Sustaining healthy diets: The role of capture fisheries and aquaculture for improving nutrition in the post-2015 era

Abstract

The Sustainable Development Goals (SDGs) agenda makes achieving food security and ending malnutrition a global priority. Within this framework, the importance of fisheries in local and global food systems and its contribution to nutrition and health, particularly for the poor are overlooked and undervalued. This paper reviews current fish production and consumption from capture fisheries and aquaculture, highlights opportunities for enhancing healthy diets and outlines key multi-sectoral policy solutions. Mirroring the call for a diversification of agricultural research and investment beyond a few staple grains, it is anticipated that productivity gains for a few farmed aquatic species will not suffice. Capture fisheries and aquaculture have a complementary role to play in increasing fish availability and access, and must be promoted in ways that support measurable nutrition and health gains. This paper argues that the lack of a nutrition-sensitive policy focus on capture fisheries and aquaculture represents an untapped opportunity that must be realised for ensuring sustainable healthy diets for all.

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Sustaining healthy diets: The role of capture fisheries and aquaculture
for improving nutrition in the post-2015 era
Shakuntala Haraksingh Thilsted
a,
⇑
, Andrew Thorne-Lyman
a,b
, Patrick Webb
c
, Jessica Rose Bogard
d,e
,
Rohana Subasinghe
f
, Michael John Phillips
a
, Edward Hugh Allison
g
a
WorldFish, Jalan Batu Maung, Batu Maung, 11960 Bayan Lepas, Penang, Malaysia
b
Harvard T. H. Chan School of Public Health, Department of Nutrition, 677 Huntington Ave., Boston, MA 02115, USA
c
Tufts University, Friedman School of Nutrition Science and Policy, 150 Harrison Avenue, Boston, MA 02111, USA
d
The University of Queensland, School of Public Health, Herston Road, Herston, Queensland 4006, Australia
e
Commonwealth Scientific and Industrial Research Organisation – CSIRO, Agriculture Flagship, 306 Carmody Road, St Lucia, Queensland 4067, Australia
f
Food and Agriculture Organization of the United Nations, Fisheries and Aquaculture Department, Via delle Terme di Caralla, Rome 00153, Italy
g
University of Washington, School of Marine and Environmental Affairs, College of the Environment, 3707 Brooklyn Avenue NE, Seattle, WA 98105, USA
article info
Article history:
Received 11 December 2015
Received in revised form 19 February 2016
Accepted 22 February 2016
Keywords:
Fisheries policies
Nutrition-sensitive fisheries
Diverse food systems
Healthy diets
Capture fisheries
Aquaculture
abstract
The Sustainable Development Goals (SDGs) agenda makes achieving food security and ending malnutri-
tion a global priority. Within this framework, the importance of fisheries in local and global food systems
and its contribution to nutrition and health, particularly for the poor are overlooked and undervalued.
This paper reviews current fish production and consumption from capture fisheries and aquaculture,
highlights opportunities for enhancing healthy diets and outlines key multi-sectoral policy solutions.
Mirroring the call for a diversification of agricultural research and investment beyond a few staple grains,
it is anticipated that productivity gains for a few farmed aquatic species will not suffice. Capture fisheries
and aquaculture have a complementary role to play in increasing fish availability and access, and must be
promoted in ways that support measurable nutrition and health gains. This paper argues that the lack of a
nutrition-sensitive policy focus on capture fisheries and aquaculture represents an untapped opportunity
that must be realised for ensuring sustainable healthy diets for all.
Ó2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Introduction
A core vision of the post-2015 development agenda is a
‘‘healthy life for all” in a world where everyone consumes food
that is ‘‘affordable and nutritious” (United Nations, 2015).
Several of the Sustainable Development Goals (SDGs) (No. 2
and No. 14 in particular) speak to the importance of supporting
consumer choice and enhanced nutrition by promoting agricul-
tural productivity among small-scale producers and supporting
links between local and global markets. Those goals focus on
the importance of sustaining food production, on the one hand,
and on securing year-round access to diverse foods, on the
other.
Fish
1
production and trade contribute significantly to global agri-
cultural output. Fish production in 2012 exceeded 158 million met-
ric tons, while the value of international fish trade amounted to
USD129 billion (HLPE, 2014). An increasingly large share of fish
entering global markets derives from aquaculture (the farming of
aquatic animals and plants); the world’s fastest growing food pro-
duction sector for more than four decades (Tveterås et al., 2012).
