Section 3      Proteins

Protein is an essential macronutrient required for growth, tissue repair, immune function and overall health. Its quality, determined by amino acid composition and digestibility, is especially important for pregnant women, young children and populations experiencing infectious diseases or undernutrition (World Health Organization, 2007). In The Gambia, protein deficiency contributes significantly to the double burden of malnutrition, with undernutrition in the form of wasting and stunting existing alongside rising levels of overweight and non-communicable diseases in children and adults (Nel and Steyn, 2022). More broadly, only 58% of children aged 6 to 23 months meet the minimum meal frequency standard in The Gambia (Terefe et al., 2023), placing them at risk for stunting and cognitive delays.

3.1 Current protein landscape in The Gambia: Nutritional Context

Animal based protein sources

Fish, particularly bonga, ladyfish, tilapia and catfish, is the most widely consumed and affordable animal protein in The Gambia (Ali et al., 2023). Fish is a crucial part of the Gambian diet, especially for coastal communities. Tilapia and other fish raised in fish ponds are cheaper than sea fish and grow faster, making them more cost-effective. Grilled or steamed fish is recommended over fried options for a healthier diet. Dried and smoked fish are widely used, though it is advised to reduce salt content by soaking before cooking. Ebbeh, a seafood dish made with palm oil, is a culturally significant dish.

Chicken and eggs are commonly eaten. Free-range local chicken contains less fat than imported varieties. Clinicians generally advise their patients with non- communicable diseases to eat chicken without skin in order to reduce saturated fat intake. Import of cheaper poultry meat from North America, South America and Europe has been increasing in recent years, leaving poultry farming unaffordable for local farmers, because of the increasing cost of poultry feed ( Baldeh and Jatta, 2023). The use of insects as feed can enhance local poultry and egg production in order to promote sustainable consumption of eggs, which is reportedly low in The Gambia (Ali et al., 2023).

Red meat, such as beef, is consumed but in small amounts, although urban settings have a higher demand for red meat (Ali et al., 2022).  To align with EAT-Lancet guidelines, it is preferable not to increase red meat consumption. Processed animal foods such as fish pies and meat pies made with refined flour are common but should be consumed in moderation. Animal protein sources are also a good source of vitamin A and zinc, which are important for improving immunity to infectious diseases and promoting growth in children.

Dairy products, including milk and fermented milk, are widely consumed in rural areas. Fermented milk products are a staple breakfast item in rural areas, while urban populations often incorporate milk and sour milk into tea or other breakfast beverages. However, the hygiene of unpasteurised milk remains a public health concern as milk is not always heat-treated due to cultural beliefs or taste preferences (Washabaugh et al., 2019). Pasteurising raw milk to remove harmful microorganisms is of utmost importance to ensure the quality and safety of milk products. Overall nutritional value of milk is not affected by pasteurisation (Acdonald et al., 2011)

Plant based and alternative protein sources

Peanuts, red and black beans, kidney beans and locust beans represent key plant protein sources (Ali et al., 2023). Locust beans can be used as a thickener in soups and stews. Melon and sesame seeds are also traditional ingredients in Gambian dishes. Baobab and melon seeds are also used to thicken soups and stews. White beans, cowpeas, and other pulses are important and should be prioritised in diets.  Bean akara is a fried croquette or fritter made commonly with black-eyed beans, onion and spices and served in a baguette. Peanuts, cashew nuts and seeds like sunflower, sesame and pumpkin seeds offer excellent plant protein options. Cashew nuts and salted peanuts are often consumed as snacks or with meals. Plant protein sources should be enhanced with diverse varieties of pulses to improve diet quality. Pulses remain important for health and the environment, and their integration into a variety of dishes should be encouraged.

Highly processed baked beans, commonly served in restaurants, often contain hidden salt and sugar and should be replaced with low-salt and low-sugar alternative recipes. Other plant-based protein sources, such as soya and tofu, are rarely accessible outside niche markets.

