The current study analyzed dietary diversity of various groups of household members (household, women and children), the associations between the DDS and consumption patterns, and the determinants of fish consumption among the household, women and children.
Going by the frequency of consumption, fish was most consumed animal protein in the households (96%). However, the proportion of women and children consuming fish was much lower than the household proportion; 70% and 71%, respectively. Similar to these findings, other studies in Bangladesh have found fish the most consumed animal protein (Akter et al. 2019; Belton et al. 2011). As noted by Rahman & Islam (2020), we found that meat (chicken, beef, duck, and goat) played an important dietary role. The average weekly quantity of fish consumed was lower than that of meat. Further, the weekly expenditure on meat was higher than that of fish. This is to imply that some households in the study area prefer meat to fish, despite fish being generally more affordable and more nutritious compared to other animal proteins. Higher expenditure on the more expensive animal protein may imply lack of knowledge on the nutritional importance of consuming fish or simply a preference to consume other kinds of proteins besides fish. Lack of knowledge on the nutritional of fish is a significant barrier to fish consumption (Rahman & Islam 2020). However, these findings may be due to possible underreporting of quantity and estimated prices of fish especially where the household consumed own produced fish. Although small fish are highly nutritious (Roos et al. 2003), less than half of the women and children consumed it. Bangladeshis have a preference for large fish and consider them tastier as compared to small fish (Kruijssen et al. 2021).
Organ meat was hardly consumed among women and children, indicating a big dietary gap especially among women of reproductive age. Diversity of fish species consumed was low. On average, households consumed two types of fish species mainly Rui and silver carp. Households that consumed a wide range of fish species are likely to benefit more from the dietary nutrition, because the concentration of nutritional value vary from species to species. Similar to findings in a study conducted in Rangpur city by Rahman & Islam (2020), the most consumed fish species in the study area was Rui. On the other hand, Punti was the most consumed dry fish. Low price was not the main determinant for the type of dry and fresh fish species consumed. The most affordable species was not the most consumed. Other factors such as taste and preference may have had a significant influence on species consumed (Rahman & Islam 2020).
Utilization of food and nutrition among household members is not entirely dependent on household’s food access. Other factors such as gender and age may influence the food consumed (Bogard et al. 2017). In the current study, discrimination in intra-household distribution of food and nutrition is demonstrated by the percentage of women and children who did not consume fish in households that recorded to have consumed fish. The high mean score of the households’ DDS (approximately 67%) in comparison to that of women (55%) and the MDDS of children (57.5%), points out to the effect of imbalanced distribution of nutrition especially among the vulnerable household members - women and children.
As compared to the average national household dietary diversity score (6.3) in Bangladesh in 2016 national (Mitu et al. 2022), the average HDDS in our study area was relatively high at a mean of 8.22. This implies that households were economically able to access food and consumed relatively diversified diets. However women and children recorded much lower dietary diversity scores that did not match the HDDS. Low dietary diversity scores especially among women and children have been recorded in other studies conducted in Bangladesh (Arsenault et al. 2013; Roy et al. 2021; Sinharoy et al. 2018; Harris-Fry et al. 2015). Low dietary diversity implies risks of nutritional deficits illnesses and diseases such as anemia, cardiovascular diseases, night blindness among others (Mellendick et al. 2018). Complementary feeding practices in the study area were suboptimal. Although almost all the children were breast fed, 43% did not achieve the minimum dietary diversity scores. Without the required minimum dietary diversity, children are at the risk of diarrheal episodes, stunting, being underweight, wasting among other nutrient deficiency related illnesses and diseases (Sheikh et al. 2020).
Fish consumption was correlated with higher dietary diversity scores for households, women and children was strongly. Similarly, fish farming was positively correlated with women and households DDS. Gibson et al. (2020), noted that children who consumed fish in Bangladesh had 5 times more chances of having an adequate dietary diversity than those who did not. Similarly, Yilma et al. (2020) reported that women in fish farming household in Ethiopia had higher DDS as compared to their counterparts in non-fish farming households. The number of fish species consumed was found to have a positive correlation with dietary diversity among households, women and children. Consumption of different fish species provide higher chances for dietary intake, given that different fish species contain varying nutrient composition (Farmery et al. 2018; Bogard et al. 2015).
