Malnourished and under nourished children in India-A reality check

Food, health and life are intricately interlinked and unless there is a balance and moderation in food intake, health is bound to be seriously affected adversely. An oft repeated question is whether the world to day is a better place to live compared to that which existed 5-6 decades ago? If the yardstick for measuring the quality of life is the health, definitely it is much worse than before. There is terrible inequality in accessing available food across the population with opulent countries enjoying a surplus of foods which are very often wasted ignoring the pitiable living conditions of millions of people spanning the three continents Asia, South America and Africa. The two aspects of food which are important to be kept in mind are quality and quantity. In many developed countries quantity of food available, if taken on an average, is more than sufficient to meet the calorie needs of their population. What is sorely missing is the quality of food consumed by them which leaves very much to be desired. Look at the health status of people in the US where more than half the population is over weight while almost one third is afflicted by obesity epidemic. This raises the inevitable question as to what constitutes a good diet and what happens if the diet is not based on factors that influence maintaining of good health.

As a thumb rule,human beings generally need about 2000 kCal, 50 g of proteins, 50 g of fat, 25 g of dietary fiber, 8 essential amino acids and two essential fatty acids which human body cannot make and vitamins and minerals. Water, though not considered a nutrient is also essential corresponding to an intake of 1 ml per calorie ingested. This is supposed to be a golden guideline for preventing development of many health disorders in life and can be easily met by judicial combination of natural food ingredients like cereals, pulses, milk, nuts, fruits, vegetables with or without animal based foods like meat, egg and fish. If the above assumption is correct why is that Americans eating rich foods including an abundance of highly nutritious animal based products still suffer from many diseases to day? Answer to this lies in the fact that the cereals they consume are highly refined devoid of practically all natural nutrients, most calories coming from highly refined white sugar or HFCS, heavy consumption of fat rich foods such as fried ones, baked goods etc and eating too much animal products. It is only recently that a scientific study in the US brought out the startling truth that eating even a small amount of whole grains about 33 g a day can reduce the chance of premature death very significantly! 

What about situation that is obtaining in India? Here again there are sufficient foods available in the country to meet the needs of every citizen but the access to these foods is constrained by economic factors. For many poor people constituting almost 40% of the country's population high quality foods like milk, pulses, egg and meat in sufficient quantities are beyond their reach. This problem is all the more intractable in the rural hinterlands of the country where most poor people live eking out a dreary existence. The highly unpredictable agricultural situation and lack of opportunities for engaging in income generation avocations make matter worse! The much touted Food Security Act does promise almost 1000 kCal of food in the form of very low priced cereals like rice and wheat, while other needs like proteins, fat and some of the essential nutrients are ignored in the scheme of things. All government programs designed so far and being implemented are just to keep hunger away among the poor people but do not bother about the quality of the food distributed under the social responsibility umbrella. 

The most recent circus government is doing under the FSA is giving away rice at Re 1 per kg and wheat at Rs 2 per kg for almost two thirds of the country's population whether all of them really deserve them or not based on economic criteria. The existing school feeding programs are also heavily loaded in favor of cereals. There are supposed to be about 7 lakh kitchens staffed by 26 lack cooks cum helpers serving about 11 crore children in thousands of schools across the country, probably the largest socially oriented scheme any where in the world. This is no doubt a tremendous feat worth appreciating and admiring. Unfortunately these numbers hide more than what they reveal. The program claims to provides about 300 kCal of energy and 16 g of protein for every kid though no one knows how far this target is fulfilled by cooking foods in these school kitchens out of cereals supplied by the government. Providing calories and proteins once a day may be theoretically adequate partially as far as nutrition is concerned but does it fill the tummy of the child who comes to the school hungry? Hardly! Many kids are reported to be coming to the school with empty stomach and wait eagerly till lunch time to get their share of meals cooked at the school. If this is so can the children be expected to concentrate on the lessons taught in the class rooms?

