This document discusses micronutrient deficiencies in India and recommendations for addressing them. It finds that iron deficiency anemia and iodine deficiency are major public health problems, affecting 50-70% of women and children. Cereal-based diets in India are deficient in micronutrients like iron, calcium, vitamin A, and others. This hidden hunger extracts a heavy human and economic toll. The document recommends strategies like micronutrient supplementation, food fortification, promoting nutrient-rich traditional foods, improving food storage and processing, and nutrition education.
Plant Breeding as a component of public health strategyRajiv Sharma
This document discusses micronutrient malnutrition, also known as "hidden hunger", which afflicts over 40% of the world's population. Billions of people in developing countries suffer from deficiencies in important vitamins and minerals due to their reliance on staple crops that are poor sources of micronutrients. This can seriously damage health, development, and economic productivity. Approaches to address malnutrition include food fortification, supplementation, and biofortification of staple crops through plant breeding to make them more nutritious. The document focuses on the burden of micronutrient deficiencies in India and efforts of organizations like the Micronutrient Initiative to combat these issues in South Asia through integrated national nutrition programs.
Anderson, Unorthodox Health Care Cost Reductionsjwanderso
Novel Big Hitter interventions that will have dramatic cost savings due to improved health. Chronic diseases of aging and how to prevent them with unorthodox, effective interventions.
Hidden hunger refers to deficiencies in essential vitamins and minerals that negatively impact health. It is a problem globally but especially in developing countries where diets lack variety. Fighting hidden hunger is important because it can increase mortality and limit economic growth and development. The key players in hidden hunger are vitamin A, zinc, iron, iodine, and folic acid. Deficiencies of these micronutrients have widespread health impacts such as increased risk of death, impaired cognitive and physical development, and reduced immunity. Prevalence of deficiencies is high in many countries according to national surveys, though coverage of interventions to reduce deficiencies is increasing.
This document discusses the economics of nutritional programs in India. It defines nutrition and describes the history and development of nutritional concepts. It then discusses nutritional development and concerns in India, focusing on malnutrition problems like deficiencies, anemia, and goiter. The document outlines an integrated multi-sector approach needed to address nutritional imbalance, including national dietary goals, preventive measures at family/community/national levels, and the need for international cooperation. It argues that improving nutrition drives economic growth by increasing productivity, and that the returns from nutritional programs far outweigh their costs.
The document discusses malnutrition among children in India. It defines protein energy malnutrition and outlines the different types. It notes that India has a high proportion of malnourished children, with approximately 47% of children under 3 being undernourished. The main causes of malnutrition in India are inadequate food intake and infections like diarrhea, which increase nutrient needs and decrease absorption.
Decades of economic growth and development along with better governance and nutrition-specific programmes had lifted hundreds of millions of people in Asia out of poverty, as well as starvation and malnutrition. However, due to the uneven development, while a large segment of Asian's population had changed their eating habits to over-nutrition diets and worrying about lifestyle diseases like diabetes, cancer and heart diseases, there are still some countries and regions suffering from lack of nutrition. For example, childhood malnutrition and stunting is still prevalent in South Asia, one Indian survey found that 21% of children suffer wasting, and a further 7.5% of children suffer it severely.
For more details, please visit: https://eiuperspectives.economist.com/sustainability/fixing-asias-food-system/white-paper/food-thought-eating-better?utm_source=OrganicSocial&utm_medium=Slideshare&utm_campaign=Amundi&utm_content=Slideshare_whitepaper
Malnutrition is a major problem in India, affecting both undernutrition and overnutrition. Undernutrition remains highly prevalent, with over one third of the world's malnourished children living in India. Stunting and wasting rates have declined slightly from 2005-2006 to 2013-2014 but remain high across many states. Exclusive breastfeeding rates have increased significantly over this period but require further improvement. Factors like poverty, large family sizes, poor access to healthcare, and cultural practices contribute to India's malnutrition problem. Malnutrition impacts individuals' health and development as well as economic productivity. The government has launched programs aiming to reduce undernutrition through school meals, child development schemes, and improving access to healthcare.
Plant Breeding as a component of public health strategyRajiv Sharma
This document discusses micronutrient malnutrition, also known as "hidden hunger", which afflicts over 40% of the world's population. Billions of people in developing countries suffer from deficiencies in important vitamins and minerals due to their reliance on staple crops that are poor sources of micronutrients. This can seriously damage health, development, and economic productivity. Approaches to address malnutrition include food fortification, supplementation, and biofortification of staple crops through plant breeding to make them more nutritious. The document focuses on the burden of micronutrient deficiencies in India and efforts of organizations like the Micronutrient Initiative to combat these issues in South Asia through integrated national nutrition programs.
Anderson, Unorthodox Health Care Cost Reductionsjwanderso
Novel Big Hitter interventions that will have dramatic cost savings due to improved health. Chronic diseases of aging and how to prevent them with unorthodox, effective interventions.
Hidden hunger refers to deficiencies in essential vitamins and minerals that negatively impact health. It is a problem globally but especially in developing countries where diets lack variety. Fighting hidden hunger is important because it can increase mortality and limit economic growth and development. The key players in hidden hunger are vitamin A, zinc, iron, iodine, and folic acid. Deficiencies of these micronutrients have widespread health impacts such as increased risk of death, impaired cognitive and physical development, and reduced immunity. Prevalence of deficiencies is high in many countries according to national surveys, though coverage of interventions to reduce deficiencies is increasing.
This document discusses the economics of nutritional programs in India. It defines nutrition and describes the history and development of nutritional concepts. It then discusses nutritional development and concerns in India, focusing on malnutrition problems like deficiencies, anemia, and goiter. The document outlines an integrated multi-sector approach needed to address nutritional imbalance, including national dietary goals, preventive measures at family/community/national levels, and the need for international cooperation. It argues that improving nutrition drives economic growth by increasing productivity, and that the returns from nutritional programs far outweigh their costs.
