CHAPTER 3

Nutritional and health issues in

Bangladesh and solutions through
traditional foods
S.
1
M. Nazmul Alam1 and M. Niamul Naser2
Department of Social Sciences, Faculty of Humanities, Curtin University, Perth, WA, Australia
2
Department of Zoology, Faculty of Biological Sciences, University of Dhaka, Dhaka, Bangladesh

Contents
3.1 Introduction 237
3.2 Nutritional and health status in Bangladesh 238
3.3 Malnutrition 240
3.4 Traditional beliefs and practices: food and health 242
3.4.1 Food taboos versus food allergy 242
3.4.2 Traditional wisdom: Khanar Bachan 243
3.4.3 Common food items of traditional beliefs 244
3.5 National guidelines for food intake 244
3.5.1 Proportion of food in a healthy diet 245
3.5.2 Food guide pyramid 245
3.5.3 Physical exercise 245
3.6 Solutions through traditional foods 247
3.7 Future outlooks 250
3.8 Conclusion 251
References 252

3.1 Introduction
Bangladesh is a small country of 147,570 km2 with an estimated population of
164.7 million (World Data Atlas, 2018; World Bank, 2019). Almost one in four
Bangladeshis (24.3% of the population) lives in poverty, and 12.9% of the population
live in extreme poverty line (BBS, 2017). This indicator perceptibly affects the nutri-
tional sketch of Bangladesh. Although starvation and famine are related to the question
of the general decline of food availability, they are also linked to the entitlements and
deprivations (Sen, 1981). The people of deltaic Bangladesh are exposed to various
types of climatic vulnerabilities such as flood (34.48%), drought (14.80%), water-
logging (13.88%), cyclone (21.31%), tornado (4.14%), storm/tidal surge (8.65%),
river/coastal erosion (4.95%), landslides (0.08%), salinity (4.09%), hailstorms (11.88%),

Nutritional and Health Aspects of Food in South Asian Countries r 2020 Elsevier Inc.
DOI: https://doi.org/10.1016/B978-0-12-820011-7.00026-5 All rights reserved. 237
238 Nutritional and Health Aspects of Food in South Asian Countries

thunderstorm (14.94%), and others (7.90%) (BBS, 2016). These further affect the
agriculture production, socioeconomic status, and household status of rural Bangladesh,
which is detrimental to the nutritional security of poor households. Bangladesh has
emerged from being a chronic food deficit country after the war in 1971 with a broken
economy, dismantled infrastructure, and repatriation of the people in the country after
the liberation. The population of the country has reached more than double in the last
few decades, and food such as rice and fish production have been accelerating parallel to
the population growth. Bangladesh has attained food self-sufficiency at the aggregate
level in attaining calorie security. The per capita calorie intake was 2318 kcal/day in
2010, which is comfortably higher than the estimated minimum requirement of
2122 kcal/day (Osmani et al., 2016). However, the nutritional situation differed recently
in Bangladesh depending upon factors such as policy, disaster, and poverty level.

3.2 Nutritional and health status in Bangladesh

Nutrition and food are among the basic needs of every human being. Agriculture
remains a primary source of energy and nutrients for the Bangladeshi population. The
nutritional status of Bangladesh can be visualized by the food and calorie intake data
of the country. Rice, vegetables, and fish are the preferred items in the daily diets of
the population. Dietary diversity has improved, along with a significant reduction of
rice intake from 416.01 g in 2010 to 367.19 g in 2016 (Table 3.1). Rural people con-
sumed more rice (386.09 g/day) than urban people (316.7 g/day) in 2016 (Table 3.2).
Fish intake has increased from 49.41 g in 2010 to 62.58 g in 2016, which is above the
desirable dietary intake pattern (60 g; BIRDEM, 2013). Although the consumption of
pulses, meat, and eggs had increased in 2016, they are still far below the desirable

Table 3.1 Food (g/person/day) intake: 2016 and 2010 HIES in Bangladesh.
Foods HIESa 2016 HIES 2010
Rice 367.19 416.01
Wheat 19.83 26.09
Pulse 15.6 14.3
Vegetables 167.3 166.08
Fish 62.58 49.41
Meat 25.42 19.07
Egg 13.58 7.25
Milk 27.31 33.72
Fruit 35.78 44.8
a
Household Income and Expenditure Survey.
Source: BBS, 2017. Bangladesh Bureau of Statistics. Preliminary Report on Household Income and Expenditure Survey
2016. Ministry of Planning, Government of Bangladesh, 149 pp.
 Nutritional and health issues in Bangladesh and solutions through traditional foods 239

