1. COMMON NUTRITION PROBLEMS IN INDIA Dr. K.VIJAYARAGHAVAN DIRECTOR – RESEARCH, SHARE INDIA (MEDICITI INSTITUTION) & Sr. Dy. Director, NIN (Retd) < [email_address] >

2. MOTHER AND CHILD SURVIVAL MMR 407/100,000 live births IMR* 58/1000 live births Child Mortality 19.5/1000 Children Rate(1-4 years) Vijayaraghavan *Gujarat 53

3. NUTRITION PROBLEMS IN INDIA WHO IS AT RISK?? PREGNANT WOMEN LACTATING WOMEN INFANTS PRESCHOOL CHILDREN ADOLESCENT GIRLS ELDERLY SOCIALLY DEPRIVED (SC & ST Communities) . Vijayaraghavan

5. PREVALENCE OF LBW IN S.E ASIAN COUNTRIES Vijayaraghavan

7. Source : Shanti Ghosh Source: Shanti Ghosh et al, 1978

8. Source: Leela Iyengar & Apte, S,V.,1970

9. Source: Leela Raman & Rajalakshmi,1974

13. SUB-CLINICAL FORMS OF PEM Vijayaraghavan HEIGHT FOR AGE STUNTING  WEIGHT FOR HEIGHT WASTING  WEIGHT FOR AGE UNDERNUTRITION

14. UNDERNUTRITION IN INDIA PRESCHOOL CHILDREN ADULTS (Females) Based on BMI Vijayaraghavan Based on NCHS weight for age

15. VIJAY’00

16. DISTRIBUTION WEIGHT FOR AGE – IAP Gujarat Normal Gr. I Gr. II Gr. III Gr. IV

17. WEIGHT FOR AGE– SD CLASSIFICATION - GUJARAT

18. VITAMIN A DEFICIENCY

19. BITOT SPOT KERATOMALACIA BILATERAL BLINDNESS V A D Vijayaraghavan

21. VITAMIN A DEFICIENCY (%) IN INDIA * 24-71 MONTHS Vijayaraghavan 2.8 - ICMR, 2001 PREGNANT WOMEN - 0.7 NNMB PRESCHOOL CHILDREN 1.03 0.7 ICMR, 2001 AGE GROUP - XN* 2.1 NIN- SURVEYS SOURCE X1B

22. VITAMIN A DEFICIENCY Districts(%) with X1B >0.5% Average prevalence (%) 2.1 Based on surveys in 126 Dts. by NIN and NNMB Vijayaraghavan No VAD VAD

23. NUTRITIONAL DEFICIENCY SIGNS IN PRESCHOOL CHILDREN Vijayaraghavan

24. Vijayaraghavan

25. ANAEMIA

26. Vijayaraghavan

27. PREVALENCE OF ANAEMIA -ADOLESCENT GIRLS

29. IODINE DEFICIENCY DISORDERS

30. 239 OF 282 DTs. SURVEYED – ENDEMIC 167 millions AT RISK ? IODINE DEFICIENCY DISORDERS GOITRE+

31. PREVALENCE OF GOITRE IN 6-12 Yr CHILDREN - Gujarat

32. DIETARY INTAKES

33. HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS VIJAY’00

34. HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS

35. NUTRIENT INTAKES AMONG INDIAN WOMEN Source: NNMB, 2000 NUTRIENTS 106 84 86 Folic Acid (  g) 29.4 28.4 32.0 Vitamin C (mg) 0.9 0.8 0.8 Riboflavin (mg) 1.1 0.9 0.9 Thiamin (mg) 1.1 142 148 Vitamin A (  g) 162 11.0 11.3 Iron (mg) 12.4 339 382 Calcium (mg) 373 21.5 24.5 Total Fat (g) 224.3 1994 1983 Energy (kcal) 56.5 47.2 49.9 Protein (g) LACTATING WOMEN PREGNANT WOMEN NPNL

36. NUTRIENT INTAKES IN PREGNANT WOMEN % RDI Source: NNMB,2000 32.9 4.9 4.9 7.3 8.5 7.3 6.1 6.1 22 Total Fat 17.1 7.3 4.9 4.9 18.3 12.2 13.4 20.7 1.2 Riboflavin Protein 2.4 9.8 40.2 36.5  100 2.4 2.4 8.5 7.3 90-100 1.2 2.4 9.8 9.8 80-90 1.2 3.7 11 23.2 70-80 0 0 17.1 8.5 60-70 7.3 9.8 11 9.8 50-60 9.8 11 2.4 3.7 40-50 22 8.5 0 1.2 30-40 53.7 52.4 0 0 <30 Iron Vitamin A % RDI Energy

38. DETERMINANTS OF MALNUTRITION MATERNAL MALNUTRITION START WITH A HANDICAP( LBW ) FAULTY CHILDFEEDING PRACTICES DIETARY INADEQUACY FREQUENT INFECTIONS LOW PURCHASING POWER LARGE FAMILIES HIGH FEMALE ILLITERACY TABOOS AND SUPERSTITIONS

39. Factors Affecting Nutritional Status High illiteracy Unemployment/ Underemployment Large families Low purchasing power Ignorance High dependence rate False food beliefs Inadequate intakes Low Procurement of foods Poor PDS High cost Low availability of foods Low production Reduced work Malnutrition of foodgrains output Poor environment Morbidity Absorption of nutrients Low Appetite Poor utilization of services poor coverage of immunization Improper health services poor infrastructure Lack of resources

41. THANKS & NAMASKAR