The document discusses malnutrition among children in India. It defines protein energy malnutrition and outlines the different types. It notes that India has a high proportion of malnourished children, with approximately 47% of children under 3 being undernourished. The main causes of malnutrition in India are inadequate food intake and infections like diarrhea, which increase nutrient needs and decrease absorption.
Decades of economic growth and development along with better governance and nutrition-specific programmes had lifted hundreds of millions of people in Asia out of poverty, as well as starvation and malnutrition. However, due to the uneven development, while a large segment of Asian's population had changed their eating habits to over-nutrition diets and worrying about lifestyle diseases like diabetes, cancer and heart diseases, there are still some countries and regions suffering from lack of nutrition. For example, childhood malnutrition and stunting is still prevalent in South Asia, one Indian survey found that 21% of children suffer wasting, and a further 7.5% of children suffer it severely.
For more details, please visit: https://eiuperspectives.economist.com/sustainability/fixing-asias-food-system/white-paper/food-thought-eating-better?utm_source=OrganicSocial&utm_medium=Slideshare&utm_campaign=Amundi&utm_content=Slideshare_whitepaper
Malnutrition is a major problem in India, affecting both undernutrition and overnutrition. Undernutrition remains highly prevalent, with over one third of the world's malnourished children living in India. Stunting and wasting rates have declined slightly from 2005-2006 to 2013-2014 but remain high across many states. Exclusive breastfeeding rates have increased significantly over this period but require further improvement. Factors like poverty, large family sizes, poor access to healthcare, and cultural practices contribute to India's malnutrition problem. Malnutrition impacts individuals' health and development as well as economic productivity. The government has launched programs aiming to reduce undernutrition through school meals, child development schemes, and improving access to healthcare.
This document summarizes the key topics of health, sanitation, and related issues in India. It discusses definitions of health and its determinants. Major health issues in India include high rates of child malnutrition, infant mortality, diseases, and lack of access to safe drinking water and proper sanitation. Poor sanitation contributes to the spread of infectious diseases and is a potential cause of malnutrition. Rural health care services remain inadequate. The document outlines various approaches to improving sanitation and waste management in India.
Malnutrition results from eating a diet where nutrients are either not enough or too much, causing health problems. It can involve calories, protein, carbohydrates, vitamins or minerals. Undernutrition refers to not getting enough nutrients and overnutrition refers to getting too many. Malnutrition commonly refers to undernutrition and its causes include poverty, infectious diseases, and lack of breastfeeding. Treatment involves improving nutrition through food supplementation, therapeutic foods, and treating underlying illnesses. Globally in 2018, 821 million people experienced undernutrition.
1. Micronutrient deficiency, also known as hidden hunger, is caused by consuming cheap but nutritionally deficient foods lacking essential vitamins and minerals.
2. It can negatively impact health and development without producing obvious symptoms of hunger. Common forms include deficiencies in vitamin A, iron, iodine, and zinc.
3. Vulnerable groups especially at risk include women, pregnant women, lactating women, children, and the elderly. Micronutrient deficiencies have social, economic, and health impacts including reduced cognitive ability and economic productivity.
Measuring Poverty through Child Malnutrition A Study With Special Referance T...iosrjce
This study examines child malnutrition in Arumbavur Village, Perambalur District, India. It finds that 81.74% of children in the village are malnourished based on body mass index (BMI) measurements, which is higher than the national average of 43%. Through interviews with 115 households, it identifies several socioeconomic factors contributing to malnutrition, including low family incomes below the national average, lack of sanitation facilities, and limited access to nutritious foods. While most children are breastfed, the average duration is only 6.7 months. The study concludes that despite families' efforts to provide nutrition, children in the village remain underweight and stunted due to their socioeconomic conditions.
This document discusses malnutrition in India. It defines nutrition and malnutrition, and notes that malnutrition results from an unbalanced diet lacking in nutrients. It then outlines some key causes of malnutrition in India, such as deficiencies in iron, vitamin C, folic acid and iodine during pregnancy that can harm fetal development. Statistics are presented showing India's large contribution to the global underweight burden in children under 5. The document concludes by recommending interventions like community-based nutrition monitoring and creating nutritional databases, and emphasizing that malnutrition can be prevented through optimal infant and child feeding.
Malnutrition in India-Background and solutions proposedRohen Agrawal
Despite India's 50% increase in GDP since 1991, more than one third of the world's malnourished children live in India. Among these, half of them under 3 are underweight and a third of wealthiest children are over-nutriented. The World Bank estimates that India is one of the highest ranking countries in the world for the number of children suffering from malnutrition. The presentation proposes how this problem of malnourishment can be eliminated from India.
Effect of Nutrition Education on Anemic Rural Adolescent Girls in OdishaYogeshIJTSRD
Adolescence is considered as the nutritionally vulnerable period due to an increased demand for nutrients due to growth spurt. It has a far reaching implication on their reproductive health in their later years. In Odisha, the prevalence of anemia among adolescent girls in general, has not been well documented. Hence, the present study investigated the prevalence of anemia and effect of nutrition education on anemic adolescent girls in a selected population of Odisha. Adolescent girls 12 17 years who were studying in schools and colleges and residing in the study area for a minimum of six months were included in this study. Total numbers of 508 adolescent girls 12 17years were screened for anemia. Considering its association with the lack of right knowledge, attitude, and practice KAP , it could be preventable. The objectives of the study were 1 to assess the Knowledge, Attitude and Practice KAP of the adolescent girls about Anemia, 2 To determine the association between the selected demographic variables and the level of KAP among the adolescent girls, 3 to analyse the effectiveness of the planned nutrition education of Anemia programme on knowledge, attitude and practice. Dr. Sandhya Rani Mohanty "Effect of Nutrition Education on Anemic Rural Adolescent Girls in Odisha" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45002.pdf Paper URL: https://www.ijtsrd.com/home-science/extension-education/45002/effect-of-nutrition-education-on-anemic-rural-adolescent-girls-in-odisha/dr-sandhya-rani-mohanty
The document outlines several major health problems in India including communicable diseases, nutritional problems, environmental sanitation issues, medical care problems, and population issues. It provides details on specific communicable diseases like malaria, tuberculosis, and diarrheal diseases. Nutritional problems discussed include protein-energy malnutrition, nutritional anemia, low birth weight, and iodine deficiency. Environmental sanitation lacks safe water and proper excreta disposal. Medical care has inadequate funding and uneven distribution of resources. Rapid population growth also exacerbates other health challenges.
