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A hidden hunger race, Health News, ET HealthWorld

New Delhi: Issues like malnutrition, child mortality, hidden hungerand child wasting still loom large over India’s growth and development story. According to the Government of India (GoI)’s own estimates, over 800 million people have been identified and provided with subsidized food grains through the Public Distribution System (PDS),

as per Global Hunger Index (GHI) 2022 report prepared by Concern Worldwide and Welthungerhilfe, India ranked 107 among 121 nations.

Undernourishment along with poverty comes as a double whammy as both are intertwined with each other. Latest multidimensional poverty index (MPI) Report by the UNDP, in partnership with the Oxford Poverty and Human Development Index, reaffirms this. Over the last two decades or so, India has significantly reduced poverty levels, from about 55 per cent (around 640 million) in 2005-06, the number of people below the poverty line (BPL) is now 16.4 per cent (around 229 million ) in 2019-21. Yet there are challenges that need to be addressed immediately if India is to achieve the United Nations (UN)’s sustainable development goals to eliminate global hunger by 2030.

What constitutes undernourishment and hidden hunger?

according to the Food and Agriculture Organization (FAO), UN, undernourishment means that a person is not able to acquire enough food to meet the daily minimum dietary energy requirements, over a period of one year. As per the GHI’s standards, an individual consuming below 1800 calories a day is considered undernourished. Hidden hunger is a problem associated with micronutrient deficiency that affects development during childhood and can cause a lifelong loss of productivity and potential.

What are the parameters used to identify undernourishment and hunger within a country?

Although there is no global consensus on the parameters used to determine undernourishment and hidden hunger within a country, broadly, the parameters used by the GHI and Comprehensive National Nutritional Survey (CNNS) to measure these deficiencies include inadequate food supply, child wasting, child stunting , child mortality, malnutrition, and macro- and micronutrient deficiencies.

Moreover, the National Family Health Survey (NFHS), which comes directly under the purview of the Ministry of Health and Family Welfare (MOHFW), GoI also puts out data measuring these parameters every year. The World Bank, the FAO, the United Nations Children’s Fund (UNICEF), and the World Health Organization (WHO) are the primary sources of information on the aforementioned indicators.

What is India’s standing on malnutrition among children?

The NFHS-5 (2019–21) report indicates, around 35.5 per cent of children under the age of five are stunted, which means their height has not grown with age. Children who weigh less than the national average for their height are classified as ‘wasted’, with a 19.3 per cent attribute rate. 32.1 percent of children are underweight, and 3.4 percent are overweight.

The GHI Report 2022 has clubbed India under the ‘Serious Category’ along with several other nations, including Afghanistan. India scored 29.1 on a scale from zero (stands for no hunger) to hundred (an extremely alarming situation).

How has India’s progress been on child mortality, and undernourishment in the last two decades?

If we compare the reports published by the GHI itself since 2000-01, we see that India has progressed on three out of four counts. India has done remarkably well in the area of ​​child mortality, it has come down substantially from 7.5 per cent to 3.9 per cent. Undernourishment has also dropped by around six per cent. From earlier 20.7 per cent, it has slipped to 14.5 per cent which means one out of seven children is still facing the brunt. On the issues of child wasting and stunting, India’s rate of change is comparatively low, at just about one per cent every year. According to GHI estimates, India’s performance on child wasting has deteriorated from 16 per cent to 20 per cent in 2022. Little more than one out of every three children (around 38 per cent) is going through a stunting phase.

Why are Indians deemed to be undernourished despite consuming enough calories from food intake?

Malnutrition, by definition, has very broad connotations attached to it. A person is considered malnourished if they are either undernourished or overnourished. The proportion of macro- and micronutrients is not distributed evenly. In other words, malnutrition also means not having a balanced diet.
The recent study titled ‘Global, regional, and national burdens of common micronutrient deficiencies from 1990 to 2019: A secondary trend analysis based on the Global Burden of Disease 2019 study’ published in the Lancet Medical Journal, highlighted the widespread underconsumption of micronutrients and confirmed the findings of the Food Safety and Standards Authority of India (FSSAI), which found that more than 70 percent of Indians do not consume the recommended daily amounts. To fulfill their needs for vitamins and minerals, Indians are opting for supplementary intake.

According to Statista, an online data inventory, the market share of OTC vitamins and minerals in India has been consistently growing since 2016. The revenue size was $1.28 billion in 2016, an increase of 64 percentage points and the market is anticipated to expand by 8.23 per cent annually (CAGR 2022–2027).
As per the standards set by the Indian Council of Medical Research (ICMR), a typical adult should eat one gram of protein per kilogram of body weight each day. In a survey conducted by the Right to Protein, an initiative to spread awareness amongst people about protein consumption, over 2142 mothers based in 16 metros and tier-I cities established the myth, with a whopping majority of 81 per cent of women believing that merely consuming dal, roti and rice is sufficient for daily protein intake.

According to the Indian Market Research Bureau as well, more than 80 percent of Indians might be protein-deficient. Apart from these factors, the excess intake of salt and staggering levels of sugar consumption also contribute to a lopsided diet.

What can India do more about it?

The government of India has several programs including Poshan Abhiyaan, the Integrated Child Development Services (ICDS) scheme, the mid-day meals, and subsidized rations to reduce nutritional deficiencies. In order to achieve the WHO’s nine nutrition goals by 2025: reducing child overweight, wasting, diabetes and anemia among adults etc more proactive measures are necessary. Food fortification can be one such measure that can help bridge the intricacies associated with hidden hunger. As per WHO, food fortification is an evidence-informed intervention that helps control micronutrient deficiencies in the general population at large.

Indians are already protein deficient but the consumer price inflation (CPI) made it even worse before it finally eased out in November 2022. The fall has driven back food inflation, which has come substantially lower at 4.7 per cent as opposed to 7.01 per cent in October 2022. This would definitely encourage people to buy more protein-rich food and make Indians more prone to a more representative diet.




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