Contribution of Food from Market Purchases and Home Production to Child Nutrient Intake: Evidence from the EFFECTS Study Baseline Data

Background Child undernutrition is prevalent in Tanzania, and households rely primarily on local markets and home production as food sources. However, little is known about the contribution of food market purchases to nutrient intakes among children consuming complementary foods. Objective To quantify the relationships between diversity of foods purchased and produced by households and adequate child nutrient intake in Mara, Tanzania. Methods Cross-sectional baseline dietary and household food source data from the EFFECTS study (ClinicalTrials.gov: NCT03759821) were collected from mothers of 586 children aged 9-23 months clustered in 80 villages in Mara, Tanzania. We conducted mixed effects linear regressions to quantify the association between diversity of foods consumed at home, from market purchases and home production, and nutrient intake adequacy (based on 24-hour food recalls). Results Children had inadequate diets, with fewer than half of children consuming adequate amounts of vitamin A, vitamin B1 (thiamine), vitamin B2 (riboflavin), vitamin B9 (folate), calcium, iron, and zinc. Breastfeeding was associated with higher overall mean adequacy (b=0.15-0.19 across models, p<0.001). Diversity of foods purchased was positively associated with intake of vitamin B12 and calcium (both p<0.001); this effect was attenuated among breastfed children. Among non-breastfed children, production diversity was positively associated with vitamin A intake (b=0.04, p<0.05) but not with intake of other nutrients. Conclusions Both household food purchase diversity and food production diversity were positively associated with children’s nutrient intake in rural Mara, Tanzania. Nutrition programming should consider the role of food markets in addition to home food production to improve child diets. Clinical Trial Registry number NCT03759821, https://clinicaltrials.gov/study/NCT03759821