Nutritional problems and programmes in indiapayelkoyena
This document discusses major nutritional problems in India and national nutritional programs. It outlines 11 major nutritional problems including protein energy malnutrition, anemia, vitamin A deficiency, iodine deficiency disorders, low birth weight, fluorosis, lathyrism, market distortion, obesity, cardiovascular disease, and cancer. It also describes 12 specific causes of nutritional deficiency in India and details several national nutritional programs aimed at addressing these issues.
Influence of Micronutrient Deficiency on the Prevalence of Respiratory Diseas...iosrjce
The study entitled “Influence of micronutrient deficiency on the prevalence of respiratory diseases
among children 6-12 years” was conducted to assess the nutritional status of the children. Majority of the socio
economic variables such as age, area of residence, family income are found to have an impact on the nutritional
status of the children with respiratory diseases.
Method: In this study anthropometric, bio-chemical, clinical and nutritional assessment was done for 100
children with respiratory diseases from thiruvananthapuram district of Kerala. The data regarding the socio
economic status, nutritional status and health status were collected using suitably structured schedule. The
nutrient intake was assessed by 24 hour recall method. The hemoglobin levels and calcium levels of the
subsamples were analyzed biochemically. The results were statistically analyzed.
Result: Nutritional anthropometry of the children with respiratory diseases indicates that 77% of the children
were underweight. The biochemical analysis of blood samples indicates that 75% were having iron deficiency
anemia. Mean nutrient intake of both male and female children with respiratory diseases indicates that both of
them are deficient in all nutrient s consumption with respect to RDA.The statistical analysis by t-test reveals that
for males fat consumption and riboflavin consumption were significant at 0.01 levels. For the females it was
found that t-test analysis shows protein, fat, iron, vitamin C and riboflavin consumption were significant at 0.01
levels.
Food Insecurity and Government Intervention for Sustainable Food Access in Od...IJLT EMAS
This paper aims to find out the status and causes of food insecurity and policy measures taken by the government to reduce insecurity in Odisha. The data used in this paper have been collected from different secondary sources like books, journals, news papers, government reports etc.
The study shows that the main cause of food insecurity in Odisha is absence of purchasing power of people to purchase adequate amounts of foods to meet basic minimum food requirements. Purchasing power is absent because of poverty. 9%of the population are extremely food insecure consuming less than 1800 kcl per day. The vulnerability is high in southern and northern regions of the state as well as among SC and ST communities and is more experienced in rural areas than urban areas.
Government of Odisha intervene the situation to counter insecurity through different measures like subsidized distribution of food grains, nutrition provisioning through Anganwadis and mid-day meals, food for work programmes etc. Because of implementation of these measures calories intake of people of KBK regions has increased from 1674.6 kcl in 2004-05 to 1819.0 kcl in 2011-12 and that of non-KBK regions has increased from 2046.5 kcl in 2004-05 to 2076 kcl in 2011-12. Finally, the paper suggests that the government should focus on development of agriculture and employment generation and price stability.
This document presents data on child malnutrition in India and other countries. It shows that India has high rates of low birth weight (28%), underweight children under 5 (41%), wasting (16%), and stunting (38%). The data examines factors contributing to malnutrition like sanitation and hygiene practices, access to safe drinking water, mother and child care practices, and access to nutrition programs. Improving these underlying factors through access to healthcare, nutrition programs, safe drinking water, and sanitation could help reduce India's high child malnutrition rates.
This document discusses several key health issues affecting rural populations in India. It states that over 1 million deaths annually are caused by unsafe water and poor sanitation. Indoor air pollution from solid fuels also kills over 1 million people yearly. Other major causes of death include malaria, urban air pollution, road accidents, climate-related impacts, and poisonings. The document also discusses high rates of malnutrition, infant and maternal mortality, and diseases in rural India due to factors like poor infrastructure, sanitation, and access to healthcare.
Malnutrition is a serious problem in India, where 189.2 million people are undernourished according to the UN. India is home to the most malnourished children in the world, with over 1/3 of children under 5 stunted and 1/5 suffering from wasting. The states with the highest rates of child malnutrition are Bihar, Uttar Pradesh, Jharkhand, Meghalaya, and Madhya Pradesh, where over 40% of children face malnutrition. Poverty, poor feeding habits, infections, and socio-cultural factors like inequitable food distribution and rapid succession of pregnancies all contribute to India's high malnutrition rates.
Malnutrition is a medical condition caused by an improper or inadequate diet that affects over 1 billion people worldwide. It is the biggest contributor to child mortality, present in half of all child deaths. Malnutrition reduces the world's IQ by an estimated 1 billion points due to iodine deficiency alone. While hunger can exacerbate other health issues, malnutrition itself can cause diseases and death. Improving nutrition, such as through food fortification and supplementation programs, is widely considered one of the most effective forms of humanitarian aid.