Insect protein has been identified by FAO as a sustainable option for human consumption and animal feed (FAO, 2021). Although more popular in rural parts of The Gambia, consumption of insect protein is not widely accepted in urban areas. There are opportunities to explore this further if culturally acceptable, considering the potential to contribute to human nutrition and environmental sustainability. 

3.2 Protein adequacy and nutritional challenges

Despite widespread consumption of protein-rich foods such as fish, The Gambia still falls short of global recommendations. In 2017, the combined supply of meat, poultry, fish, dairy and eggs amounted to 164 grams per person per day, well below the EAT Lancet recommended target of 334 grams and significantly under the global average of 428 grams (Ali et al., 2023; Willett et al., 2019). Furthermore, protein intake is often dominated by cereals, which are low in essential amino acids and also contain amino acids that are poorly digestible (Schönfeldt and Gibson Hall, 2012).

In general, the African population consume less protein than the WHO recommendation of 75 grams of protein per day, with national averages closer to 62 grams (Schönfeldt and Gibson Hall, 2012). Inadequate intake of digestible and utilisable protein is especially problematic for children and those with frequent infectious diseases such as diarrhoea, malaria and tuberculosis  (Ghosh et al., 2012).

In rural areas and during the lean-season (June to October), households have significantly lower access to protein and iron-rich foods (Ali et al., 2023). Additionally, cultural beliefs regarding certain foods, such as taboos against consuming eggs or fish during pregnancy, still persist in some areas and may limit intake (Perez and Garcia, 2013).

Public health and developmental implications

Protein insufficiency in early life is associated with stunting, wasting and long-term developmental challenges. Evidence shows that animal source foods significantly improve child growth, including height-for-age and reduction in stunting by up to 7 percent (Ghosh et al., 2012; Aguayo and Menon, 2016). Pairing cereals with pulses, as well as cereals or pulses with nuts and seeds, improves protein quality through complementary amino acid profiles. Utilisable protein that the body can digest, absorb and use for various functions, rather than crude protein, is a better predictor of child growth outcomes (Ghosh et al., 2012).

Historical data also link protein deficiency to intestinal damage and poor absorption in infants, which contributes to growth faltering (Lunn et al., 1980; Whitehead et al., 1977). These effects may persist into adolescence, even with later interventions.

Social and economic barriers

• Fish remains more accessible than meat or eggs, but the supply of pulses is low (less than 10 g/person/day) in The Gambia compared to West Africa  (Ali et al., 2023).

• Urban populations consume more imported and processed proteins, while rural diets rely heavily on traditional foods (Bah et al., 2022).

• Local production of animal and plant proteins is insufficient to meet demand, increasing reliance on imports (Ali et al., 2023).

• There is limited data on seasonal and regional patterns in household-level protein consumption, hindering effective planning (Sidebottom et al., 2022). 

Strategic recommendations

Improve protein quality and variety

• Promote meals that combine cereals and pulses to complement amino acid profiles, and include fish as a high-quality, highly digestible source of protein.

• Encourage consumption of protein-rich local options such as groundnuts (peanuts), cashew nuts, locust beans and moringa.

• Grilled or steamed chicken is preferred over fried versions for better health outcomes. Eggs are a good source of protein and vitamins.

• Avoid consuming coffee, tea etc with iron-rich foods to facilitate absorption of iron, and try to pair lemon and other citrus fruits.

Increase access to affordable animal source foods

• Invest in local poultry, egg and dairy production, especially poultry farming using insect feed, created by insect farming using fruit and vegetable waste. This circular system uses waste products to create animal source foods.

• Improve fish processing (drying, smoking) and storage to reduce loss and maintain affordability.

Strengthen school feeding programmes

• Incorporate eggs, pulses, seeds and fish into school meals.

• Explore pilot projects using insect and plant-based proteins in institutional feeding schemes.

