India's Malnutrition Crisis

India is all prepared to observe International Nutrition Week from September 1 - September 7. Amid this, the country's malnutrition crisis remains a pressing concern. Despite rapid economic growth, millions of Indians, particularly children and women, suffer from malnutrition. The latest 2024 data from the Women and Child Development Ministry reveals alarming statistics, with about 36% of children under 5 suffering from stunting, 6% wasted, and 17% being underweight.

The three terminologies—stunted, wasted, and underweight—are the primary indicators that reflect levels of malnutrition in children. Wasting is a sign of acute malnutrition used for children who are too thin for their height. Stunting is attributed to children who are too short for their age. In contrast, underweight children have a low weight for their age, thus carrying traits of both stunting and wasting or either of them.

What are the parameters for measuring nutrition

Body mass index (BMI)

A standard measurement for malnutrition in school-aged children in India and internationally. BMI is calculated using the formula weight (kg) / height (m)

Height

Average height is a primary indicator of nutrition, public health, and standard of living. A decline in average height can indicate that a country is regressing on public health and economic goals.

Body composition

An essential part of nutritional assessment is that studies show that Indian children have higher body fat for a given BMI than Western populations.

Skinfold measurements

A widely used anthropometric method for assessing nutritional and fat status. It can determine the proportion of fat to non-fat tissue.

Recumbent length

Used to measure the "height" of young children (below two years). The child is laid on their back on an infantometer with their head touching the headboard and legs towards the sliding board.

Physical examination

An essential component of nutrition assessment that can identify muscle wasting, subcutaneous fat loss, and oedema

Based on the data announced by the WCD minister, Uttar Pradesh tops the stunting chart with rates as high as 46.4%. In comparison, Lakshadweep leads in wasting with almost 13.22% children affected. When it comes to the rate of underweight children, Madhya Pradesh assumes the top position, with the percentage of affected children being at 26.21%. These strikingly high figures are a result of primarily inadequate food intake, diseases, poor dietary diversity and quality, inadequate access to healthcare and sanitation, limited awareness about nutrition, lack of healthy eating practices, and socio-economic disparities and poverty.

India's malnutrition crisis also has far-reaching health as well as neurological consequences, including impaired cognitive development and learning abilities in children, increased risk of chronic diseases, reduced productivity and economic growth, and perpetuation of poverty and socio-economic disparities.

However, while malnutrition remains a black spot in India, some states have fared better when caring for their children's nutrition. Goa, for instance, has the lowest malnutrition rates across India, with stunting being at only 6%, wasting at under 1%, and underweight children at 2.2%. These numbers are the lowest across the country and suggest a dire need for better nutrition policies and health conditions.

Nutritionists and healthcare professionals also emphasise the importance of addressing malnutrition through a multi-faceted approach, including improving access to nutritious food, enhancing healthcare services, promoting sustainable agriculture practices and food security initiatives, and encouraging policy reforms to address the socio-economic determinants of malnutrition. Initiatives like the National Nutrition Mission (NNM) or the POSHAN Abhiyaan aim to address malnutrition through targeted interventions.

With all these initiatives in place, India needs increased funding, improved implementation, and community engagement to achieve significant progress and meet the target of eradicating malnutrition. We must also adopt a comprehensive approach that involves strengthening healthcare systems and nutrition services, promoting nutrition education and awareness campaigns, and encouraging reforms. Addressing malnutrition requires a multi-sectoral approach involving government agencies, civil society organisations, and the private sector. Collaboration and coordination among these stakeholders are crucial to effectively implementing nutrition programs and schemes.

To make the most of today's technology, innovation, and data-driven society, novel solutions, such as mobile health technologies and digital platforms, can enhance nutrition services and facilitate access to vulnerable populations. Our key while addressing malnutrition is to ensure that vulnerable populations have access to nutritious food, healthcare, and education. This can be achieved through sustainable agriculture practices, food security and social protection programs, and community-based initiatives. Regarding community-based initiatives, India can learn from successful nutrition and credit-based programs in other countries, such as Brazil. Their Bolsa Familia program has shown significant reductions in child malnutrition, and by adapting these models to the Indian context, we can develop practical solutions to address its malnutrition crisis.

Guidelines to counter malnutrition

The National Institute of Nutrition has laid down some guidelines to counter malnutrition in India:

• Eat a variety of foods: Eat a balanced diet by eating a variety of foods from at least eight food groups.
• Eat more protein: Increase protein consumption to 14% of total daily energy from the current 6-9%. Good sources of protein include pulses, meat, poultry, and fish.
• Reduce processed foods: Avoid processed foods that are high in salt, sugar, and fat.
• Breastfeed: Exclusive breastfeeding for the first six months, and continue breastfeeding for up to two years or more.
• Provide micronutrient-rich foods: Provide micronutrient-rich foods to elderly people to help them stay fit and active.
• Get vitamin D: Get exposure to sunlight to obtain vitamin D

The complex issue of malnutrition requires a comprehensive and sustained response. By understanding the root causes and adopting a multi-faceted approach, we can significantly progress in addressing this challenge. We must also empower local communities to take ownership of nutrition programs to ensure that interventions are tailored to meet the specific needs of vulnerable populations. With all these steps and concerted efforts, India can provide its citizens with a healthier, more nourished future and achieve zero hunger and malnutrition.