Malnutrition project proposal ( Increasing knowlege about importance of a bal...Oriba Dan Langoya
This is a project proposal implemented by Students of Makerere University Under Community Based and Education Research (COBERS)
Meeting the Nutrition requirements of children aged 6months to five years has become a major global
challenge and as such an estimate of 55 million pre- school children globally are malnourished. In 2010,
the nutrition status of children under five in Uganda was estimated to be 38% stunted, 16% acutely
malnourished and 19% undernourished and by 2011 the statistics stand at 33% for stunting,5% for
wasting ,14% for underweight, vitamin A deficiency at 38%. The current levels of malnutrition hinder
Uganda’s human, social, and economic development.
This document discusses social responsibility in providing safe, affordable food and nutrition in Asia. It begins by outlining the scope and intent of the presentation, which is to raise awareness of food insecurity issues in Asia and highlight private industry responses. It then discusses key drivers seeking to address these issues, such as UN Millennium Development Goals and strategies to combat malnutrition. Examples are provided of contributions from private companies like Cargill, Monsanto, and DSM to improve nutrition through partnerships with organizations like the World Food Program. The document stresses the need for both short-term relief and long-term sustainable solutions to issues of undernutrition and overnutrition in Asia.
Epidemiology of Childhood Malnutrition in India and strategies of controlsourav goswami
This presentation includes the epidemiology of childhood malnutrition in India. the problems and challenges that are being faced in the improvement of the condition and the different strategies for its control.
Manuel Salto-Tellez on Personalised medicine and the future of tissue pathologyCirdan
Personalised / Precision Medicine has revolutionized cancer treatment and, in parallel, is also deeply transforming the way we practice tissue pathology. The aim of this talk is to briefly review the status of molecular diagnostic tests applicable to tissues and cells, as well as the main technical and conceptual areas that, in my opinion, will be dictating the evolution of tissue pathology and its integration with the molecular era. These areas are, among others – a) digital pathology in the pipeline of therapeutic pathology; b) tissue-based NGS and its integration in routine diagnostics; c) the promise of liquid biopsy diagnostics and its necessary “partnership” with tissue molecular testing; d) Pathology IT, databases and bioinformatics; and e) the training of future tissue pathologists. In the process of this review, it may be apparent that a solid, integrated, morpho-molecular approach to pathology may serve our patients better.
Force is a push or pull that can change an object's state of rest, motion, speed, direction, or shape. There are two types of forces: contact forces, which are applied through contact between objects like muscular, frictional, or viscous forces, and non-contact forces, which act on objects without touching them, such as gravitational or magnetic forces. Force is calculated using Newton's Second Law, which states that force equals mass times acceleration and is measured in units of newtons.
Big Data is synonymous with exponential growth and availability of massively spread-out data - both structured and unstructured.
Visit : http://bit.ly/2b7ZKO6
This document summarizes the key topics of health, sanitation, and related issues in India. It discusses definitions of health and its determinants. Major health issues in India include high rates of child malnutrition, infant mortality, diseases, and lack of access to safe drinking water and proper sanitation. Poor sanitation contributes to the spread of infectious diseases and is a potential cause of malnutrition. Rural health care services remain inadequate. The document outlines various approaches to improving sanitation and waste management in India.
Malnutrition results from eating a diet where nutrients are either not enough or too much, causing health problems. It can involve calories, protein, carbohydrates, vitamins or minerals. Undernutrition refers to not getting enough nutrients and overnutrition refers to getting too many. Malnutrition commonly refers to undernutrition and its causes include poverty, infectious diseases, and lack of breastfeeding. Treatment involves improving nutrition through food supplementation, therapeutic foods, and treating underlying illnesses. Globally in 2018, 821 million people experienced undernutrition.
1. Micronutrient deficiency, also known as hidden hunger, is caused by consuming cheap but nutritionally deficient foods lacking essential vitamins and minerals.
2. It can negatively impact health and development without producing obvious symptoms of hunger. Common forms include deficiencies in vitamin A, iron, iodine, and zinc.
3. Vulnerable groups especially at risk include women, pregnant women, lactating women, children, and the elderly. Micronutrient deficiencies have social, economic, and health impacts including reduced cognitive ability and economic productivity.
Measuring Poverty through Child Malnutrition A Study With Special Referance T...iosrjce
This study examines child malnutrition in Arumbavur Village, Perambalur District, India. It finds that 81.74% of children in the village are malnourished based on body mass index (BMI) measurements, which is higher than the national average of 43%. Through interviews with 115 households, it identifies several socioeconomic factors contributing to malnutrition, including low family incomes below the national average, lack of sanitation facilities, and limited access to nutritious foods. While most children are breastfed, the average duration is only 6.7 months. The study concludes that despite families' efforts to provide nutrition, children in the village remain underweight and stunted due to their socioeconomic conditions.
This document discusses malnutrition in India. It defines nutrition and malnutrition, and notes that malnutrition results from an unbalanced diet lacking in nutrients. It then outlines some key causes of malnutrition in India, such as deficiencies in iron, vitamin C, folic acid and iodine during pregnancy that can harm fetal development. Statistics are presented showing India's large contribution to the global underweight burden in children under 5. The document concludes by recommending interventions like community-based nutrition monitoring and creating nutritional databases, and emphasizing that malnutrition can be prevented through optimal infant and child feeding.
Malnutrition in India-Background and solutions proposedRohen Agrawal
Despite India's 50% increase in GDP since 1991, more than one third of the world's malnourished children live in India. Among these, half of them under 3 are underweight and a third of wealthiest children are over-nutriented. The World Bank estimates that India is one of the highest ranking countries in the world for the number of children suffering from malnutrition. The presentation proposes how this problem of malnourishment can be eliminated from India.