Address cultural and behavioural barriers

• Launch culturally sensitive awareness campaigns to counter food taboos related to animal sources of protein.

• Involve community leaders in nutrition education targeting pregnant women and caregivers.

Support agricultural and policy development

• Expand smallholder livestock, seeds, nuts and legume farming to strengthen local food systems.

• Develop food-based dietary guidelines that prioritise sustainable, affordable and locally sourced protein.

Improve monitoring and evaluation

• Conduct national dietary surveys focused on protein consumption across age groups and regions.

• Prioritise data collection in children aged 6 to 23 months to guide interventions for life-long behaviour change (Terefe et al., 2023).

To conclude, protein-related undernutrition in The Gambia remains a complex challenge shaped by poor economic access, vulnerable food systems, infectious disease burden and cultural practices. While energy intake has improved with economic development, the diversity and quality of protein sources remain inadequate. Addressing this will require coordinated action across agriculture, education, food services, health and policy. Emphasis should be placed on increasing access to high-quality protein sources, promoting local food production and ensuring vulnerable groups such as children and mothers are prioritised. Strengthening food systems and revising national dietary guidelines to reflect these goals will be essential to achieve long-term nutrition security.

Table 3. Traffic Light Rating: Protein Foods in The Gambia

(Based on EAT–Lancet dietary target intake:~50g/day total protein from diverse sources)

• • Green foods are healthier choices, providing good nutrients without excess fat, sugar, or calories.

  • Yellow foods are generally nutritious but may contain higher amounts of fat, oil, or refined ingredients, but these recipes can be prepared with modifications to be healthier.

  • Red foods that are high in salt, sugar, fats and can be consumed only occasionally.

Protein power – Pulses

• Pulses are a rich source of affordable and sustainable protein, essential amino acids, fibre, slowly digesting starch, various minerals (iron, zinc, magnesium and potassium), vitamins (Vitamin B1, B3 and B9) and polyphenols.

• They are low in fat and salt content, have a low glycaemic index and are very useful in maintaining healthy blood sugar and cholesterol levels

• Cultivation of pulses helps reduce greenhouse gas emissions, increase carbon sequestration and improve soil fertility by nitrogen fixation

• Pulses can grow in a dry climate and have a long shelf life

• They are gluten-free and high in antioxidants

• A study at Oxford Brookes University has identified health as the main driver for consuming pulses.

• A variety of dishes can be prepared by using pulses in flour, split and whole forms.

• Mix chickpea flour with rice or wheat to make pancakes and snacks. Add lentils and beans to soups, stews, curries, sandwiches and salads. Make bean akaras, burgers or savoury bean pudding.

References 

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• Aguayo, V.M. and Menon, P. (2016). Stop stunting: improving child feeding, women's nutrition and household sanitation in South Asia. Maternal & Child Nutrition, 12 (Suppl 1), pp.3–11. https://doi.org/10.1111/mcn.12283

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• Perez, G. M. and Garcia, A. P. (2013) ‘Nutritional taboos among the Fullas in the upper river region, The Gambia’, Journal of Anthropology, 2013, 873612.

• Schönfeldt, H.C. and Gibson Hall, N. (2012). Dietary protein quality and malnutrition in Africa. British Journal of Nutrition, 108(S2), pp.S69–S76. https://doi.org/10.1017/S0007114512002553

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• Washabaugh, J. R., Olaniyan, O. F., Secka, A., Jeng, M., Bernstein, R. M. (2019). Milk hygiene and consumption practices in the Gambia. Food Control, 98,

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• Whitehead, R.G., Coward, W.A., Lunn, P.G. and Rutishauser, I. (1977). A comparison of the pathogenesis of protein-energy malnutrition in Uganda and The Gambia. Transactions of the Royal Society of Tropical Medicine and Hygiene, 71(3), pp.189–195. https://doi.org/10.1016/0035-9203(77)90004-9

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