Much of fish produced and traded within low-income countries
derives from capture fisheries (non-fed fish harvested from undo-
mesticated ecosystems). These two production systems have impor-
tant complementary roles in meeting rising demand for fish and
other products (such as animal feed and fish oil), and enhancing
incomes and nutrition among smallholder producers, fishers and
poor consumers. However, fisheries policies are increasingly
articulated around value-creation through export to urban and
http://dx.doi.org/10.1016/j.foodpol.2016.02.005
0306-9192/Ó2016 The Authors. Published by Elsevier Ltd.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
⇑
Corresponding author. Tel.: +45 40292497.
E-mail addresses: s.thilsted@cgiar.org (S.H. Thilsted), a.thorne-lyman@cgiar.org
(A. Thorne-Lyman), patrick.webb@tufts.edu (P. Webb), jessica.bogard@live.com
(J.R. Bogard), rohana.subasinghe@fao.org (R. Subasinghe), m.phillips@cgiar.org
(M.J. Phillips), eha1@uw.edu (E.H. Allison).
1
The term ‘fish’ is used in the broadest sense to include all aquatic animals,
including fish (both fed and non-fed), crustaceans (e.g. shrimp, prawns, crabs),
molluscs (e.g. oysters, mussels, snails) and other aquatic invertebrates.
Food Policy 61 (2016) 126–131
Contents lists available at ScienceDirect
Food Policy
journal homepage: www.elsevier.com/locate/foodpol

international markets. Capture fisheries institutions concentrate
ownership and use of fishing assets to maximize economic output
which may bring benefits to resource conservation and trade, but
decreases the quantity of fish available on local markets (Béné
et al., 2010). Aquaculture policies tend to focus on maximizing
productivity and economic efficiency (Hishamunda et al., 2009).
These policies leave little room for promoting diversity of systems
and species, or accessibility of fish among poor consumers whose
diets typically lack nutrient-rich foods.
Acknowledging the need for public health policymakers to
actively engage with agricultural sub-sectors, the Second Interna-
tional Conference on Nutrition (ICN2) stated that ‘‘fisheries and
aquaculture need to be addressed comprehensively through
coordinated public policies” (FAO and WHO, 2014). The call for
improved policy coordination, environmental protection, enhanced
fish production and reduced loss and waste represents a major
opportunity to promote capture fisheries and aquaculture as key
nutrition-sensitive agricultural sub-sectors.
The term ‘nutrition-sensitive agriculture’ was described by Ruel
and colleagues as agriculture policies and interventions that sup-
port improved nutrition outcomes as distinct from ‘nutrition-speci
fic’ public health interventions (such as vitamin A supplementation
or promotion of exclusive breastfeeding) (Ruel et al., 2013). While
there is much debate regarding the impact of agriculture on
nutrition, fish systems are rarely mentioned. Indeed, the role of
the fisheries sector in improving diets continues to be overlooked
in discussions of sustainable food systems. The benefits of fish
for health are well demonstrated. Can fisheries play a greater role
in healthy diets in coming years? In answering in the affirmative,
this paper argues that the lack of a nutrition-sensitive policy focus
on capture fisheries and aquaculture represents an untapped
opportunity.
This paper has three parts: the first describes the current state
of production and consumption of fish in selected countries and
evidence on the value of fish to nutrition and health. Section
‘Capture fisheries and aquaculture in healthy diets’ explores oppor-
tunities for enhancing future diets and challenges to production
and trade, with a focus on low-income countries where the highest
burden of undernutrition and micronutrient deficiencies are found.
Section ‘Policies for nutrition-sensitive capture fisheries and
aquaculture’ proposes a policy agenda to enhance and sustain the
capture fisheries and aquaculture sub-sectors as a core part of the
SDGs development agenda to 2030.
Capture fisheries and aquaculture in healthy diets
Estimated global consumption of fish continues to increase,
reaching an all-time high of 19 kg/capita/year in 2011 (Table 1),
up from 9 kg/capita/year in 1961 (FAOSTAT, 2015). Fish production
continues to grow at an average annual rate of 3.2%, largely due to
increases in aquaculture with relatively stable supply from capture
fisheries (FAO, 2014). Aquaculture is projected to contribute 63% of
global fish consumption by 2030, and in some Asian countries,
particularly China, fish production from aquaculture already now
exceeds that from capture fisheries. Fish is one of the most traded
food commodities, with consumption in mid- and high-income
countries increasingly derived from imports, while low-income
countries are more heavily reliant on local supply (FAO, 2014).
