macrobrachium malcolmsonii
Trey changwa plieng Esomus longimanus
Malnutrition concerns and associated illnesses/diseases:
Malnutrition Concern: Major associated Illness/Disease
Calcium Rickets (Roy et al. 2011)
Vitamin A deficiency Night blindness, infant mortality (FAO, 1999)
Iron deficiency Anemia (FAO, 1999)
Iodine deficiency Goiter (FAO, 1999)
Zinc deficiency Physical and mental development problems (FAO, 1999)
SIS fish and major nutrients present:
Fish High source of:
(for raw, edible parts)
Puti, Tengra Calcium (Roos et al. 2003))
Mola, Chanda Vitamin A (Roos et al. 2003)
Darkina Iron (Roos et al. 2003)
Najari Icha, Darkina Iodine (Bogard et al. 2015)
Trey Changwa Plieng Zinc (Roos et al. 2007)
Conclusion:
In conclusion, this practicum experience was extremely beneficial in developing my
research skills as a future public health professional. As we continue to identify and address
global health issues, research remains the foundation of effective solutions. For this project, we
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have successfully performed a systematic literature review and have been able to collate SIS
nutrition and small-scale fishery data. Going forward, we will analyze the data, summarize our
findings, and recommend ways to improve nutrition using locally-available fish. We are
confident that our research will prove to be a valuable resource for other public health
professionals, and we plan to submit our work for publication. Overall, this practicum has been a
very positive experience and I have enjoyed working with Satana and Ismini, and especially with
my advisor, Katie. Working together reiterated the importance of teamwork, communication,
thoroughness, and keeping detailed records – all of which are valuable skills of a public health
professional. I know I will be able to look back fondly on this project and I hope to be able to use
this research in my future public health career.
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References:
Bogard, J.R, Thilsted, S.H., Marks, G.C., Wahab, M.A., Hossain, M.A.R., Jakobsen, J., &
Stangoulis, J. (2015). Nutrient composition of important fish species in Bangladesh and
potential contribution to recommended nutrient intakes. Journal of Food Composition and
Analysis 42: 120–133.
Food and Agriculture Organization (FAO). (1999). Nutrition Country Profile – BANGLADESH.
Retrieved from: ftp://ftp.fao.org/es/esn/nutrition/ncp/BGDmap.pdf
Galib, S.M. (2009). Small Indigenous Species (SIS) of Fishes. BdFISH Feature. Retrieved from:
http://en.bdfish.org/2009/11/small-indigenous-species-sis-of-fishes/
Puwastien, P., Judprasong, K., Kettwan, E., Vasanachitt, K., Nakngamanong, Y., &
Bhattacharjee, L. (1999). Proximate Composition of Raw and Cooked Thai Freshwater
and Marine Fish. JOURNAL OF FOOD COMPOSITION AND ANALYSIS 12, 9-16
Roos, N., Islam, M.M., &Thilsted, S.H. (2003). Small Indigenous Fish Species in Bangladesh:
Contribution to Vitamin A, Calcium and Iron Intakes. The Journal of Nutrition, 133(11),
4021S-4026S
Roos, N., Wahab, A., Chamnan, C., & Thilsted, S. (2007). The Role of Fish in Food-Based
Strategies to Combat Vitamin A and Mineral Deficiencies in Developing Countries. The
Journal of Nutrition, 137(4), 1106-1109.
Roy, S.K., Rakib, R., Alam, N., Haque, S., Das, H.K., Ali, M., Talukder, T.H., Rahaman,
S.M.M., Chowdhury, M.A.R., Amin, S., Iqbal, M., Bhuiya, A., Khanam, M., & Begum,
A. (2011). Rickets in Bangladesh: An Emerging Public Health Nutrition Crisis. High
burden of childhood rickets in Bangladesh: The first national prevalence survey of
mineral deficiency. ICDDR,B, Bangladesh & Rickets Interest Group (RIG), Bangladesh
(UNICEF, NNP, CARE, BRAC, SARPV, Plan BD). Retrieved from:
http://www.capgan.org/downloads/2011congress/Swapan%20Roy%20rickets%20CAPG
AN%202011.pdf
World Food Program. (2016). Hunger Statistics. Retrieved on August 15, 2016 from:
https://www.wfp.org/hunger/stats
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Attachments:
Below are screenshot examples of data recorded in Google Drive: