New strategies to reduce anaemia and risk of overweight and obesity through complementary feeding of infants and young children in Peru

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Peru is experiencing rapid change with progressive economic development and increasing migration to cities. Dietary habits and health are also changing. Infants and children are getting taller but also getting heavier. In the last 10 years there have been significant increases in overweight and obesity among children, adolescents and adults. At the same time, however, the diets of infants and young children aged 6-23 months do not contain enough micronutrients (essential vitamins and minerals), particularly iron. Despite good provision of dietary supplements (micronutrient supplements including iron) to women and young children through national health services, there is still a high prevalence of anaemia (a deficiency of red cells or haemoglobin in blood) caused by iron and other micronutrient deficiencies. New strategies are required to address these two dietary problems of anaemia and overweight/obesity. An underlying driver of these two nutritional challenges is the consumption of foods that are high in energy and low in nutrients. Infant feeding is a critical time for health because the nutrition and growth of infants has a significant effect on health in childhood, adolescence and adulthood. A lack of research and poor understanding of the multiple factors influencing infant and young child feeding is a barrier to improving nutrition and health. This project will take a holistic approach to identifying the factors that drive food consumption in infants and young children in Peru, particularly the role of caregivers and families, communities and local neighbourhoods (health facilities and daycare facilities). There is a need for stronger evidence that accounts for the environments that people live in to inform strategies to promote healthier feeding of infants and young children. Our project will use novel methods and adopt a holistic approach to examine infant and young child feeding in two peri-urban centres reflecting different ecologies of coastal Lima and highland Huánuco. As well as understanding infant feeding patterns and practices, we will organise community-based participatory workshops to identify solutions to the identified challenges of healthy complementary feeding. The workshops will lead to prototypes for solutions (interventions) to improve infant and young child nutrition which will be piloted in the local community.Compliance with Official Development Assistance This project addresses SDG2: reduce hunger and malnutrition and ensure children have access to sufficient and nutritious food; and SDG3: ensure healthy lives and wellbeing. Optimal infant and child feeding is critical for healthy growth and development and to prevent lifelong disparities in health. In Peru, peri-urban households with lower socio-economic status are at significant risk of nutrient-poor diets that are also high in energy. This increases the risk of overweight and diet-related non-communicable disease over the lifecourse. The Peruvian Ministry of Health has invested in national programmes to reduce anaemia and to promote healthy complementary feeding practices, however, this has not yet achieved substantial reductions in anaemia and novel, more holistic, strategies are needed. This study will therefore work with the peri-urban populations in Lima and Huánuco to develop tailored strategies to improve infant and young child feeding. The work will benefit children, families, local communities, health services, regional and national health authorities whilst informing local and national policies.