However, trade is bidirectional, with a trend for low-income coun-
tries to export high-market value fish products and import low-
market value products for domestic consumption (Asche et al.,
2015). This trade pattern is demonstrated in Table 1, with total
per capita fish production being much higher than consumption
in some countries (e.g. Norway, Peru and Chile), whereas, per cap-
ita consumption is greater than production in others (e.g. Nigeria,
Japan and Republic of Korea). Consumption patterns vary widely,
with fish as the most important animal-source food in Bangladesh
and Indonesia, and India with the lowest per capita consumption.
The benefits of fish to nutrition and health are well-documented.
Rimm and Mozaffarian found that fish intake is associated with a
36% reduced mortality risk from heart disease (2006), while a
meta-analysis by Zhao et al. showed that consumption of 60 g fish/
day is associated with a 12% reduction in mortality (2015). Focusing
on global mortality, Lim et al. found that diets low in seafood
omega-3 fatty acids accounted for 1.4 million deaths in 2010
(2012). Building on the same data, Ezzati and Riboli calculated that
diets low in fish and seafood are responsible for roughly 1% of the
world’s total burden of disease-related disability-adjusted life years
(DALYs) (2013). In addition, fish consumption in United States of
America is significantly associated with long-term weight loss
(Smith et al., 2015). As a result, an increasing number of countries
(mostly high-income) are recommending minimum levels of
regular fish consumption in their national dietary guidelines
(National Health and Medical Research Council, 2013; The Danish
Veterinary and Food Administration; U.S. Department of
Agriculture and U.S. Department of Health and Human Services,
2010).
The benefits of fish are associated in part with high concentra-
tions of bioavailable minerals and vitamins, essential fatty acids
and animal protein (Bogard et al., 2015b; Wheal et al., 2016).
Fig. 1a–f shows the contribution to recommended nutrient intakes
from selected fish species for pregnant and lactating women,
infants and young children (FAO and WHO, 2004). Fig. 1b shows
that fish are a rich source of vitamin B12, only found in animal-
source foods, which is essential for multiple functions, including
growth, brain function and nervous system maintenance. As a
source of highly bioavailable calcium, small fish are particularly
important in the diets of the poor which are often low in milk
and milk products (Hansen et al., 1998). The same applies to zinc
and iron which are considered ‘problem nutrients’ globally. Fish
are also a unique source of long chain omega-3 fatty acids. It has
been shown that intake of omega-3 fatty acids in pregnancy is
associated with reduced risk of early preterm delivery (and a mod-
est increase in birth weight) (Imhoff-Kunsch et al., 2012), whereas,
low seafood consumption during pregnancy increases the risk of
suboptimal neurodevelopmental outcomes, including cognition
and fine motor skills (Hibbeln et al., 2007). In addition, fish
enhances the uptake of micronutrients from plant-source foods
in the meal (Michaelsen et al., 2009; Sandström et al., 1989). The
high levels of nutrients in fish underpin the potential value of fish
to healthy diets. Small indigenous fish species which are eaten
whole (with bones, head and viscera; very little cleaning loss and
no plate waste) have large potential to contribute to micronutrient
intakes (Bogard et al., 2015b). Similarly, ground dried small fish
provide a dense source of nutrients which is valuable for young
children who eat small meals due to limited stomach capacity
(Bogard et al., 2015a).
Estimated global fish consumption (19 kg/capita/year in 2011) is
expected to increase to 22 kg/capita/year in 2024, with increases in
all regions (OECD and FAO, 2015). However, this projected increase
masks widening global inequities in fish consumption, with the
poor in all regions continuing to have low intakes. To address this
issue, policymakers globally must consider how to make more fish
accessible to the poor, while increasing supply sustainably.
Opportunities for enhancing current and future diets
As recommended by ICN2 (FAO and WHO, 2014), sustainable
food systems that promote healthy diets must build on
‘nutrition-sensitive agriculture’. To be nutrition-sensitive, agricul-
ture policies and interventions should leverage production and
S.H. Thilsted et al./ Food Policy 61 (2016) 126–131 127

value chain investments to achieve measurable impacts on nutri-
tion (Ruel et al., 2013). This requires integration of capture fish-
eries and aquaculture into local and national food systems to
improve future diets. There are three interlinked opportunities
for this: (a) improving the quality and quantity of fish supply
(which can improve diets of both producers and consumers); (b)
facilitating women’s empowerment; and (c) promoting equitable
trade and enhanced markets.
