Dual Burden of Malnutrition
By Smiley Gumber
The dual burden of malnutrition is characterized by the coexistence of malnutrition in the two widely categories – under nutrition along with overweight and obesity. In the context of a changing global nutrition landscape, influenced by the economic and income growth, urbanization and demographic change, diet-related epidemiology has seen a significant shift in recent decades.
This crisis exists in a way that the poorly nourished individuals can be seen at both ends of the spectrum (i.e. underweight and overweight/obesity). The usual mind set with the term malnutrition say – malnourishment occurs mostly in individuals who do not have an adequate intake of calories or protein. However, on the contrary, overweight and obese individuals are also seen to be malnourished with deficiencies in other nutrients such as vitamins and minerals.
This dual malnutrition trap is alarming for India, where not only the urban populations are rising, and but also the lifestyle which is taking a shift to a much more people sedentary approach.
The alarming recent WHO statistics have estimated –
- The annual cost of malnutrition to the world economy is costing approximately $80 billion.
- Similarly, the direct cost to the Indian economy is around $10 billion, and the total costs, direct and indirect, at 2-3% of GDP. With every second case of obesity or malnutrition in children, India is taken a step back in its growth curve.
- The states which have seen the highest obesity rates are: Rajasthan, Kerala, Gujarat, New Delhi, Tamil Nadu, Pondicherry. Out of which Kerala has the highest prevalence of hypertension and cholesterol in urban men and women while Pondicherry has the highest prevalence of diabetes.
- In India- 34% of men and 44% of women are overweight and 13% of men & 11% of women are underweight in India.
- There are 16% of children born with low birth weight (LBW) in Urban areas which puts them at a risk for infections and even early death.
The States with highest rate of Malnutrition –
These states across India have experienced India’s highest rates of malnutrition.
i. Uttar Pradesh: A majority of children under the age group of 5 are stunted
ii. Tamil Nadu: According to a National Family Health Survey, 23% of children here are underweight. 25% of Chennai children show moderately stunted growth.
iii. Madhya Pradesh: As per 2015 data, the state has India’s highest number of malnourished children. 74.1 % of the state’s children under 6 suffer from anaemia, and 60 % suffer from malnutrition.
iv. Jharkhand and Bihar: Jharkhand has India’s second highest number of malnourished children (56.5%), followed by Bihar (55.9%)
Steps taken by Government to tackle Malnutrition –
- Expanded the safety net through the ICDS scheme to cover all the vulnerable groups such as children, adolescent girls, mothers, expectant women.
- Fortification of essential foods with appropriate nutrients required by the body (e.g., salt with iodine and/or iron).
- Popularize and availability of low cost nutritious food.
- Initiating and launch of the Mid-day Meal Programme.
- Ensuring food security by increasing production of food grains and cereals.
- Improve dietary patterns by promotion, production and increasing per capita availability of nutritionally rich food.
What MORE is needed to eliminate Malnutrition –
- Empower women and womanhood because they are the best caretakers when it comes to nutrition of their children and they know what exactly is required for nourishment of the child.
- Prevention of anaemia, which is needed to prevent the young, adolescent girls and pregnant women which can be done by fortification and implementation of nutritional programmes proper with iron and folic acid availability.
- Building a team of anganwadi and community workers, who can help to safeguard and promote government policies and schemes to the socio economic classes.
- Introduction of specific growth monitoring cards, BMI and other index for assessing nutritional status for children visiting at the anganwadi levels.
- Proper immunization; checkups should be made with help of anganwadi workers and community managers to help the pregnant, lactating mothers and children to prevent the communicable and non – communicable diseases at a early stage.
- National health and sanitation committees should keep well organised, regular monitoring for the nutrition programme along with conducting promotions for national health and nutrition days
Over to you
Tackling obesity will be uplifting the economy and the environment, as healthy and sustainable diets are good for productivity for all the sectors. While tackling undernutrition there should be assurance of adequate nutrition in order to ensure the right balance of nutrients and to get rid of this global problem. Along with this, it’s equally important to revisit the existing government running nutrition plans and policies to simultaneously address the undernutrition and the emerging non-communicable diseases related to obesity.
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