Table 3.2 Food (g/person/day) intake: rural versus urban people in 2016.
Foods Rural Urban
Rice 386.09 316.7
Wheat 17.44 26.22
Pulse 15.12 16.88
Vegetables 164.78 174.06
Fish 60.59 67.91
Meat 22.32 30.04
Egg 12.73 15.85
Milk 26.29 30.04
Fruit 32.24 45.23

Table 3.3 Calorie (kcal/capita/day) intake: rural versus urban people in 2016 and 2010.
Year Rural Urban Total
2016 2240.2 2130.7 2210.4
2010 2344.6 2244.5 2318.3
Source: BBS, 2017. Bangladesh Bureau of Statistics. Preliminary Report on Household Income and Expenditure Survey
2016. Ministry of Planning, Government of Bangladesh, 149 pp.

dietary pattern. Consumption of milk has declined from 33.72 g in 2010 to 27.31 g in
2016 (Table 3.1). The intake of vegetables has increased since 2010 (166.08 g),
although it is far away from the reaches of the FAO/WHO recommendations (400 g/day).
The overall daily food intake by the rural people is lower than the food intake by the
urban people (Table 3.2). The trends of food consumption score levels are widespread
across the country.
The per capita calorie intake in 2016 was 2210.4 kcal/day, which was lower than
2010 per capita consumption (Table 3.3) and was comfortably higher than the esti-
mated minimum requirement of 2122 kcal/day (BBS, 2017).
Similarly, the calorie intake level is higher in rural areas than in urban areas if the
consumption is estimated separately. The per capita protein intake in 2016 was
63.80 g with the consumption being higher among the urban people (65.00 g/person/
day) than the rural people (63.30 g/person/day) (BBS, 2017). It is evident that rural
people consume less food than urban people due to the affordability and availability of
the products.
The agricultural and food systems including livestock and fisheries are being
strengthened to contribute adequately and efficiently toward meeting the dietary and
nutritional needs of the population. The nutrition-related activities and policies of
Bangladesh have focused on the increased production on meeting the nutrition
required for the growing population of the country.
240 Nutritional and Health Aspects of Food in South Asian Countries

On the human development index for the year 2018, Bangladesh has been placed
at the 136th position among 187 countries. Bangladesh scored 0.608 on the index
with 72.8 years of life expectancy at birth, multidimensional poverty index of 0.194,
and $3677 per capita gross national income (UNDP, 2019).
Bangladesh has a top-ranking position among the countries that provide free medi-
cal services to the people at the community level through various public health facili-
ties. The primary healthcare is provided through an extensive network of health
facilities extending down to the community level with upward referral linkage.

3.3 Malnutrition
Humans require energy, protein, vitamins, and minerals to reach their full physical,
mental, and cognitive potential that results from consuming nutrient-rich food. Lack
of awareness regarding the importance of nutrition and traditional food preparation
and consumption patterns have led to decreased nutrient retention contributing to
malnutrition. Children and women in Bangladesh suffer from high levels of malnutrition
and micronutrient deficiencies such as low birth weight, undernutrition (underweight,
stunting, and wasting), vitamin A deficiency, iodine-deficiency disorders, iron-deficiency
anemia, and overweight being a significant emerging issue.
Tragically, the rates of malnutrition in Bangladesh are among the highest in the
world. More than 54% of preschool-aged children, equivalent to more than 9.5 million
children, are stunted, 56% are underweight, and more than 17% are wasted (FAO,
2019). All administrative divisions of Bangladesh were affected by child malnutrition.
However, some differences in the prevalence of three anthropometric indicators exist.
The prevalence of underweight ranged from 49.8% in Khulna to 64.0% in Sylhet, which
also showed the highest incidence of stunting (61.4%) and wasting (20.9%). Despite the
upper levels, rates of stunting have declined steadily over the past decade (Osmani et al.,
2016; FAO, 2019).
Children of Bangladesh also suffer from high rates of micronutrient deficiencies,
particularly vitamin A, iron, iodine, and zinc shortage in the body. Malnutrition
among women is also extremely prevalent as more than 50% of women suffer from
chronic energy deficiency. The prevalence of women with a body mass index (BMI)
,18.5 kg/m2 ranged from 47.6% in Khulna to 59.6% in Sylhet (Ahmed et al., 2012).
Studies suggest that there has been little improvement in women’s nutritional status
over the past 20 years (FAO, 2019). Poor reproductive healthcare and anemia due to
no-support given after baby-birth issues are related to the malnutrition in women in
Bangladesh (Ahmed, 2000).
The Government of Bangladesh has made substantial investments to improve
nutrition, including the establishment of the National Nutrition Program, which
provides comprehensive nutrition-specific interventions to children and women at
 Nutritional and health issues in Bangladesh and solutions through traditional foods 241