Effect of Nutrition Education on Anemic Rural Adolescent Girls in OdishaYogeshIJTSRD
Adolescence is considered as the nutritionally vulnerable period due to an increased demand for nutrients due to growth spurt. It has a far reaching implication on their reproductive health in their later years. In Odisha, the prevalence of anemia among adolescent girls in general, has not been well documented. Hence, the present study investigated the prevalence of anemia and effect of nutrition education on anemic adolescent girls in a selected population of Odisha. Adolescent girls 12 17 years who were studying in schools and colleges and residing in the study area for a minimum of six months were included in this study. Total numbers of 508 adolescent girls 12 17years were screened for anemia. Considering its association with the lack of right knowledge, attitude, and practice KAP , it could be preventable. The objectives of the study were 1 to assess the Knowledge, Attitude and Practice KAP of the adolescent girls about Anemia, 2 To determine the association between the selected demographic variables and the level of KAP among the adolescent girls, 3 to analyse the effectiveness of the planned nutrition education of Anemia programme on knowledge, attitude and practice. Dr. Sandhya Rani Mohanty "Effect of Nutrition Education on Anemic Rural Adolescent Girls in Odisha" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-5 , August 2021, URL: https://www.ijtsrd.com/papers/ijtsrd45002.pdf Paper URL: https://www.ijtsrd.com/home-science/extension-education/45002/effect-of-nutrition-education-on-anemic-rural-adolescent-girls-in-odisha/dr-sandhya-rani-mohanty
The document outlines several major health problems in India including communicable diseases, nutritional problems, environmental sanitation issues, medical care problems, and population issues. It provides details on specific communicable diseases like malaria, tuberculosis, and diarrheal diseases. Nutritional problems discussed include protein-energy malnutrition, nutritional anemia, low birth weight, and iodine deficiency. Environmental sanitation lacks safe water and proper excreta disposal. Medical care has inadequate funding and uneven distribution of resources. Rapid population growth also exacerbates other health challenges.
Nutritional problems and programmes in indiapayelkoyena
This document discusses major nutritional problems in India and national nutritional programs. It outlines 11 major nutritional problems including protein energy malnutrition, anemia, vitamin A deficiency, iodine deficiency disorders, low birth weight, fluorosis, lathyrism, market distortion, obesity, cardiovascular disease, and cancer. It also describes 12 specific causes of nutritional deficiency in India and details several national nutritional programs aimed at addressing these issues.
Influence of Micronutrient Deficiency on the Prevalence of Respiratory Diseas...iosrjce
The study entitled “Influence of micronutrient deficiency on the prevalence of respiratory diseases
among children 6-12 years” was conducted to assess the nutritional status of the children. Majority of the socio
economic variables such as age, area of residence, family income are found to have an impact on the nutritional
status of the children with respiratory diseases.
Method: In this study anthropometric, bio-chemical, clinical and nutritional assessment was done for 100
children with respiratory diseases from thiruvananthapuram district of Kerala. The data regarding the socio
economic status, nutritional status and health status were collected using suitably structured schedule. The
nutrient intake was assessed by 24 hour recall method. The hemoglobin levels and calcium levels of the
subsamples were analyzed biochemically. The results were statistically analyzed.
Result: Nutritional anthropometry of the children with respiratory diseases indicates that 77% of the children
were underweight. The biochemical analysis of blood samples indicates that 75% were having iron deficiency
anemia. Mean nutrient intake of both male and female children with respiratory diseases indicates that both of
them are deficient in all nutrient s consumption with respect to RDA.The statistical analysis by t-test reveals that
for males fat consumption and riboflavin consumption were significant at 0.01 levels. For the females it was
found that t-test analysis shows protein, fat, iron, vitamin C and riboflavin consumption were significant at 0.01
levels.
Food Insecurity and Government Intervention for Sustainable Food Access in Od...IJLT EMAS
This paper aims to find out the status and causes of food insecurity and policy measures taken by the government to reduce insecurity in Odisha. The data used in this paper have been collected from different secondary sources like books, journals, news papers, government reports etc.
The study shows that the main cause of food insecurity in Odisha is absence of purchasing power of people to purchase adequate amounts of foods to meet basic minimum food requirements. Purchasing power is absent because of poverty. 9%of the population are extremely food insecure consuming less than 1800 kcl per day. The vulnerability is high in southern and northern regions of the state as well as among SC and ST communities and is more experienced in rural areas than urban areas.
Government of Odisha intervene the situation to counter insecurity through different measures like subsidized distribution of food grains, nutrition provisioning through Anganwadis and mid-day meals, food for work programmes etc. Because of implementation of these measures calories intake of people of KBK regions has increased from 1674.6 kcl in 2004-05 to 1819.0 kcl in 2011-12 and that of non-KBK regions has increased from 2046.5 kcl in 2004-05 to 2076 kcl in 2011-12. Finally, the paper suggests that the government should focus on development of agriculture and employment generation and price stability.
This document presents data on child malnutrition in India and other countries. It shows that India has high rates of low birth weight (28%), underweight children under 5 (41%), wasting (16%), and stunting (38%). The data examines factors contributing to malnutrition like sanitation and hygiene practices, access to safe drinking water, mother and child care practices, and access to nutrition programs. Improving these underlying factors through access to healthcare, nutrition programs, safe drinking water, and sanitation could help reduce India's high child malnutrition rates.
This document discusses several key health issues affecting rural populations in India. It states that over 1 million deaths annually are caused by unsafe water and poor sanitation. Indoor air pollution from solid fuels also kills over 1 million people yearly. Other major causes of death include malaria, urban air pollution, road accidents, climate-related impacts, and poisonings. The document also discusses high rates of malnutrition, infant and maternal mortality, and diseases in rural India due to factors like poor infrastructure, sanitation, and access to healthcare.
Malnutrition is a serious problem in India, where 189.2 million people are undernourished according to the UN. India is home to the most malnourished children in the world, with over 1/3 of children under 5 stunted and 1/5 suffering from wasting. The states with the highest rates of child malnutrition are Bihar, Uttar Pradesh, Jharkhand, Meghalaya, and Madhya Pradesh, where over 40% of children face malnutrition. Poverty, poor feeding habits, infections, and socio-cultural factors like inequitable food distribution and rapid succession of pregnancies all contribute to India's high malnutrition rates.
