Nutritional Deficiencies : What are the Remedies ?

Debi Mukherjee (India, 06/05/06)

 

Recent press report has quoted the UNICEF saying "India is worse than sub-Saharan Africa when it comes to feeding its children". Press report further states that the Union government disagrees with the findings of the UNICEF that India is home to the largest population of malnourished children. Without going into merits and demerits of each point of view on so called statistics, a close look at the conditions of living of the weaker section of the society would reveal that a lot needs to be done to combat the problem of malnutrition. The reasons for malnutrition are manifold :

 

¨       Lack of food security

¨       Low purchasing power

¨       Inadequacy of formal and informal nutritional awareness programs on the part of Govt. as well as Voluntary Consumer Activists (termed as NGOs).

 

In order to understand and appreciate the problem let us refresh our knowledge starting with the basics.   

  

Food is an integral part of our life. In terms of priority it occupies the place just after air and water. Substances inherent in food providing energy and raw materials for the synthesis and maintenance of living matter are termed as Nutrients.

 

Human nutrients are carbohydrate, fat, protein, essential amino acids, essential fatty acids, minerals and vitamins. The daily requirements of these nutrients vary widely. The nutrients like carbohydrate, fat and protein which are required in higher quantities are known as macronutrients.  The nutrients which can not be made from the raw materials in food in the body but are required in minute quantities(microgram to milligram) are called essential nutrients. These are also termed as micronutrients. Lack of essential nutrient results in a specific deficiency disease. Inadequacy of Vitamin A in the diet affects our vision, less iron intake leads to anemia specially in women whereas iodine deficiency causes retardation in physical and mental growth, abortion, still birth and goitre.   

 

Fortification of food, which is the enrichment of commonly consumed foodstuff with nutrients/micronutrients in order to improve the nutritional quality of the diet, offers considerable benefits to the population. Food fortification can be used to prevent micronutrient deficiencies in populations where nutrition problems are prevalent. The concept of fortification is not new. The addition of iodine to table salt  to prevent the development of goitre(swelling of neck) was suggested in France 150 years ago. Also other types of food fortification are carried out regularly in many countries. The focus is on both staple foods, as well as any other food item produced and processed industrially. Examples are addition of iodine to Table salt (Switzerland 1923); Vitamin D in Milk (UK, USA 1933); Vitamin A in Margarine (Denmark, 1930); Vitamin B1, B2 and Niacin in flour, bread and corn meal (USA 1941); Vitamin A in Sugar (Central America, 1974).

 

In India, the National Nutrition Policy, 1993 adopted by the Govt. of India emphasizes the need for food fortification specially Vitamin A, iron and iodine. The standards for Margarine and Vanaspati laid down under the Prevention of Food Adulteration Act, 1954 and Rules 1955 (PFA ) provide for addition of Vitamin A. The standards for Iodised salt and Iron fortified salt have also been prescribed.

 

The PFA Rules also provide for standards for Fortified Atta and Maida – atta/maida containing added calcium, iron,  and a few Vitamins of  B complex group [Thiamin( Vitamin B₁-needed for growth), Riboflavin (VitaminB ₂-required for healthy skin and eyes) and Niacin (deficiency causing sore tongue, diarrhea, sunburn like lesions on the skin, mental confusion and depression); Protein rich Atta and Maida-atta/maida containing groundnut or soya flour or a combination of both up to an extent of 10 percent so as provide more protein to the consumers  through chapati/roti eaten daily.

 

Till date these standards remain on paper except iodised salt which has become a daily consumable item in all most all households. Credit goes to untiring effort on the part of National Iodine Deficiency Disorders Control Program (NIDCCP) being run by the Union Ministry of Health and Family Welfare through regular  survey coupled with mass awareness campaigns.

 

No wonder that the District Nutrition Profile studies  conducted during 1995-96 in 18 States/UTs by the National Nutrition Monitoring Bureau (NNMB) reveal the following dismal findings:

 

·         Consumption of cereals, roots and tubers was found adequate in most of the States.

·         The total dietary calorie intake was deficient in majority of the States due to inadequate consumption of other energy rich food

·         Intake of green leafy vegetables was found inadequate in majority of the States.

·         The consumption of milk and milk products per consumption unit was inadequate in almost all the districts of India excepting those belonging to North Region and Gujarat.

·         Intake of fats and oils found inadequate in most districts of India.

·         Dietary intake of protein was marginal higher in almost all the districts of the State.

·         Iron intake was around 70% of the recommended level.

·         A close co-relation was observed by and large between adequacy/food consumption pattern and the income level of consumers.

·         Average nutrients intake revealed an adequacy of Protein, Calcium, Thiamin, Niacin and Vitamin C in almost all the districts surveyed while Vitamin ‘A’ and Riboflavin and Iron Intake was inadequate in most districts.

 

Only solution to combat these deficiencies lies in aggressive educational  activities for the general masses including school children advising them to consume:

 

Ø Soaked pulses like whole moong, chana  preferably germinated which become the source of protein as well as vitamins. These could be consumed as such with salt, green chillies, raw onions thus saving     the fuel cost.

Ø Broken wheat or dalia in combination with milk or cooked with dal.

Ø Lots of green leafy vegetables cooked with dal.

Ø Carrots, radish,  onions, spring onions, tomatoes, cucumber in the form of salad with juice of lime or lemon.

Ø Raw fruits like banana, guava, orange, grapes, apples and mangoes.

Ø Making chapaties from  atta mixed with besan or groundnut flour or soya flour.

Ø Cooked soybeans in the form of chunks or nuggets.

 

 

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