the community level. These include national-level infant and young child feeding
counseling, food supplementation, vitamin A supplementation, and immunization
programs, some of which have brought about dramatic changes in reducing vitamin
A deficiencies, night blindness, and child morbidity and mortality (Yosef et al.,
2015).
As an outcome of these interventions, Bangladesh has made significant progress in
eliminating some forms of malnutrition including vitamin A and iodine deficiency.
Bangladesh has made a considerable achievement in reducing child stunting and is
commended as a success story in the global nutrition settings (Nisbett et al., 2017).
The prevalence of stunting (low height-for-age) among children under five decreased
from 55% in 1997 to 36% in 2014 (Osmani et al., 2016). Maternal undernutrition, as
measured by “low” BMI, also declined significantly, from 52% in 1997 to 17% in
2014 (WFP, 2016). This trend has been conveyed as one of the most sustained
diminutions in child undernutrition in the world (Headey et al., 2015).
The Bangladesh Government, in its 7th Five Year Plan (FY2016 20), set an ambi-
tious target reducing 25% stunting of under 5-year children by 2020, that is, 3.8 million
children, from the 5.5 million children estimated in 2014 (Fig. 3.1). As the rate of
stunting-reduction has accelerated between 2012 and 2016, the World Health Assembly
has targeted 3.6 million children by 2025. The current trend could support such a
decrease of 4 million stunting of under 5-year children by 2025 (EC, 2017).
The underlying causes of malnutrition are multifaceted and go beyond the lack of
availability and access to diverse, safe and nutritious food. Table 3.4 provides some of
the drivers of malnutrition.
Malnutrition in early life has long-lasting and adverse effects on overall growth,
which are influenced by cross-cutting and underlying socioeconomic, cultural, and
political factors at the community and national levels.

• 5.5 million • 3.8 million

children children
National
Current
target
2014
2020

Expected WHA
target target
2025 2025
• 4.0 million • 3.6 million
children children

Figure 3.1 Current and projected plans for reducing stunting under 5-year old children. EC, 2017.
European Union. Country Profile on Nutrition, Bangladesh. European Commission, July 2017. https://ec.
europa.eu/europeaid/sites/devco/files/2017_country_profile_on_nutrition_-_bangladesh.pdf (accessed
10.04.19.).
242 Nutritional and Health Aspects of Food in South Asian Countries

Table 3.4 Root cause of malnutrition.

• Household food insecurity

• Inability to grow or purchase a nutritionally adequate amount and variety of foods
• Lack of dietary diversity
• Inappropriate knowledge of healthy diet and practices
• Inadequate maternal and childcare
• Lack of access to safe water and sanitation facilities
• Inadequate access to quality health services
Source: FTF, 2018. Feed the Future. Global Food Security Strategy: Bangladesh Country Plan 2018. ,https://www.
usaid.gov/documents/1867/global-food-security-strategy-gfss-bangladesh-country-plan. (accessed 04.04.19.).

3.4 Traditional beliefs and practices: food and health

Traditional beliefs refer to the knowledge that has been embedded in a society’s cul-
tural and spiritual belief system and has been passed on from generation to generation.
Most communities are characterized by an intertwined set of specific beliefs and prac-
tices related to food and health including ways that food can be produced and pre-
pared, which food could be prohibited, and better health can be maintained.

3.4.1 Food taboos versus food allergy

Dietary practices often take the form of rules stating which foods should not be eaten,
that is, food proscriptions or taboos. In some cases the persistence of cultural beliefs
and practices in the areas of food and health presents an obstacle to the improvement
of food and nutrition outcomes.
There are a number of taboos found among rural and even urban people in
Bangladesh. People avoid eating shim (green beans), begoon (brinjal), chal kumra (Hairy
gourd), boal fish (freshwater shark, Wallagonia attu), and gojar fish (Great snakehead,
Channa marulius), and gura-chingri (small freshwater shrimp) is forbidden for kids, old,
and rural people for allergic reactions at certain periods of time. Every year during the
rainy season, some people die by having pufferfish (Tetraodon cutcutia and Tetraodon
potoca) curry due to its toxicity.
Several food taboos are prevalent in pregnant women who inadvertently deprive
them of some vital nutrients. Among the rural women in Bangladesh, food such as
ripe papaya, grape, and pineapple are avoided during pregnancy with the belief that
such foods could cause abortion, placental disruption, difficult labor, and many
others. The use of herbal remedies is considered culturally in Bangladesh, for pro-
moting healthy deliveries of the gestational woman for a good intention but may
medically cause anemia and hemorrhagic-related complications (Choudhury and
Ahmed, 2011).
Food allergy represents a substantial health problem. Despite eating traditional food
items, few foods have been identified as allergic to consumption. These are yams and
 Nutritional and health issues in Bangladesh and solutions through traditional foods 243

vegetables such as leaf, stem, and root of maan kochu bhorta (Giant taro), kochur mukhi
(Taro corms), and maan kochu (root of giant taro). Food allergies may increase stress
and impact on both the quality and quantity of food choices resulting in inadequate
intake of nutrients.

