Malnutrition not just a problem of the poor; focus should be on correct feeding practices, say experts

New Delhi: Malnutrition not only affects the poor but the affluent families too as they are struggling with overnutrition, which is also a form of malnourishment, healthcare experts have said. As the ‘poshan maah’ (nutrition month) draws to close, experts have highlighted the importance of correct feeding practices which they say is a key to address the problem of malnutrition. Dr. Shailesh Jagtap, Regional Technical Advisor, Maternal and Child Health and Nutrition, Nutrition International Asia said the common understanding is that malnutrition means undernutrition, which is not the case in reality. “It has two spectrums. Undernutrition and overnutrition, which is mostly due to macro-nutrient deficiency i.e., inadequate diet. Another aspect is micronutrient deficiency which is a hidden malnutrition having its own effects on growth and development,” Jagtap told PTI. “Once we understand this, we would realise that malnutrition is not the problem of only the poor. Poor are grappling with undernutrition and the rich are grappling with overnutrition,” he added. He said affordability may not be the issue with most of the community, but lack of awareness certainly is. “Lack of awareness on recommended dietary diversity and which locally available food can constitute a diversified diet, along with misconceptions in the community on what food to eat, when to eat, how much and how many times to eat, would need to be addressed,” he said. He stressed on the importance of correct feeding practices during the first 1,000 days of the growth of children. He advised women to include micronutrient supplementations like Iron Folic Acid (IFA) and calcium during pregnancy, early initiation of breastfeeding, and exclusive breastfeeding till completion of six months. Jagtap said it is important to introduce adolescents to good nutrition early on to avoid the development of poor eating habits. Dr Seema Puri, Associate Professor, Department of Nutrition, Institute of Home Economics University of Delhi, said malnutrition or undernutrition is more common among the poor, which could mainly be due to lack of food, but even in economically better off sections, different forms of malnutrition like micronutrient malnutrition or hidden hunger are seen. Anemia affects all ages and income groups, vitamin D deficiency is mainly due to lack of sun exposure and hence seen in more affluent sections of the society. “Low birth weight babies, their prevalence is quite high even in the highest wealth quintiles. Obesity, which is a form of malnutrition, is now being reported even from slum areas, among the poor,” she said. “The influence of social media has increased wherein information available may not always be evidence based and correct. So, making the wrong food choices, increasing portion sizes, erratic eating schedules are the reasons. But other factors play an important role - for obesity - lack of physical activity is a major driver. Sedentariness has increased tremendously,” she said. Puri said the way to tackle this is to create awareness about a healthy lifestyle- diet and physical activity. She said it is important for mothers to avoid ultra processed foods in the child’s diet and make conscious healthy choices. Dr Vandana Sabharwal, Assistant Professor at Department of Food and Nutrition, Institute of Home Economics at University of Delhi, concurred with Puri saying malnutrition is affecting both the poor and affluent society of the country. “Findings from National Family Health Survey- 4 (2015-16), reflect that neither the poor nor the rich are consuming a balanced diet having a variety of nutritious foods in our country,” she said. “For instance, there is not much difference in daily consumption of dark green leafy vegetables among men and women belonging to the lowest and the highest income quantile,” Sabharwal said. While many poor families cannot afford or access enough nutritious foods, the underlying reason among affluent society is clearly lack of awareness, she added. “This can be well supported by evidence from the same report (NFHS-4), which states that 36.9 per cent of women belonging to the high-income groups consume aerated drinks as compared to 13.6 per cent of women of poor households,” she said. “Nothing less than a revolution is required to reverse these trends. Intensified behaviour change communication initiatives for limiting consumption of processed foods and encouraging consumption of foods close to our traditional diets rich in millet, local and seasonal foods are required,” she added.