What is known about the fish intake of people living in disadvantaged communities in the UK? A Scoping Review

Fish provides essential nutrients, including protein, omega-3 fatty acids (oily fish) and other micronutrients, and may be seen to have a prominent role in protecting against non-communicable diseases, especially cardiovascular disease. Recent UK National Diet and Nutrition Survey analysis suggests people are not meeting their weekly fish intake recommendation of at least two portions per week, of which one should be oily. Lower socioeconomic groups are more likely to eat poor-quality diets, with low fish intake, resulting in poor health outcomes. The aim of this scoping review was to examine the factors influencing fish consumption in people living within ‘disadvantaged communities’ in the UK. The review was guided by Arksey and O'Malley's five-stage framework and Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Peer-reviewed literature was searched, focusing on studies carried out in the UK (published in CINAHLPlus, PubMed, Scopus, Web of Science and MEDLINE) and grey literature (Google Scholar, consultations and websites) between January 2000 and December 2023. Selected studies were reviewed and analysed descriptively or using content analysis. A total of n = 26 papers were reviewed, with collated findings suggesting a nuanced picture in relation to fish intake within ‘disadvantaged communities’. Specific barriers were identified, including physical and economic accessibility, with poor access to fish and the high cost of fish (especially oily) positively associated with income level. Demographic characteristics of age, gender, and ethnicity were shown to influence fish intake. Education level also plays a role, namely the higher the education level, the higher the likelihood of regular (i.e., weekly or daily depending on study) fish consumption. Similarly, cultural factors can determine fish-related food choices in adults, which can also influence children's fish intake. Despite some inherent limitations, this review provides important insights into the fish intake of disadvantaged communities. Recommendations are made for researchers, practitioners, and policy makers engaged in (blue) food system strategies to inform the design of interventions and campaigns to promote fish intake, enhance education of its health benefits, and skills in its preparation/cooking in disadvantaged communities to support action to tackle health inequalities.