Some pundits have suggested that government should consider providing break fast also to the school kids besides the midday meals   May be a good suggestion but where is the end for such freebies , especially in a country like India not considered to be very rich to squander its resources? A honest citizen often wonders what is the role of the government in welfare of a citizen? A family which spawns a child has no responsibility to look after it and see through its adulthood and further till it can stand on its own legs? Look at India to day where there are government freebies for practically every thing from conception till the end whether they deserve them or not! If government has to give free medical service, child care service, educational service, housing service, subsidized transportation, special allowances for female children, heavily subsidized food grains, pension for old age population and widows, write off loans taken from government banks, provide subsidized fertilizers to farmers whether rich or poor and many other hidden economic help, what is the role of the parents? In this case if breakfast and lunch are provided at school, what else parents have to do? How can a child consider his parent as his own if they are not providing him with food at home? After all government is even giving jobs under NREGA for at least 100 days that puts about Rs 15000 in the hands of many laborers who declare that they do not have any other income.With Rice and Wheat being made available at Rs 1-2 per kg where is the problem in feeding the children at home? If low response to the NREGA scheme as reported in Karnataka is really true, poor people might be hard to find who are enamored by the Rs 15000 that can be earned by working for 100 days! May be there are a few genuine cases with extremely low income who must be identified  as targets for such freebie schemes.             

Many NGOs and international bodies are lamenting that 1 out of 3 children in India is malnourished and world's largest malnourished children live in India. It may sound shocking that 50% of childhood mortality is attributed to malnutrition and under nourishment. Similarly another stock claim is that 46% of children below 3 years of age in India have low Body Mass Index (BMI) which is supposed to be a manifestation of undernourishment and malnutrition. They further aver that inadequate food in quantity and nutritional quality during pregnancy, lactation and after birth are responsible for this sordid situation. One of the critical deficiencies being focused is essential fatty acids (EFA) like Omega-6 and Omega-3 fatty acids which are necessary for proper development of brain, eyes and preempting onset of diseases like CVD, high blood pressure, diabetes, obesity, Alzheimer's, dementia and others during growth later. Plant foods are not considered excellent sources of these essential fatty acids and well to do population derive them from fish and marine food sources. But two plant sources Soybean and Sunflower seeds can be significant sources of EFA , both Omega-6 and Omega-3 and all the programs presently running under the food service schemes must consider including one or more of these oil seeds in the meal recipes being followed.  

V.H.POTTY

http://vhpotty.blogspot.com

http://foodtechupdates.blogspot.com

FOOD PUZZLE-WHAT TO EAT AND WHEN TO EAT

If some one claims that foods with high fats are healthy on April 1, people will consider it as a prank to make them "April Fools". That was what happened when the news item, that a breakfast rich in fat could keep people free from long term metabolic diseases like CVD, blood pressure and diabetes, was flashed all over the world on 1 April 2010! However it became apparent that there is some truth in the claim which was based on the scientific findings appearing in the internationally reputed and peer reviewed publication, International Journal of Obesity.

According to these findings, the metabolic pattern for the day is decided by the type of food one eats first thing in the morning for breakfast (BF) and a fat loaded BF can make fat burning the predominant metabolic activity for the rest of the day. Eating varied types of foods subsequently does not result in unnecessary fat accumulation in the body, preempting the possibility of getting exposed to obesity related health disorders. In contrast eating a carbohydrate rich BF can only promote carbohydrate metabolism through out the day, making the fat components vulnerable to be deposited and consequent weight gain. High fat BF enables the body to transfer energy utilization between carbohydrate and fat during the entire day.

How far one can take it as a credible evidence to support regular consumption of fat-rich BF remains uncertain because these studies were carried out using mice as experimental animals. It certainly requires further corroborative studies using human subjects to validate the theory and if confirmed such a finding finding can have far reaching implication in diet formulation and food consumption practices. Probably the present mindset amongst consumers, health experts and nutritionists cannot accept the preaching that a BF based on "Bacon, Sausage and eggs along with beans, mushroom, tomato and black pudding" can be really healthy!