3.4.2 Traditional wisdom: Khanar Bachan

Culturally, many traditional beliefs exist in the country and in every household.
Bangladesh has a long history of traditional food products related to agriculture or
local products. The traditional knowledge goes back to the early civilization of
Bengal. A poetess and legendary astrologer named Khana of ancient Bengal composed
many small verses in the form of rhyme known as “Khanar Bachan” (Khana’s verses)
on agricultural and health-related topics between the 9th and 12th centuries CE. The
existence of her sayings is observed reflecting in the then Bengali lifestyle, agriculture
practices, health and nutrition, weather prediction, food habit and cooking, plantation,
and animal husbandry (Nawaz, 1989).
Her verses were the basic guidelines for traditional agriculture practices, especially
the time of sowing seeds, harvesting, and seasonal adaptation in Bangladesh. Her
humongous influences are also used in modern agriculture advancement. Table 3.5
details some of the Khana’s health and food-related remarkable quotes.

Table 3.5 Khana’s Bachan on food and health.

Khana’s Bachan Interpretation
Kochi patha, buro mesh, Dodhir aag, Ingest young goat, mature bull, and drink top creamy
gholer shesh layer of yogurt, and bottom part of milk-shake
Tal, tetul, doi, Boiddo boley ooshud Toddy palm (Borassus flabellifer), tamarind, and yogurt
koi? can spoil the action of medicine in the body
Mangsey mansho bridhe, Ghreetey Meat helps in developing body muscles while ghee
bridhe bol, Dudhey birjo bridhe, (melting butter) increases energy, and milk improves
Shakey bridhe mol sperms while leafy vegetable promotes feces
Tok, tita, chukka, jhal, Ei char Men do not like four things—higher bitterness,
purusher kal sourness, saltiness, and spicy-hot in food
Tel tamakey pittoo nashto, Jodi hoy ta Oily food and smoking for years can result in health
baro maash havoc
Jol khaey fol khaey, Jom boley aye aye Eating fruit after having a glass of water is not
suitable for health
Baro mashey baro fol, Na kheley jay Twelve types of seasonal fruits during the 12 months
rosatol and become healthy
Alo haowa bedhona, Rog e voge Do not obstruct light and air into the house to avoid
moriona suffering from the diseases
Source: Nawaz, A., 1989. Khanar Bachan Krishi-O-Bangalee Sanskriti (Khana’s Quotes for Agricultural and Bengali
Culture). Bangladesh Agricultural Research Council, Dhaka, Bangladesh, 320 pp. (in Bengali).
244 Nutritional and Health Aspects of Food in South Asian Countries

Table 3.6 Traditional beliefs and some common food items of health benefits.
Bengali term English name Traditional beliefs and uses
Lal shak Red amaranth For the anemic patient to recover hemoglobin level
Kolmi shak Water spinach To regain mineral and vitamin loss of the body
Kacha kola Green banana To recovery of taste from the loss of appetite and fever
Korola Bitter gourd Fresh juice for diabetic patient, and fry for an appetizer
Misti alu Sweet potato Source of carbohydrate for the patients after the fever
Shuji payesh Rice pudding Used as food supplements for the infant
Sajina torkari Drumstick Curry to overcome diseases such as chickenpox and others
Kakrol Spiny gourd Deep frying used as an appetizer and improves the taste
Kacha pepe Green papaya Cooked with a meat curry and help digestion
Kolar thor Banana flower Mashed that treats for infections, and premature aging.
Singh machh Sting catfish Mild curry/soup for recovering from illness
Magur Catfish Mild curry/soup for the sick patient
machh
Rui machh Rui fish Fry used for celebration and offering to the bridal party
Ilish machh Hilsa shad Fried ilish served in traditional ceremonies
Shidol Fish paste Fermented fish paste used as a protein supplement
Chepa sutki Punti fish Paste for the protein supplement

Most Bangladeshi populations relate to agriculture directly or indirectly. Khana’s

verses pertinent to agriculture are verbal folk communication and the resource that
poor farmers rely on for wisdom to apply in their daily life for ages. They are still
being integrated into modern agriculture practices.

3.4.3 Common food items of traditional beliefs

In Bangladesh, some traditional food items are believed to achieve many of the nutri-
tional and health benefits. Some selected plants and fish food used in traditional beliefs
are listed in Table 3.6.