Location was a determinant of fish consumption among households and women. In line with our findings, Onumah et al. (2020), found city of residence to influence fish consumption informed. Similarly, Traoré et al. (2018) noted that location of respondents’ residence may determine fish availability, consequently influencing fish consumption.
Own production was the most common source of the fresh fish consumed, followed by the market. Regression results indicate that in households where fish farming was practiced, women and other household members were likely to consume fish than those in non-fish farming households. This is mostly due to availability of fish within the households, which promote direct consumption (Nguka et al. 2017; Akuffo & Quagrainie 2019). Daba et al. (2021) reports that livestock keeping is associated with consumption of animal source proteins. In Rangpur and Rajshahi divisions, a wide range of fish species are produced in ponds for home consumption and for sale in the local markets (Kruijssen et al. 2021), giving the households an opportunity to grow their preferred fish species, hence increasing consumption. Consuming other types of animal protein was associated with lower likelihood of consuming fish, as indicated in the household and women regressions. This is a clear indication that households in Rangpur and Rajshahi divisions substituted consumption of fish with other animal proteins (milk, eggs and meat). As opined by Rahman & Islam (2020), meat and chicken play an important role in dietary preference of Bangladeshis.
Additional year in the education of the person in charge of preparing meals was associated with a decrease in fish consumption. Contrary, higher levels of formal education was found to influence consumption of eggs in Ethiopia (Daba et al. 2021). Increase in formal education may be associated with rise in status. Given that fish is a commonly consumed food in Bangladesh, increase in formal education may influence consumers’ preference and consumption of the less common types of animal protein such as chicken. While analyzing the socioeconomics of fish consumption and child health in Bangladesh, Dasgupta et al. (2021) reported similar findings. Dasgupta et al. (2021) highlights that higher levels of formal education among mothers introduced a status bias towards eggs and meat, reducing children’s’ fish consumption.
A unit increase in fish prices was found to increase the odds of fish consumption in the households and among women but not for children fish consumption models. As noted in the previous section in this paper, the lowest priced fish species (African Magur) which cost BDT 100 was not the most commonly consumed fish. Instead, Japani rui which cost BDT 139 was the most consumed fish species. This may due to the general affordability and availability of fish in Bangladesh, enabling the households in Rajshahi and Rangpur divisions to consume preferred fish types that are not the cheapest. These counterintuitive findings may also imply that in the two divisions, increase in price of fish is associated with increase in quality. Similar findings from Rangpur are reported by Hoque et al. (2021) whose study indicates a positive relationship between price and the possibility of choosing farmed shrimp. However, contradicting findings are reported by Cornelsen et al. (2016), who noted that reduction of fish prices in Kenya would increase demand. Although price is a fundamental factor in determining consumption, the economic insight that low prices increases consumption, does not always hold true. As reported by Akter et al. (2019), Hoque et al. (2021), Rahman & Islam, (2020) and Onumah et al. (2020), taste, all year availability and quality are also strong determinants of fish consumption.
Increase in distance to the market was found to increase the odds of fish consumption. Contrary to our findings, John et al. (2021) found that shorter distance to the market increased access and consumption of pulses in India. Our finding may be explained by the possibility of households’ strong preference and choice to consume fish species that were not available in nearby local markets. Some consumers may prefer going to markets with a large variety of fish, as noted by Kruijssen et al. (2021), and these markets may not always be the closest.
Age and size of household size increased the odds of fish consumption among children. Thorne-Lyman et al. (2017) noted that in Bangladesh, meat and fish are not common in infants’ diets but increases with age. The authors explain that presence of bones in fish was a major barrier to incorporating fish in the children’s diet. Other reasons for delayed incorporation of fish in children’s diet include care giver cultural beliefs and fear of allergies and illnesses (Gibson et al. 2020; Cartmill et al. 2022). The number of household members could increase the probability of fish availability hence the higher odds of child’s fish consumption.