Globally, fish production from both capture fisheries and
aquaculture depends heavily on small-scale fishers and farmers,
many of whom are poor. An estimated 30.6 million people
derive their livelihoods from small-scale fisheries, and consume
a proportion of their catch – thereby, direct consumption pro-
vides an opportunity to improve dietary quality (HLPE, 2014).
Capture fisheries are typically diverse, however, aquaculture
globally focuses on a few select species. Nutrient composition
of fish varies widely (Fig. 1a–f), and so diversity of species in
aquaculture (e.g. polyculture systems) requires much greater
emphasis than currently exists, for this opportunity to be fully
realized. Nutritional quality can also be improved by develop-
ment of value chains that reduce loss and improve processing
methods (e.g. fish drying and smoking) which preserve and con-
centrate nutrients and increase seasonality of availability. Invest-
ments in local and regional market chains are an effective way
of making nutritious food available to the poor. Improving qual-
ity and quantity of fish supply requires complementary invest-
ments in both improved capture fisheries management to
maintain diversity and ensure that fish are not over-harvested;
and growth in aquaculture of diverse species.
Increasingly, reduction in food loss and waste is seen as essen-
tial for achieving food and nutrition security. Fish loss and waste
amount to 39% of fish landed globally (HLPE, 2014), with large dis-
cards (portion of catch returned to the sea) from marine capture
fisheries, prior to landing. Post-harvest loss is high in low-income
countries, due to poor infrastructure, cold chain, processing and
storage facilities, whereas, large waste (at retail and consumer
level) occurs in rich countries. Recommendations to reduce fish
loss and waste include improving conditions for workers (many
of whom are women) and processing technologies (e.g. solar dry-
ing) in low-income countries to deal with peak capture periods,
extend seasonality of consumption, and increase reach to people
without access to fresh fish, as well as the use of safe, nutrient-
rich loss and waste from processing for suitable fish products, in
all countries.
In capture fisheries, men are predominantly engaged in catch-
ing and women in processing, trading and selling, particularly in
sub-Saharan Africa (Weeratunge et al., 2014). Yet, the estimated
56 million women involved in this sub-sector (HLPE, 2014), are
constrained by deplorable working conditions, poor market and
transportation infrastructure, limited financial and business ser-
vices, competition for limited catches, and variable supply. Invest-
ments that strengthen women’s empowerment are known to lead
to improvements in nutrition and health of women and their fam-
ilies (World Bank, 2011). Development of aquaculture systems in
which women are engaged offers opportunities to increase fish
consumption by all household members. Homestead aquaculture
provides women who spend considerable time on household activ-
ities and child care, opportunities to participate more actively, pri-
marily in fish feeding. In Bangladesh, where there are concerted
efforts to engage women in pond polyculture, there are reports
of increased control of income and greater decision-making by
women (Farnworth et al., 2015). However, data on time use, the
balance between work time and, for example, child care and leisure
are needed.
Fish is one of the most globally traded foods, with a net flow
from low- to high-income countries (Smith et al., 2010). That said,
vibrant markets for fish, including dried small fish exist across the
developing world, which are particularly accessible to poor con-
sumers, as they are sold in small portions for relatively low prices.
Increased aquaculture production, especially in Asia has helped to
stabilise fish prices, keeping fish within the reach of the poor.
Aquaculture also has beneficial effects for reducing price volatility
due to increased control over production and resulting stability in
supply (Tveterås et al., 2012). In Bangladesh, aquaculture produc-
tion more than doubled over the past decade, reducing the price
of farmed fish (few large species) which became more accessible
to poor consumers as a result. However, the price of indigenous
small fish from capture systems, which are more nutrient-rich
and more likely to be consumed by the poor, has risen sharply
(Belton et al., 2014; Toufique and Belton, 2014). The net effect on
nutrition and health of these relative price effects and product sub-
stitution among poor consumers is not known.
Table 1
Fish production and consumption in selected countries.