3.5 National guidelines for food intake

The nutrients including protein, energy, carbohydrates, fats and lipids, a range of vita-
mins, and a host of minerals and trace elements are essential to lead a healthy and
energetic life. People can select nutritionally rich diets from a variety of available and
affordable foods. A food-based dietary guideline is developed to improve the nutri-
tional status of the Bangladeshi population and prevent nutrient deficiencies and dis-
eases (Nahar et al., 2013). The guidelines are a set of advisory statements providing
principles and criteria of good dietary practices to promote social well-being
(Table 3.7).
 Nutritional and health issues in Bangladesh and solutions through traditional foods 245

Table 3.7 Food-based dietary guidelines in the Bangladesh context.

• Eat a well-balanced diet with a variety of foods at each meal

• Use in moderation foods high in fat and minimize fats and oils in food preparation
• Limit salt intake and condiments and use only iodized salt
• Take less sugar, sweets or sweetened drinks
• Drink plenty of water daily
• Consume safe and clean foods and beverages
• Maintain desired body weight through a balanced diet and regular physical activity
• Adopt and follow appropriate preparation and cooking practices with good eating habits
• Eat supplementary food and take extra care during pregnancy and lactation
• Practice exclusive breastfeeding for the first 6 months of life, introduce and continue
complementary feeding along with breastfeeding up to 2 years
Source: Nahar, Q., Choudhury, S., Faruque, M.O., Sultana, S.S.S., Siddiquee, M.A., 2013. Dietary Guidelines for
Bangladesh. FAO Research Grant from National Food Policy Capacity Strengthening Programme (NFPCSP) Phase II
to Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM),
Dhaka, Bangladesh, 53 pp.

3.5.1 Proportion of food in a healthy diet

The proportion of food items (in percent) for a healthy lunch is proposed by the food
plate method (Nahar et al., 2013) that could be met through traditional food items in
Bangladesh.
According to the benchmarks, 53% will be rice or wheat or any carbohydrate like
mashed potato. Mixed vegetables are 15% while leafy vegetables are 15%. Many
options are available in preparing this menu. Meat or fish could account for 6%, and
plant protein lentil accounts for 4% of the prescribed diet. The remaining 7% is for
fruits of seasonal origin.

3.5.2 Food guide pyramid

A complete dietary guideline for Bangladesh was developed by Nahar et al. (2013)
with a food pyramid showing different types of foods to be taken. For Bangladeshis,
the bottom of food pyramids exerts eating rice or wheat, fruits, and vegetables in the
diets liberally. The middle zone of the pyramid is composed of fish, meat, and eggs,
which are suggested for eating moderately. The top-notch of the pyramid is limited to
sugar as well as fats and oils in the diet (Fig. 3.2).

3.5.3 Physical exercise

Physical exercise is not commonly practiced among the general population of
Bangladesh. Socially, men go to work, and wives remain in households. There is a
growing concern about overweight among the children and housewives in
Bangladesh. Among the 17% of the overweight or obese adults in Bangladesh,
246 Nutritional and Health Aspects of Food in South Asian Countries

Ea
Sugar:

ts
5 serves daily

pa
rin
Fats and oil:

gly
3–6 serves daily

Ea
Pulses: 1–2 serves daily

tm
od
Fish, meats, and eggs:

era
1–4 serves daily

tel
y
Fruits: 1–3 serves daily

Ea
tl
Vegetables: 3–6 serves daily

ibe
ral
Rice, bread, and cereal: 9–15 serves daily

ly
Figure 3.2 Food pyramid in a Bangladesh context.

Table 3.8 Guidelines for regular physical activity.

• Maintain ideal body weight by balancing food consumption through physical activity
• Take 30 45 min of daily physical activity such as walking, running, jogging, cycling, and
household works
• Maintain body mass index (BMI: 18.5 23.0)
• Avoid the risk of obesity-related metabolic complications (waist circumference .90 cm for
male and .80 cm for female)
• Maintain healthy waist-hip ratios (male 0.9: female 0.8)
• Engage in light activity such as household chores and walk after the meal
Source: Nahar, Q., Choudhury, S., Faruque, M.O., Sultana, S.S.S., Siddiquee, M.A., 2013. Dietary Guidelines for
Bangladesh. FAO Research Grant from National Food Policy Capacity Strengthening Programme (NFPCSP) Phase II
to Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM),
Dhaka, Bangladesh, 53 pp.