Malnutrition is a medical condition caused by an improper or inadequate diet that affects over 1 billion people worldwide. It is the biggest contributor to child mortality, present in half of all child deaths. Malnutrition reduces the world's IQ by an estimated 1 billion points due to iodine deficiency alone. While hunger can exacerbate other health issues, malnutrition itself can cause diseases and death. Improving nutrition, such as through food fortification and supplementation programs, is widely considered one of the most effective forms of humanitarian aid.
Malnutrition project proposal ( Increasing knowlege about importance of a bal...Oriba Dan Langoya
This is a project proposal implemented by Students of Makerere University Under Community Based and Education Research (COBERS)
Meeting the Nutrition requirements of children aged 6months to five years has become a major global
challenge and as such an estimate of 55 million pre- school children globally are malnourished. In 2010,
the nutrition status of children under five in Uganda was estimated to be 38% stunted, 16% acutely
malnourished and 19% undernourished and by 2011 the statistics stand at 33% for stunting,5% for
wasting ,14% for underweight, vitamin A deficiency at 38%. The current levels of malnutrition hinder
Uganda’s human, social, and economic development.
This document discusses social responsibility in providing safe, affordable food and nutrition in Asia. It begins by outlining the scope and intent of the presentation, which is to raise awareness of food insecurity issues in Asia and highlight private industry responses. It then discusses key drivers seeking to address these issues, such as UN Millennium Development Goals and strategies to combat malnutrition. Examples are provided of contributions from private companies like Cargill, Monsanto, and DSM to improve nutrition through partnerships with organizations like the World Food Program. The document stresses the need for both short-term relief and long-term sustainable solutions to issues of undernutrition and overnutrition in Asia.
Epidemiology of Childhood Malnutrition in India and strategies of controlsourav goswami
This presentation includes the epidemiology of childhood malnutrition in India. the problems and challenges that are being faced in the improvement of the condition and the different strategies for its control.
Manuel Salto-Tellez on Personalised medicine and the future of tissue pathologyCirdan
Personalised / Precision Medicine has revolutionized cancer treatment and, in parallel, is also deeply transforming the way we practice tissue pathology. The aim of this talk is to briefly review the status of molecular diagnostic tests applicable to tissues and cells, as well as the main technical and conceptual areas that, in my opinion, will be dictating the evolution of tissue pathology and its integration with the molecular era. These areas are, among others – a) digital pathology in the pipeline of therapeutic pathology; b) tissue-based NGS and its integration in routine diagnostics; c) the promise of liquid biopsy diagnostics and its necessary “partnership” with tissue molecular testing; d) Pathology IT, databases and bioinformatics; and e) the training of future tissue pathologists. In the process of this review, it may be apparent that a solid, integrated, morpho-molecular approach to pathology may serve our patients better.
Force is a push or pull that can change an object's state of rest, motion, speed, direction, or shape. There are two types of forces: contact forces, which are applied through contact between objects like muscular, frictional, or viscous forces, and non-contact forces, which act on objects without touching them, such as gravitational or magnetic forces. Force is calculated using Newton's Second Law, which states that force equals mass times acceleration and is measured in units of newtons.
Big Data is synonymous with exponential growth and availability of massively spread-out data - both structured and unstructured.
Visit : http://bit.ly/2b7ZKO6
This short document promotes the creation of Haiku Deck presentations on SlideShare by stating "Inspired?" and providing a button to "GET STARTED" making your own Haiku Deck presentation. It aims to encourage users to easily make and share image-based slideshows on SlideShare using Haiku Deck with just 3 words and a call to action button.
1. The lesson plan aims to teach students a poem titled "Women" through various listening, speaking, reading and writing activities.
2. Students will comprehend the poem, learn new vocabulary words, and discuss the struggles faced by women in society who lack freedom.
3. A variety of activities are outlined, including modeling pronunciation of the poem, group discussions, enacting conversations between career roles, and identifying famous women leaders. The lesson seeks to develop students' language skills while raising awareness of women's issues.
Through completing this coursework, the student learned how to use several new technologies. They used WordPress to create a blog, SurveyMonkey to develop a survey for market research, and Photoshop and InDesign to design elements of their final product like a reader profile, front cover, and double page spread. The student gained experience with social media for sharing work and conducting research online. They learned technical skills like using layers and tools in Photoshop and formatting columns and styling text in InDesign.
The document provides feedback on a magazine cover draft. It notes that the main photo chosen was too serious for the artist and looked edited in a way that caused bruising. It was suggested to use a more fun photo shown. The text on the cover also received feedback. Some text blended in too much and the quote did not make sense. It was advised to make the text box more even. Positive feedback included that the faded corners looked professional and the colors were eye-catching. Small details like the barcode were appreciated. The text subject matched what would be expected on the magazine.
This document discusses protein energy malnutrition (PEM) in India, which is a major health problem, particularly affecting young children. It defines PEM and describes the different types, including undernutrition, overnutrition, and specific nutrient deficiencies. The document then examines the incidence and causes of PEM in India, including inadequate food intake and infections exacerbating malnutrition. It outlines the classification of PEM and effects on health, growth, and development. In conclusion, it analyzes the high rates of child malnutrition in India and discusses strategies to reduce it, including nutrition programs, economic development, and cross-sectoral partnerships.
