Galvanize the infant nutrition lifecycle approach
The lack of knowledge about healthy food choices, the poor diversity of the diet and the emphasis on fatty, sweet and salty foods have a disastrous impact on nutritional status
The Fifth Data Series from the National Family Health Survey (NFHS-5) paints a holistic picture of India’s state of health, giving us reason to rejoice and others to reflect. . Data on the nutritional status of India highlights the triple burden of malnutrition (undernutrition, micronutrient deficiencies and obesity) the country faces even before the start of the COVID-19 pandemic. As required, the focus for the past year and a half has been on the immediate threat of the virus, followed by immunization of the population. India is now entering a new phase in which a true resilient recovery can only take place if we commit to focusing on nutrition, especially of the young population collectively.
The second phase of NFHS-5 conducted in 2019-2021 shows that the percentage of children with stunted growth, wasting and underweight has only slightly decreased. There is, however, a slight increase in the percentage of severely wasted and overweight children. At the same time, there has been a sharp increase in anemia in all age groups. The percentage of overweight or obese women and men (BMI —25.0 kg / m2) aged 15 to 49 has also increased.
The Comprehensive National Nutrition Survey for 2016-2018 reveals that one in two Indian adolescents suffers from some form of malnutrition. About a quarter of adolescents are thin for their age while five percent are overweight (BMI for age> +1 SD). Less than half of preschoolers, a quarter of school children and almost a third of adolescents were anemic.
An often overlooked aspect of malnutrition is the lack of proper eating habits. Lack of adequate knowledge and awareness about healthy food choices, low dietary diversity and emphasis on foods high in fat, sugar and salt (HFSS) have a disastrous impact on nutritional status . The existing underlying nutritional challenges have been further exacerbated by the collateral impact of the fight against COVID-19. With the disruption of food and nutrition services such as Integrated Child Development Services (ICDS) and Midday Meals (MDM) and weekly iron and folic acid supplementation (WIFS) in schools, the challenge of malnutrition worsened further. Prolonged school closures and extended online classes not only impacted eating habits, but also decreased children’s physical activity levels, increasing susceptibility to obesity.
Micronutrient deficiency during infancy can often spread into adolescence, which, if left untreated, can have long-term effects on health, cognition, education and productivity . Thus, adolescence can be seen as a second window of opportunity to improve the nutritional status of the individual. India is home to nearly a fifth of the world’s adolescent population (10-19 years). Nutritional requirements increase dramatically and peak during this period with an increase of 15-25% in height, reaching 40-60% of peak bone mass, and up to 50% of adult body weight – as well as ‘blood loss due to the onset of menstruation in girls.
Taking a life-cycle approach, ensuring good nutrition for our children and adolescents, will go a long way in ensuring the good health of future generations.
To strengthen the health of the country tomorrow, we must ensure the optimal nutritional and health status of our children and youth today. To understand the state of nutrition in different segments of the population and the target areas on which to focus for effective, immediate and sustainable interventions, research in the form of rapid assessment must be conducted.
Dietary factors are associated with an increased risk of chronic disease and undernutrition, national and international dietary guidelines recommend improving dietary diversity to achieve a balanced diet. This requires that the needs and sources of macro and micronutrients are understood and accessible by all, especially growing children and adolescents. By enabling and empowering the present and future generation through access and knowledge of healthy food and its sources, India also enables subsequent economic and development goals.
Considering the scale and size of India, in order to achieve this goal, all stakeholders need to take conscious action. Public-private partnerships between sectors can help align efforts towards common goals to combat malnutrition and strengthen immunity. The food technology and logistics expertise of the private sector can be leveraged to strengthen and scale up government initiatives such as Poshan Abhiyaan and Anemia Mukt Bharat. Converging efforts would maximize impact while maximizing value for money across nutritional outcomes for India.
(The author is Associate Professor, Department of Food and Nutrition, Institute of Home Economics, University of Delhi. The opinions expressed are personal.)