4% were obese, and obesity rates in Bangladesh are increasing at a slower pace.
Obesity rates in adults grew from 2% to 4%, and rates in children and adolescents
remained at about 1.5% from 1980 to 2013 (Stewart and Persaud, 2014). The prev-
alence of overweight and obesity is found to be higher in girls than in boys among
children and adolescents, and prevalence rates are higher in females than in males in
the adults where it is also higher in urban people compared with rural people living
in Bangladesh (Banik and Rahman, 2018). A guideline provided by Nahar et al.
(2013) recommended engaging individuals with adequate levels of physical activity
throughout their lives to achieve overall physical, mental, social, and spiritual
health. Table 3.8 presents key messages from the guideline regarding physical
activities.
Maintaining the desired body weight through regular physical exercise and a bal-
anced food improves oxygen utilization, lowers blood glucose, and increases working
capacity.
 Nutritional and health issues in Bangladesh and solutions through traditional foods 247

3.6 Solutions through traditional foods

Food-based approaches focusing on dietary diversification are an active pathway for
reducing micro- and macronutrient deficiencies in malnourished populations (FAO,
2010). In Bangladesh, rice is the leading cereal food consisting of two-thirds of the tra-
ditional dietary habits providing 69% of food energy although it is low in fat, essential
amino acids, and micronutrients (FAO, 2007). Animal source foods, which contain
high-quality protein and bioavailable iron and vitamin A, make up less than 2% of
total energy intake (FPMU, 2009). Rice is accompanied by some vegetables, a little
amount of pulses, and small quantities of fish. Milk and milk products and meat are
consumed occasionally and in minimal amounts. Consumption of fruits is seasonal
although banana and papaya are available throughout the year. The traditional dietary
habits often do not meet good nutritional outcomes due to lack of inadequate nutri-
tion information and requirement.
On the other hand, food preparation methods result in significant nutrient losses.
Minerals and vitamins, especially B-complex vitamins, are lost (40% of thiamine and
niacin) even during the washing of rice before cooking. Boiling rice and then discard-
ing the water results in even more nutrient losses. The manner of washing and cook-
ing vegetables leads to considerable losses of vitamin C and B-complex vitamins
(FAO, 2007).
Dietary diversification approaches combine homestead gardening, backyard animal
rearing, and pond-based aquaculture practices, which are uniquely well suited to
reducing hidden hunger and malnutrition in Bangladesh. There have been many rice
varieties, chicken, ducks, oxen and cows, goats, wild bulls, pigeons, rabbits, 265 species
of inland fish, and more than 60 species of shrimps, lobsters, and crabs to feed the
Bangladeshi population. Besides, more than 100 species of medicinal plants are avail-
able from the forest and homestead gardens (Hasan et al., 2014). All these traditionally
consumed local food plants and animals contribute substantially to the local availability
of nutrient-rich foods.
Most traditional foods of Bangladesh are also recognized as functional foods
because of the presence of functional components such as body-healing chemicals,
antioxidants, dietary fibers, and probiotics. These functional molecules help in weight
management and blood sugar level balance, and they support the immunity of the
body (Sarker et al., 2015). The functional properties of foods are further enhanced by
processing techniques such as sprouting, malting, and fermentation (Hotz and Gibson,
2007).
The fertile alluvial soil and subtropical climate of Bangladesh make it ideal for
growing a diverse range of horticultural crops and are considered a significant source
of the vitamins and minerals that are essential for human nutrition. Vegetables are a
substantial part of daily food intake along with rice that makes a balanced diet.
248 Nutritional and Health Aspects of Food in South Asian Countries

Consumption of green leafy vegetables contributes to meet the nutritional requirement

and overcome micronutrient deficiency at minimum cost. Lal shak (Red amaranth), kolmi
shak (Water spinach), begoon (brinjal), dherosh (Okra), and kochu (Taro) are now the pre-
ferred vegetables growing in the rural areas.
There is growing evidence of additional health benefits from a range of phytonu-
trients such as carotenoids in pumpkin, which is widely available throughout the year
in Bangladesh. The carotenes help to slow the aging process, reduce the risk of certain
types of cancer, improve lung function, and reduce complications associated with dia-
betes (Plant and Food Research, 2018). Potato is one of the mainstream crops in
Bangladesh, containing higher levels of carbohydrate and provides higher energy.
Taro is a perennial, tropical plant primarily grown as a root vegetable for its edible
starchy corm, and as a leaf vegetable (Fig. 3.3). In Bangladesh, taro is a popular
vegetable known as kachu. It is usually cooked with small prawns or the ilish fish into
a curry, although some dishes are cooked with dried fish. Its green leaves (kachu pata)
and stem (kachu) are also eaten. Taro stolons (kachur loti) are favored by Bangladeshis,
and are cooked with shrimps, dried fish, or the head of the ilish fish. Taro benefits
include its many nutrients, including magnesium, iron, fiber, potassium, manganese,
zinc, copper, and phosphorus. It contains good amounts of antioxidants, as well as
vitamins A, B6, C, and E (Li and Siddique, 2018).

