Cancer incidence in Nigeria from 2009 to 2013

Background: 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, inNairobi, 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 longterm, problems that tend to be perpetuated in subsequent generations. Animal-source foods (ASF) supply a calorically dense source of microand macronutrients, and supplementation with ASF has been shown to improve linear growth and cognition. Correspondingly, increasing consumption ofASF by pregnant women and children has been proposed as ameans to disrupt the intergenerational cycle of undernutrition causedby food insecurity. Our objective was to review the literature regarding the dietary benefits and accessibility of ASF for the urban poor in subSaharan Africa, and to identify knowledge gaps relevant to improving health outcomes through increased consumption of ASF. Methods: Our review is based predominantly on studies from Kibera and greater Nairobi. Data was derived from peer-reviewed publications whenever possible. Findings: In Nairobi, 80% of the lowest income quintile is food insecure. Observational studies indicate that consumption of ASF is positively associated with increased weight gain in pregnancy, increased birth weight and length, postnatal infant growth, linear growth in toddlers, better cognitive outcomes, and improved physical activity levels. Despite the availability of ASF in local markets, however, the urban poor consume only 75% of the FAO’s recommended minimum animal protein consumption per year. This supports that low purchasing power is a major impediment to ASF consumption. Economic data derived from household surveys in Nairobi indicates that ASF are both income and price elastic; the demand for ASF increases disproportionately with increases in income or decreases in price. Lastly, analysis of ASF value-chains revealed that the lowest income consumers purchase food from smaller retail outlets where meat and eggs are sold in larger, indivisible quantities. This precludes many from the regular purchase of ASF due to the restrictive cost. While strong evidence exists for the role of increased consumption of ASF in promoting maternal and child health, there are multiple gaps in our knowledge regarding the minimal levels of specific ASF required for healthy development in the nutritional and environmental context of crowded urban settlements. In addition, understanding which public policies and private market actions improve or jeopardize food security provide opportunities to implement change. Interpretation: Increased consumption of ASF would decrease child stunting in the urban informal settlements, and near-term interventions are possible because ASF are readily available in local markets. Addressing the identified knowledge gaps will provide new opportunities to develop, implement, and assess interventions, including market and policy changes. Funding: No funding was required for this research. Abstract #: 01NCD012