Adding Fruit in our Diet: The Only Solution to Hidden HungerReetika Sharma
In present times forty four nations have "severe" or "alarming" levels of hunger. The fight against hunger has mostly stagnated internationally in recent years. The cumulated effect of war, climate change, economic effects of the COVID-19 pandemic and the crisis in Ukraine, have driven up the price of food, gasoline and fertilizer around the world. According to the Global Hunger Index 2022, India is ranked at 107 out of 121 nations and is classified as "severe" with a score of 29.1. At 19.3%, India has the highest child wasting rate in the world, which is worse than the levels seen in 2014 (15.1%) and because of India's large population, this rate raises the average for the region. Insufficient dietary intake and absorption of vitamins and minerals (such as zinc, iodine, folate, vitamin A, vitamin B12, and vitamin D, among others) hinders the growth and development of an individual. Thus, increasing the problem of hidden hunger, a type of undernutrition. Micronutrient deficiencies are caused by a poor diet, increased micronutrient requirements during particular life phases, such as pregnancy and lactation and health issues like illnesses and infections or parasites. According to the Food and Agriculture Report, 2018, India is home to 195.9 million of the 821 million malnourished people worldwide and has a 14.8% prevalence of undernutrition, which is greater than the average for Asia and the rest of the world. According to the National Health Survey, about 19 crore individuals in the country were estimated to be forced to sleep on an empty stomach every night in 2017.
The document discusses major nutritional problems in India including communicable diseases, population issues, environmental sanitation, medical care access, and specific deficiencies like anemia, iodine deficiency, obesity, and malnutrition. It notes that while mortality has decreased, undernutrition reduction has been slower. Most children and women suffer from anemia and micronutrient deficiencies. Nutrition is critical for health, development, learning, and breaking cycles of poverty. The document outlines several government programs aimed at improving nutrition, including ICDS, vitamin A supplementation, anemia prophylaxis, and iodine deficiency disorder control. It discusses the objectives, beneficiaries, and implementation of these programs.
This document discusses transgenic crops for biofortification. It begins by noting the global problem of micronutrient malnutrition and hidden hunger affecting billions of people. It then discusses biofortification as a strategy to deliver micronutrients through staple crops using conventional breeding or genetic engineering. The document outlines several key micronutrient deficiencies like vitamin A, iron, zinc, and iodine that impact health worldwide. It also reviews factors affecting the availability and absorption of micronutrients from soil, plants and diets. The document advocates for biofortification as a sustainable and cost-effective way to combat hidden hunger and micronutrient deficiencies.
This document discusses nutritional anemia (iron deficiency anemia) in India. It defines anemia, describes the causes and risk factors, prevalence rates in different states and groups, signs and symptoms, consequences, control programs and strategies. Some key points are:
- Nutritional anemia is the most common micronutrient deficiency globally, affecting over 2 billion people worldwide.
- In India, prevalence is highest among young children (6-59 months), with Bihar having the highest rate at 78%.
- Causes include inadequate intake of iron-rich foods, poor absorption from diets high in phytates, blood loss from hookworm infection, and increased demands from pregnancy and growth.
- Control programs
Malnutrition is a global health issue that contributes to over 1/3 of child deaths worldwide. Prolonged malnutrition can lead to stunted growth and development. Healthcare systems can work collaboratively to address malnutrition by increasing food availability and quality of health environments, as well as improving women's education and status which impacts childcare. International organizations provide aid to developing nations where food insecurity and limited resources contribute to high rates of malnutrition.
Human nutrition and it’s public health importanceDrSindhuAlmas
Understanding of Nutrition and Malnutrition
Types of Malnutrition
Causes of Malnutrition
Global Burden of Malnutrition
Challenges faced to cope malnutrition
Policies and Strategies to Improve Nutrition
Interventions for Improving Nutrition Status
This document summarizes the development of nutrition programs in India from the 1930s to the present. It identifies four distinct phases: 1) a medical/clinical phase supported by biochemists and labs, 2) a food production and technology phase supported by food technologists, 3) a community development phase focused on nutrition education, and 4) the current phase emphasizing intersectoral coordination and addressing specific deficiencies like vitamin A and iodine. It also analyzes the magnitude of India's malnutrition problem, arguing that claims it is exaggerated ignore vulnerable groups like young children and specific deficiencies causing conditions like blindness.
Food gardens have the potential to help address malnutrition in children aged 0-5 years in South Africa. While food gardens may improve access to micronutrients like vitamin A, it is unclear if they can provide sufficient nutrition on their own. For food gardens to be effective, they must be paired with nutrition education programs and focus on growing nutrient-dense crops. Larger, more structured programs in schools and early childhood centers may have better outcomes than small household gardens alone.
Malnutrition is a major problem in India, affecting nearly half of all children. It impairs physical and cognitive development and increases susceptibility to illness. The main causes are poor maternal health and nutrition, improper infant feeding practices, lack of access to healthcare and sanitation, and gender inequality. Malnutrition costs India billions annually in lost productivity and places a significant burden on the country's development. While India has implemented programs to address malnutrition, more focus and coordinated implementation is still needed to effectively reduce rates of this critical issue.
Prevalence of iron deficiency anemia among adolescent girls and its risk fact...eSAT Publishing House
IJRET : International Journal of Research in Engineering and Technology is an international peer reviewed, online journal published by eSAT Publishing House for the enhancement of research in various disciplines of Engineering and Technology. The aim and scope of the journal is to provide an academic medium and an important reference for the advancement and dissemination of research results that support high-level learning, teaching and research in the fields of Engineering and Technology. We bring together Scientists, Academician, Field Engineers, Scholars and Students of related fields of Engineering and Technology.
A Study on Knowledge, Attitude and Practice KAP on Anemia and Socio Economic ...YogeshIJTSRD
This study examined the knowledge, attitudes, and practices (KAP) related to anemia among 508 rural adolescent girls in Odisha, India before and after a planned nutrition education program. The study found that 55% of participants had mild anemia at baseline. Scores for knowledge, attitudes, and practices all improved significantly after the education program, indicating it was effective at positively changing KAP related to anemia. Certain demographic variables like age, family income, and mother's education were also found to influence KAP levels. The results suggest planned nutrition education can help address anemia issues among adolescent girls.