Figure 3.3 Some minor vegetables of nutrition and health benefits. www.google.com.
 Nutritional and health issues in Bangladesh and solutions through traditional foods 249

Sajina (Moringa oleifera) is another inexpensive, eco-friendly, and socially beneficial

alternative, especially for the socially neglected population, suffering from poverty and
malnutrition. This promising food source in Bangladesh is full of the leaf at the end of
the dry season when other foods are typically scarce (Fig. 3.3). Sajina is universally
called the “miracle plant” or “the tree of life” with enormous potentials. Various parts
of the plants such as leaves, roots, seeds, barks, fruits, flowers, and immature pods
attributed to multiple health effects, including cardiac and circulatory stimulants, pos-
sess antipyretic, antioxidant, antiepileptic, antiinflammatory, and antiulcer (Pal et al.,
1995; Gupta et al., 2018). Sajina is said to provide 7 times more vitamin C than
oranges, 10 times more vitamin A than carrots, 17 times more calcium than milk,
9 times more protein than yoghurt, 15 times more potassium than bananas, and
25 times more iron than spinach (Rockwood et al., 2013). That is why it is being
called a superfood. Food and Agricultural Organization of the United Nations recog-
nized Moringa as the September 2014 traditional crop of the month (Alegbeleye, 2018).
Many wild vegetables such as Shapla stem (Nymphaea stellata), Kalmishak (Ipomoea
aquatica), and Helecha (Enhydra fluctuans) are traditionally consumed with staple food
in both rural and urban areas in Bangladesh. These wild vegetables are rich in vital
minerals such as Na, K, Ca, and Mg and essential trace elements such as Fe, Cu, and
Zn, which are sufficient to fulfill the recommended dietary allowances by FAO/
WHO (Satter et al., 2016).
The tropical fruits of Bangladesh are an excellent source of antioxidant vitamins
such as vitamin C, β-carotene, and antioxidant minerals such as zinc, copper, and
manganese iron (Shajib et al., 2013). Varieties of mangoes grown seasonally are rich
sources of vitamin C, fiber, and essential minerals and provide sustainable health bene-
fits (Ara et al., 2014).
The star gooseberry, monkey jack, pineapple, and golden apple are very rich in anti-
oxidant vitamins and minerals; mango, blackberry, jackfruit, and carambola are also rich,
whereas melon and java apple are insufficient in antioxidant vitamins and minerals.
People could meet up their vitamin C requirements with magic fruits such as amra
(Spondias mombin), kamranga (Averrhoa carambola), guava (Psidium guajva), and amloki
(Phyllanthus emblica), as these are available throughout the year in Bangladesh
(Fig. 3.4). Amra contains twice the vitamin C contents than oranges. It is rich with
antioxidant properties and makes the blood pure, prevents aging and sunburn, and
manages hair fall problem. Amloki helps fight common cold and infections. Its high
fiber content helps prevent constipation while various antibacterial and astringent
properties help stimulate the immune system of the body (Hasin, 2018). Kamranga
with its sweet and sour flavor contains pantothenic acid, potassium, and copper, which
help to cure headaches and treat sore eyes. Guava, another favorite fruit, contains sev-
eral vital vitamins and minerals, and the antioxidant poly-phenolic compound help to
prevent cancer, antiaging, and immune booster (Hasin, 2018).
250 Nutritional and Health Aspects of Food in South Asian Countries

Figure 3.4 Some vitamin C rich fruits in Bangladesh. www.pinterest.com.au.

Underutilized or minor fruits can be used as alternative sources to combat hidden

hunger such as vitamin A deficiency (Bioversity International, 2004). Nowadays,
increased minor or underutilized fruits are contributing substantially to overcome the
malnutrition in Bangladesh (Rahim et al., 2008). Minor fruits such as bel (Aegle marme-
lous) contains 65 mg/100 g, Kalojaam (Syzygium cumini) contains 25.65 mg/100 g, and
Payla (Flacourtia jangomas) contains 25.64 mg/100 g, which are higher amounts of
vitamin C than jackfruit (11 mg/100 g) and mango (Mangifera indica, 10.88 mg/100 g)
(FAO-NFPCSP, 2010).
Micronutrient-rich small fish species are providing poor and vulnerable households
in Bangladesh with a source of food and nutrition security. Mola (Amblypharyngodon
mola), darkina (Esomus danricus), and dhela (Ostreobrama cotio cotio) have the potential to
meet the nutritional needs of the Bangladeshi people (Thilsted and Wahab, 2014).
Small fish, fresh or dried, are also made into bhortas and eaten with rice and vegetables,
which are tasty, well-liked, and rich in micronutrients. Table 3.9 presents the amount
of fish meat required to meet the daily requirements of vitamin A for Bangladeshi
people.
People can grow these traditional food items to fight malnutrition and to achieve
nutritional security compliant to the Sustainable Development Goals 2, 3, and 12 of
the United Nations.

