Promoting healthy nutrition in children of Bangladeshi origin in East London: Nurture Early for Optimal Nutrition (NEON)

Bangladeshi children living in east London have a much higher risk of poor nutrition and obesity than the average child in the UK. The British-Bangladeshi community is much more likely to develop longer-term health problems and chronic diseases as a result such as heart disease, poor oral health and diabetes.

Previous public health efforts to address this issue have tended to consider all South Asian populations together, which limits understanding of the relevant cultural and social factors that would influence whether a health intervention is accepted.

NEON (Nurture Early for Optimal Nutrition) is a community-based approach to help improve nutrition when a child is 6 months-2 years old, a key time in their development. The study trained community members as ‘community researchers’ to recruit members of their community, interview them, and analyse and interpret the findings. This included introducing female health workers into local women’s groups, based on the WHO-recommended Participatory Learning and Action cycle.

Some 141 people from the British-Bangladeshi community in Tower Hamlets in East London were interviewed. This included parents and grandparents of children aged 6-23 months, as well as community leaders and health professionals.

The model underpinning this approach is a proven model from South Asia. It is the first time that a developing country intervention has been adopted to improve nutritional outcomes and applied to a relevant ethnic community in the UK.

The second phase of the of the NEON project will include a feasibility randomised controlled trial and development of an intervention for other South Asian communities across more boroughs in East London. Funded by the NIHR Academy (£805,854), the next phase aims to optimise infant feeding, care, and dental hygiene practices among South Asian infants under 2 years old. 

The study identified infant feeding and care practices, and features of this community and environment, that could be targeted to improve children’s health. This included:

• specific cultural beliefs (e.g. ‘chubby equals healthy’), and modifiable practices (e.g. a tendency to over feed and preference for fast food). Members of the community offered insights; one mother described kheer, a sweet dish made from milk, rice and sugar. She said of her son: “He absolutely loves it. Any time of the day you feed him that, he’ll eat it.
• environmental factors such as fast-food outlets and advertising. First-time parents were especially keen to have more support and information from health professionals
• cultural behaviours such as that hand feeding by parents is seen as a symbol of love for the child and may continue for years, potentially causing over-feeding.

Overall, improved nutrition and feeding practices, maternal and neonatal survival rates.

The researchers found that consulting the community led to more appropriate and better-quality interventions than ‘top-down’ approaches devised at a distance

The research has influenced Tower Hamlets and Newham Local Authority early year programmes.

The NEON film has been included in The Birthing a Better Future Art & Science Exhibition, aimed at raising awareness of the crucial first two years of life, currently touring the UK.

University College London

London Borough of Tower Hamlets

The Parent and Family Support Services in Tower Hamlets

UCLPartners

British Heart Foundation

Newcastle University

Tower Hamlets GP Care Group