A similar study earlier, using women as subjects, had found that a high calorie BF, which can deliver as much as 50% of the daily energy need, prevents putting on weight but such a BF can be based on carbohydrates also. Conversely people who skip their daily BF tend to be invariably heavier. Another interesting observation is that women during conceiving can hope to get a baby boy if heavy BF is taken and a baby girl with a low calorie BF.

Looking at the Indian situation, the above studies probably mean that BF based on fried items like poori, parotha, vada, uppuma, dosa etc could be better than those based on idli, phulka, dry roti, plain rice preparations, puddings, puttu, idiyappam etc. Many people in India, because of circumstantial compulsions, take heavy meals in the morning before going to work, take a light meal along with them for the lunch at the work place before returning home after the work and in a city like Mumbai one can rarely see "fat" people on the road. Similarly some of the best administrators hailing from Tamilnadu during nineteen forties, fifties and sixties, were heavy eaters in the morning while being frugal during the remaining part of the day. The old English saying that "eating like a king at breakfast, like a prince at lunch and like a pauper during dinner" may yet turn out to be a home truth after all, till proved other wise.

V.H.POTTY
http://vhpotty.blogspot.com/
http://foodtechupdates.blogspot.com

'KIDDING' AROUND THE KID'S FOOD- YOU ARE WARNED!

Managing kids to make them eat their food regularly is a challenging task for many mothers. Till the age of three, mothers have to do lot of coaxing,cajoling, and persuasion to feed their children. The problems after wards is making the kid eat the right food with balanced nutrition. If the meals in a day are divided into three portions, breakfast time, between 7 am and 10 am is most important because body's energy reserve is at its lowest. 12-14 hours gap between previous day's dinner and next day's breakfast can result in depletion of all nutrients, though the body is relatively inactive during sleeping, only basal metabolism taking place at the resting period. Logically, therefore, breakfast provides the required recharging to raise the level of body function sufficiently to meet the energy and nutrient needs for the physical as well as brain activities, at least till the lunch time.

A recent survey in the US has brought out a chilling reality that 22% of the school going children do not have enough time or inclination to eat their breakfast and are allowed to go to the school almost on an empty stomach 3 to 5 times a week. A further 20% skip their breakfast on 1 or 2 days in a week. What are the implications of such a situation on the health and attitudes of these children as they grow up? One of the serious consequences could be the ability of such children to focus on the learning with an energy level considered low by normal standards. According to some experts this is analogous to driving an automobile without fuel which can cause serious damage to the engine! How far such a claim can stand scientific scrutiny is another matter. But such children will consider taking break fast as redundant and get adjusted to a routine in life with no morning meal before starting the day. Probably this might be the basis on which many school breakfast programs are operating in many countries. But can this be taken as the gospel truth? Is there sufficient scientific evidence to say categorically that body does not have adequate reserve resources to meet the temporary contingency caused by missing the breakfast? Are the parents of such children guilty of abdicating their responsibility of giving them a decent future? Highly subsidized foods available in the school canteens could be one of the reasons for lulling the mothers to a sense of complacency.

Some stray findings here and there do indicate that breakfast is an important meal and as far as possible must be consumed before starting the day's work. It is believed that children regularly missing their breakfast invariably tend to become obese adults of tomorrow, the odds against them being 4-fold. There are also reports suggesting that those kids with irregular breakfast eating habit have less visuospatial memory and alertness compared to normal kids. They also tend score less in maths and perform below par in attention and memory tests; but their capacity for sustained attention in the class room is not affected adversely. A recent report even suggests that the reaction time of children who did not eat breakfast or who ate simple carbohydrate breakfast was almost same as that of a 70 year old person, which is indeed alarming. Thus not eating the breakfast and eating a 'bad' breakfast such as junk foods are undesirable practices deserving to be discouraged. Even if existing data on ill effects of not consuming breakfasts regularly, do not warrant raising an alarm, common sense and logic demand that kids must be discouraged from ignoring the first meal of the day for the simple reason that a hungry child will tend to over eat at lunch, that too preferring foods rich in calories and fat, certainly not good in the long run. Growing children must get their act together as far as eating habits are concerned to become healthy adults of tomorrow!

V.H.POTTY
http://vhpotty.blogspot.com/