3.7 Future outlooks

Bangladesh is the largest delta on earth. Agriculture is the most important economic
sector and a powerful driving force in providing foods and incomes, supporting liveli-
hoods alleviating poverty and contributing to the overall economy. Agriculture can
sustainably contribute to improving dietary diversity and nutrition outcomes. The
population growth in Bangladesh is projected at 218 million by 2050 and could stabi-
lize at around 260 million in the middle of the next century (UN, 1998). This highly
 Nutritional and health issues in Bangladesh and solutions through traditional foods 251

Table 3.9 Intake of vitamin A from fish meat (g/day) in the Bangladesh population.
Age group Vitamin A Required fish meat per day (g)c
requirement
a
(μg RAEb)

Male Female Mola Dhela Taki Koi Ilish Rui Catla

Less than 1 year 375 375 15.0 40.8 269.8 127.1 1875.0 2884.6 1704.5
1 3 years 400 400 16.0 43.6 287.8 135.6 2000.0 3076.9 1818.2
4 6 years 450 450 18.0 49.0 323.7 152.5 2250.0 3461.5 2045.5
7 9 years 500 500 20.0 54.5 359.7 169.5 2500.0 3846.2 2272.7
10 18 years 600 600 24.0 65.4 431.7 203.4 3000.0 4615.4 2727.3
19 65+ years 600 600 24.0 65.4 431.7 203.4 3000.0 4615.4 2727.3
Pregnancy 800 32.0 87.1 575.5 271.2 4000.0 6153.8 3636.4
Lactation 850 34.0 92.6 611.5 288.1 4250.0 6538.5 3863.6
a
FAO/WHO (2001) and Nahar et al. (2013).
b
μg RAE retinol activity equivalent.
c
Bogard et al. (2015).

dense population will play a crucial role in constricted agricultural landscapes against
all the odds of climate change vulnerabilities to augment the food production and to
feed the growing population (Streatfield and Kara, 2008).
Rice continues to be the dominant crop in Bangladesh and has evolved signifi-
cantly over the last 5 years, as demonstrated by Bangladesh’s marked improvement in
rice production and increased exports of rice and vegetables (World Bank, 2016; FTF,
2018). However, challenges to agricultural-led growth remain. The small size of farm
plots, limited diversity and adaptive capacity, healthy agroecosystems, and weak local
governance have made the region one of the adversely affected countries on the planet
(Chowdhury, 2019).
The geopolitical situation on transboundary rivers, rising sea levels, dryness in the
northern barind highlands, and increases of salinity in the southern part of Bangladesh
restrict crop and fish production that requires a technological shift to alternative food
production. Long-term planning is essential for facing the upcoming challenges and
needs of the growing population, nutritional requirements, survival of traditional food
crops and their conservation, and maintaining a sustainable consumption.

3.8 Conclusion
Inhabitants, farmers, and fishers have developed different locally adapted agricultural tech-
niques for traditional farming and harvesting since ancient times. These traditions have
resulted in a vibrant mixture of sociocultural, ecological, and economic support to
humankind. Unfortunately, these agrarian practices are threatened by many influences
including climate change, population pressure, pollution, invasive species, modern agri-
cultural practices, and increased competition for harvesting natural resources that have
resulted in the loss of traditional farming practices and many endemic species.
252 Nutritional and Health Aspects of Food in South Asian Countries

Despite having considerable progress toward reducing malnutrition in recent years,

Bangladesh needs a more significant climate-smart agriculture. Diversifying farms and
farming landscapes in horticulture, livestock, poultry, and fisheries together with more
robust rural nonfarm enterprise development are required to foster future growth,
reduce poverty, and improve food and nutrition security.
Promoting a mass awareness of nutrition education to enhance the regular intake
of minor fruits and wild vegetables could help alleviate common dietary deficiency
diseases from Bangladesh. Increased use of minor fruits and veggies would also help to
grow imitativeness for cultivation to protect them from extinction and to maintain
biodiversity.
Nationwide research is suggested to scientifically document the health benefits of
traditional foods across various regions to create a database for the preservation of
knowledge on food composition and dietary guidelines. This endeavor could contrib-
ute to health, nutrition, and food policy program planning for future endeavors and
benefit the Bangladeshi and international communities.

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