Pulse consumption patterns, protein intake, and child nutrition outcomes in Central Madagascar

Pulses offer a cost-effective plant-based protein source, yet their role in improving household dietary quality and child nutrition outcomes in developing countries remains underexplored. This study examines whether increased pulse consumption improves household protein adequacy and reduces early childhood stunting in rural Madagascar, where protein-energy malnutrition remains prevalent. Using a unique high-frequency household panel dataset spanning seven waves from rural central Madagascar collected over three years, combined with concurrent child anthropometric measurements, we estimate the association between pulse consumption and household Protein-Energy Ratios (PERs—a measure of protein adequacy relative to energy intake) and assess whether PERs mediate the pathway linking pulse consumption to child linear growth. Results reveal that a 10-percentage point increase in pulse consumption share within household food expenditure leads to a significant 1.6% improvement in household PERs. Compared to this consumption-share baseline, self-produced and market-purchased pulse consumption showed comparable PER improvements (1.6% and 1.5% per 10-percentage point increase, respectively), as do increased common bean consumption (1.64% improvement) and per capita monthly pulse expenditure (1.86% improvement). Mediation analysis further shows that both contemporaneous and lagged in PER improvements are significantly associated with reductions in early childhood stunting. These findings establish pulses as an effective, accessible intervention for addressing protein-energy malnutrition in smallholder communities. Future research should implement randomized interventions targeting low-consumption households and track sustained nutritional outcomes over longer periods to establish causal pathways between pulse consumption timing and child growth trajectories.