Production Apparent consumption
Total fish
(million t/yr)
Capture fisheries
(million t/yr)
Aquaculture fish
(million t/yr)
Total fish
(kg/capita/yr)
Fish
(kg/capita/yr)
Fish protein
(% total animal protein)
Selected low- and mid-income countries
Bangladesh 3.41 1.55 1.86 21.1 19.7 56.2
China 59.82 16.27 43.55 43.2 33.5 22.4
India 9.20 4.65 4.55 7.3 5.2 13.0
Indonesia 9.92 6.10 3.82 39.70 28.9 54.8
Malawi 0.11 0.11 0 7.1 5.7 27.7
Nigeria 1.02 0.72 0.30 5.8 17.1 43.1
Peru 5.98 5.85 0.13 196.9 22.7 22.5
Viet Nam 6.01 2.80 3.21 65.7 33.6 27.3
Selected high-income countries
Chile 2.80 1.77 1.03 159.1 14.6 8.3
Japan 4.27 3.66 0.61 33.5 51.7 37.3
Norway 3.32 2.07 1.25 658.8 53.4 23.4
Republic of Korea 2.00 1.60 0.40 40.6 60.4 38.7
United States of America 5.67 5.23 0.44 17.7 21.7 7.4
Global total 162.76 92.57 70.19 22.5 18.9 16.5
Note: Data for fish production and consumption are sourced from 2013 (Fisheries and aquaculture software, 2015), and 2011 (FAOSTAT, 2015), respectively. Quantities are
expressed in live weight equivalent. Apparent consumption refers to the quantity of fish available for consumption (production plus imports less exports and non-food uses).
128 S.H. Thilsted et al. / Food Policy 61 (2016) 126–131

Policies for nutrition-sensitive capture fisheries and
aquaculture
Current policies and public and private sector investments are
typically framed around their potential to reduce poverty and food
insecurity but rarely with a nutrition-sensitive lens. By narrowly
focusing on maximizing productivity and income-generating
potential, the goals of fisheries policies remain largely sectoral
and include little explicit consideration of the sector’s potential
contribution to broader societal goals such as diets, nutrition,
Fig. 1. Contribution (%) of selected fish species to recommended nutrient intakes for pregnant and lactating women and infants and young children in Bangladesh. Note: Light
blue and dark blue bars represent contributions to recommended nutrient intakes (RNIs) for pregnant and lactating women (PLW), and infants and young children (6–
23 months), respectively. Arrows represent contributions that exceed 100% of RNI. Contributions were calculated by assigning an average RNI target for each nutrient,
accounting for variations in requirements throughout the three trimesters of pregnancy and first 12 months of lactation, and for infants, throughout the period from age 7 to
23 months; then by calculating the contribution from a standard portion (50 g/day for PLW and 25 g/day for infants) of each species (Bogard et al., 2015b). The RNIs for iron
are based on 10% bioavailability and for zinc, moderate bioavailability (FAO and WHO, 2004). (For interpretation of the references to colour in this figure legend, the reader is
referred to the web version of this article.)
S.H. Thilsted et al. / Food Policy 61 (2016) 126–131 129

health and sustainability (Ahmed and Lorica, 2002). Multi-sectoral
policy solutions lie in: (a) diversification of production systems; (b)
efficient management and protection of all systems; (c) improved
value chain and markets; and (d) consideration of context-
specific consumer preferences and nutritional needs.
Diversification of production systems
To achieve improved access to diverse and healthy diets that
include nutrient-rich foods, policymakers must broaden the scope
of their agricultural support to embrace species diversity and
nutritional quality. In capture fisheries, ecosystem-based fisheries
management and habitat conservation can increase both fish
stocks and biodiversity, thereby enhancing the quantity and nutri-
tional quality of fish available for consumption. Improvements in
the management of rice-fish systems hold great potential for
increasing productivity and species diversity (Dey et al., 2013).
Within aquaculture, pond polyculture systems are a way of realis-
ing these objectives – a mix of nutrient-rich small fish species and
‘cash-crop’ species for household consumption and markets can be
grown together to maximize the use of input resources – similar to
the principle of intercropping (Thilsted, 2012). The production of
the small fish, mola (Amblypharyngodon mola) in pond polyculture
has been shown to be cost-effective approach to reduce micronu-
trient malnutrition in Bangladesh, by estimating DALYs saved
(Fiedler et al., 2016).
Efficient management and protection of all systems
Nutrition-sensitive fisheries management can be best-served by
ensuring that small-scale fishers and processors have equitable
access to common resources of coastal and inland waters
(Toufique and Gregory, 2008). This is already mandated by a series
of international codes of conduct and voluntary standards adopted
(though not necessarily implemented) by member states of the UN
Food and Agriculture Organization (FAO, 1995, 2015). Policy must
be mindful that food production is not the only use made of aqua-
tic and marine space. Damming of rivers and lakes for irrigation
and hydropower, draining of fish-rich floodplains and wetlands
for cropping or industrial development, coastal urbanisation and
industrialisation, tourist development, offshore renewable energy,
mining and oil and gas exploration, as well as protected-area con-
servation all compete with fish production (Sale et al., 2014). Thus,
as promoted by SDG 14, nutrition-sensitive water resource, coastal
and ocean policies must consider the nutritional consequences of
non-fisheries activities. The future of fisheries is closely tied to
the impacts of climate change such as rising seawater levels and
temperatures, water scarcity, and food price volatility. In this
respect, climate change is requiring a drastic re-think of food pro-
duction policies – and this offers a good opportunity to apply a
nutrition lens going forward. A major policy concern lies in the
use of wild small fish for fish feed which, on the one hand enhances
the nutritional quality of farmed fish, but on the other, directs low-
cost, nutritious fish away from direct human consumption. Glob-
ally, there are calls to make a greater proportion of these fish
(e.g. sardines, anchovies) available for human consumption.
