Children’s Day 2019: India can break the vicious cycle of malnutrition

The face of malnutrition today is complex. More children are surviving birth and early childhood but most are not thriving. Consider this: half of all the world’s children under the age of five suffer from “hidden hunger”. They don’t get diverse meals across the food groups. The result: inadequate micronutrients in the diet lead to adverse cognitive, developmental, and in the longer run, financial issues. [caption id=“attachment_7647041” align=“alignleft” width=“380”]  Representational image. Image source: Getty Images.[/caption] The pulls of globalization, urbanization, fast-food commercialization, the changing but still narrow role of women in society, all contribute to “the triple threat of malnutrition”: undernutrition, hidden hunger, and overweight among children under the age of five. On Children’s Day today, we look at the UNICEF’s exhaustive “State of Our World’s Children 2019” survey of the situation surrounding the food, nutrition and developmental needs of children, for cues on how India can break the vicious cycle of malnutrition.

Maternal and Child Health

The mother’s health has a lasting, and potentially permanent, impact on the lives of her children. Deficiencies in important nutrients tend to be carried over to the next generation. The latest statistics on maternal and child health emphasize this point.   Indicators of Malnourishment: Two crucial indicators for malnourishment are stunting and wasting. Both of these are concerning in the Indian context. Stunting is a form of undernutrition in which children are too short for their age. Stunting in populations has been described as the most reliable indicator of malnourishment since it is a chronic condition; consistent shortage of food or lack of access to micronutrients causes stunting. Thirty-eight per cent of the country’s population (22% among the well-to-do and 51% in the poorest families) is stunted. This is markedly higher than the global average of 22%. Wasting, an extreme form of undernutrition in which a child is too thin for his or her height. It is often caused by an acute shortage of nutritious food and is most common among children under two years of age. About 21% of Indian children have moderate or severe wasting. By contrast, 7% of the world’s children and 15% in South Asia suffer from wasting. Left untreated, children with severe acute malnutrition (SAM) are nearly 12 times more likely to die than a healthy child.

Maternal Health Indicators

According to the UNICEF report, 9% of new moms in India are aged 18 or below. More than half (51%) are anaemic, compared with the world average of 33%. And 24% are inadequately nourished with a body-mass index or BMI of less than 18.5 kg/m2. BMI is the ratio of weight to height. A BMI under 18.5 indicates that the person is underweight. Globally, 9% of new moms have a BMI under 18.5. Maternal malnutrition, in the form of underweight and anaemia, increases the risk of preterm birth and low birth weight, which in turn increase the risk of neonatal death, stunting and wasting.

Intergenerational malnourishment

Malnutrition during pregnancy has long-term effects on brain development, cognition, school readiness, behaviour and productivity into the school-age years and beyond. Malnourished children are more likely to test poorly, have more trouble focusing in the classroom and struggle to find jobs later on in life. The vicious cycle feeds itself: being born into unfavourable circumstances is often followed by inadequate schooling and job opportunities, keeping families locked in the poverty trap.  

Timely interventions

Studies have shown promising signs that there is a way to “catch up” to these nutritional shortcomings. Middle childhood (ages 5-9) is a time of transition; diets change and gender roles subtly start getting defined. A 2010 study conducted in Peru showed that stunted children who caught up by the age of six performed as well on cognitive tests as non-stunted children. However, it is the first 1,000 days of life, the “golden period” that is the most crucial to the development of a child. Supporting the nutrition of adolescent girls and mothers, and encouraging improved infant feeding and hygiene practices in the first two years of life is crucial in the fight against cyclical malnutrition. A spate of other studies conducted recently has shown that the cycle of undernourishment can be arrested within a generation, provided timely and adequate nutrition is provided to children of malnourished parents. This is just a segment of the various issues that need to be understood and tackled to attain good universal nutrition in India. Initiatives like POSHAN Abhiyaan need continued support and reliable funding to address the nutritional shortcomings of the country. One can hope that over time these targeted efforts will pay off. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health. For more information, please read our article on   Malnutrition: Symptoms, Causes, Treatment, and Prevention_._