Wednesday, 7 March 2012

How much is right: Nutrition manual for Indians

By Syed Akbar
A majority of Indians are malnourished. Even those who consume sufficient 
quantity of food suffer from malnutrition because they don not get well-
balanced food. Nationwide surveys by Central government agencies over the 
years reveal that Indians, including those living in urban areas, suffer from 
common nutrition problems like protein energy malnutrition and 
micronutrient deficiencies (vitamin A, iron, iodine and vitamin B-complex).
Keeping this in view, the Hyderabad-based National Institute of Nutrition has 
come out with a Nutrition Manual containing dietary guidelines for Indians, 
particularly adolescent girls and pregnant women. The guidelines give a 
broad perspective on the present nutritional scenario in the country, besides 
suggesting the type of food one should take for healthy, long and happy life. 
The nutrition quota differs from person to person depending on the amount 
and type of work he or she undertakes. It also varies depending on age and 
sex.
The nutrition guidelines assume importance in the backdrop of the poor 
health scenario in several parts of the country. About one-third of infants 
born are low in weight i.e. less than 2.5 kgs. This is as against less than 10 
per cent of low birth weights recorded in developed countries including small 
nations like Israel. It was also noticed that two per cent of nursery school 
children in the country suffer from severe and florid forms of protein energy 
malnutrition leading to health problems like Kwashiorkor and marasmus.
Health surveys reveal that children below five years suffer from sub-clinical 
under-nutrition resulting in low weight for age. This is less than 75 per cent 
of median weight for age as fixed by the National Centre for Health 
Statistics. About 65 per cent of these children are stunted (low height for 
age). Under-nutrition if continued throughout the growing phase of 
childhood leads to short stature in adults. Half of the adults in the country 
have body mass index  below 18.5, which in other words means chronic 
energy deficiency.
The dietary goals as envisaged by the NIN include maintenance of a state of 
positive health and optimal performance in populations at large, ensuring 
adequate nutritional status for pregnant women and lactating mothers, 
improving birth weights and promoting growth of infants, children and 
adolescents to achieve their full genetic potential and preventing chronic diet-
related disorders.
The dietary guidelines are: consuming nutritionally adequate diet through a 
wise choice from a variety of foods; additional food and extra care during 
pregnancy and lactation; food supplements for infants by four to six months; 
consumption of green leafy vegetables, other vegetables and fruits in large 
quantities; moderate use of oils, sugar and salt; avoidance of processed and 
ready-to-eat foods; and adequate amounts of water.
According to NIN, a balanced diet should provide around 60 to 70 per cent of 
total calories from carbohydrates, preferably starch, about 10-12 per cent 
from proteins and 20-25 per cent from fat.
Nutrient dense low fat foods are recommended for old people for being 
physically active and healthy. Nutritionally adequate diet with extra food for 
child bearing/rearing women for maintenance of health productivity and 
prevention of diet-related disease and to support pregnancy/lactation.
Body-building and protective foods are recommended for adolescents for 
growth spurt, maturation and bone development. For children's growth, 
development and to fight infections, energy, body-building and protective 
food (milk, vegetables and fruits) are recommended. And for infants, breast 
milk and energy rich foods (fats and sugar) are needed for growth and 
appropriate milestones.
The balanced diet recommended for an adult man (sedentary) per day is: 20 
grams of oil/fats; 25 grams of sugar, 300 grams of milk and milk products, 60 
grams of pulses (for vegetarians), 30 grams of pulses, egg/meat/chicken/fish 
(for non vegetarians), 400 grams of vegetables, 100 grams of fruits and 420 
grams of cereals and millets. Elderly people may reduce 90 grams of cereals 
and millets and add an extra serving of fruit.
In case of women, 300 grams of vegetables, 300 grams of cereals and millets 
and 20 grams of sugar, besides the other dosage recommended for men.
Half of the people suffer from nutritional anaemia and this is more 
pronounced in women as 70 to 90 per cent of them are found to be anaemic. 
Health statistics indicate that anaemia caused due to malnutrition kills over a 
lakh pregnant women. Coming to iodine deficiency, about 300 million people 
live in areas where iodine is in short supply. Iodine deficiency leads to 
problems like goitre, neonatal hypothyroidism, mental retardation, delayed 
motor development, stunting, deaf-mutism and neuromuscular disorders. 
Around one lakh still-birth and neonatal deaths occur every year because of 
deficiency of iodine in mothers.
Studies by the National Nutrition Monitoring Bureau show that the daily 
intake of most foods, except cereals and millets (470 grams) is much below 
the recommended dietary allowances. The diets provide negligible amounts 
of protective foods like pulses (29 grams) and vegetables.
Consumption of green leafy vegetables and other vegetables (70-80 grams), 
which are rich sources of micronutrients like beta-carotene, folate, calcium, 
riboflavin and iron, is woefully inadequate. Intake of visible fat is less than 
60 per cent of the RDA.
"The proportion of households with energy inadequacy is 48 per cent while 
that with protein inadequacy is 20 per cent. Thus, in the cereal/millet-based 
Indian dietaries, the primary bottleneck is energy and not protein, as was 
earlier believed. This dietary energy gap can be easily overcome by 
increasing the quantities of habitually eaten foods by the poor," the study 
points out.

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