Depleting wild fish stocks and associated increasing costs are
prompting efforts to use alternative ingredients such as nutrient-
rich algae for fish feed. Strong multi-sectoral policy coordination
and action are required in this regard for fisheries to contribute
to healthy diets and realisation of the SDGs.
Improved value chain and markets
Current fisheries policy is focused on international trade and
markets to ensure large quantities of safe fish and fish products
for consumption in high-income countries. For these markets,
there is large investment in food inspection systems and improved
traceability, with importing countries often insisting on chain-of-
custody certification. In contrast, the vast local and regional trade
of nutrient-rich fish products (particularly dried and smoked small
fish) on which the poor depend is largely neglected in global and
national analyses. Policies should be re-oriented to prioritise access
and ensure affordability of fish and fish products for the poor,
which contribute to their nutritional needs. This requires compre-
hensive multi-sector policy coordination involving, for example,
labour rights, transport and infrastructure, and social welfare. Lack
of data presents a serious problem in understanding this complex
system. Attention must be paid to prioritising the supply of
diverse, nutrient-rich fish species, infrastructure to maintain qual-
ity and year-round access of fish, and the protection of both actors
– many of whom are poor women, and consumers in local and
domestic values chains. With no policy support, this sector is vul-
nerable to negative impacts of an increasingly globalised market in
which fish trade to high-income countries is projected to increase.
Consideration of context-specific consumer preferences and nutritional
needs
Fisheries policies must be positioned within a food systems
approach to healthy diets. This includes consideration of the cul-
tural preferences, food habits and nutritional needs of consumers,
particularly of vulnerable groups such as women and young chil-
dren. Integrated production systems, in the context of local diets,
for example, fish – rice systems, and homestead pond polyculture
with vegetables grown on the dykes, as practised in Bangladesh,
can extend the overall benefits of the fisheries sector to healthy
diets. In addition, the importance of consumer preferences in shap-
ing food demand should not be underestimated. This has impor-
tant implications for analysing trends in demand and predicting
future fish supply (Kobayashi et al., 2015).
In general, lack of suitable data makes it difficult to provide evi-
dence for the positive or negative outcomes of different policy
options for the development of nutrition-sensitive capture fish-
eries and aquaculture. A shift in policy orientation must therefore
be accompanied by a shift in the priorities for research and moni-
toring. Knowledge gaps include: fish consumption patterns, disag-
gregated by season, income group, within household, and
geographic location (beyond national aggregate estimates from
food balance sheets and population size); the contribution of fish
in diets, both nutritionally and culturally, as distinct from other
animal-source foods; nutrient composition at species level, partic-
ularly of indigenous fish; studies linking interventions in capture
fisheries and aquaculture to impacts on nutritional status and
health outcomes; and women’s workload within the fisheries
sector.
Conclusions
Fish are beneficial to nutrition and health and will play an
essential role in sustaining healthy diets (where culturally appro-
priate) in the future. If the vision of the SDGs is to be attained,
the fisheries sector, in the context of growing demand will require
policy frameworks that are nutrition-sensitive. To make this hap-
pen, coordinated policy actions and investments across relevant
sectors are essential. Fisheries must be seen as a core component
of the agriculture sector, as well as an entry point for multi-
sectoral interventions aimed at improving nutrition and health
outcomes. The present narrow focus on productivity gains and eco-
nomic outputs will not suffice. A more balanced approach to sus-
taining capture fisheries and growth in diverse aquaculture
130 S.H. Thilsted et al. / Food Policy 61 (2016) 126–131

systems is required. Complementarities between the capture fish-
eries and aquaculture sub-sectors must be clearly articulated and
capitalised on in order for countries to sustainably increase the
quantity and quality of fish supply while promoting nutrition
and health gains, particularly for poor consumers, between now
and 2030.
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