Processed snack foods: Their vitamin and mineral composition and percentage c...Innspub Net
Proper nutrition is important as children grow, and snack time should be just as healthy and delicious as breakfast, lunch and dinner. The study aimed to evaluate the vitamin and mineral composition of four processed snack foods and to analyze the % RNI contributed by these foods to the daily needs of school children. Moreover, the researchers attempted to identify the most concentrated sources of vitamin B1, vitamin B2, Vitamin B3, vitamin B9, calcium, and iron among the snack items. Results showed that of the six vitamins evaluated, vitamin A is the only vitamin supplied in ADEQUATE amounts by the four snack items namely Jute-Malabar Nigthshade Pastillas, Banana Blossom Cookies, Malunggay Polvoron, Squash-Carrot Pastiyema. In terms of the minerals, calcium and iron, only Malunggay Polvoron met at least 20% of the RNI for these nutrients for both age groups 4-6 and 7-9 years old. All the four snack items supply at least 20% of the RNI for vitamin A and riboflavin for the two age groups. On the other hand, the snack item with the most dense nutrients is Malunggay Polvoron. Sensorial qualities to include quality characteristics, consumer acceptance as well as their packaging may be conducted. Furthermore, the development of other nutrient-dense snack items with emphasis on the incorporation of leafy and fiber-rich vegetables is encouraged.
Hidden hunger refers to micronutrient deficiency caused by a diet that is filling but lacks essential vitamins and minerals. It is difficult to detect but negatively impacts health and development. Common deficiencies include vitamin A, iron, iodine, and zinc. These deficiencies especially impact women, children, and the elderly. Micronutrient deficiency undermines economic productivity and hinders progress on development goals related to poverty, health, and education. Addressing hidden hunger requires diversifying diets, fortifying foods, supplementing intake, and promoting behavior changes.
Addressing food and nutrition security in developing countries depends on livelihood security, vulnerability, and coping strategies. Food security exists when all people have reliable access to sufficient nutritious food. Key elements of food security assessments include livelihoods, vulnerability to risks and shocks, and coping strategies. The three pillars of food security are availability of food, access to food, and utilization of food. Malnutrition is a global problem impacting health, growth, and development. An integrated approach blending traditional and modern agricultural and nutrition practices can help support food and nutrition security.
Biofortification is the process of breeding staple crops to increase their nutritional value. It has potential to help address undernutrition by developing varieties of crops like rice, cassava and sweet potatoes that are naturally enriched with vitamins and minerals. However, biofortification alone cannot solve undernutrition and engagement with local communities is important for acceptance of biofortified crops. While selective breeding is widely used, genetic modification approaches remain controversial. Overall, biofortification may provide a cost-effective strategy as part of broader efforts to improve nutrition, but its impact depends on social and economic development.
This document summarizes biofortification as an approach to addressing micronutrient malnutrition. It discusses key minerals and vitamins needed for human health, including iron, zinc, vitamin A, and iodine. Common interventions for alleviating micronutrient deficiencies include food fortification, supplementation, and promoting dietary diversification, but these approaches face limitations in developing countries. Biofortification aims to breed micronutrients directly into staple food crops and has potential as a sustainable, cost-effective strategy to deliver more micronutrients, especially in rural populations with limited access to other interventions. The document provides an overview of biofortification and its advantages compared to alternative approaches.
This document discusses the importance of integrating nutrition into development efforts. It summarizes 12 briefs on how good nutrition is essential and linked to achieving goals in various areas like health, education, gender equality, poverty reduction, and the environment. Undernutrition levels in developing countries are high, with over 150 million children affected. Improving nutrition can boost outcomes across sectors like reducing child mortality, bolstering education performance, empowering women, and supporting agricultural productivity. The briefs provide evidence of these impacts and recommendations for interventions to integrate nutrition into related policies and programs.
This document provides information on protein energy malnutrition (PEM), including:
- PEM refers to a range of pathological conditions arising from coincidental lack of proteins and calories, most frequently affecting infants and young children.
- Assessment of nutritional status can be done through dietary, clinical, anthropometric, biochemical, morphological, radiological, and epidemiological evaluations.
- PEM is caused by a combination of inadequate dietary intake and illness/infection, and is a major public health problem in developing countries, contributing to over half of deaths in children under 5 years old.
The document discusses malnutrition as a problem in the Philippines. Micronutrient malnutrition is prevalent not just in developing regions but also industrialized nations, affecting all age groups but most at risk are children and pregnant women. The Philippines loses billions in GDP due to vitamin and mineral deficiencies mainly from increased healthcare costs of undernutrition. Common deficiencies include iron, iodine, vitamin A and zinc. The government has implemented programs to address malnutrition but more efforts are still needed to reduce prevalence of deficiencies and their social and economic impacts in the country.
The document discusses malnutrition in children, focusing on the first 1000 days of life from conception to age 2. It defines various forms of malnutrition like stunting, wasting, and underweight. Around 1/3 of under-5 mortality is due to undernutrition. The first 1000 days are critical for meeting nutritional needs. It provides global statistics on the prevalence of issues like stunting, underweight, low birth weight. It also discusses diagnostic criteria and interventions to address malnutrition.
This document discusses priorities for research and action to address micronutrient deficiencies in India. It begins by outlining the magnitude of the problem, noting that iron deficiency anaemia and iodine deficiency disorder are major public health issues. It then examines the dietary causes of micronutrient deficiencies in India and the consequences of deficiencies in iron, iodine, vitamin A, B vitamins, vitamin D, vitamin C, and zinc. Finally, it discusses current strategies to increase micronutrient access such as supplementation, food fortification, food-food fortification, and biofortification, and provides recommendations to improve programs and identify research opportunities in these areas.
This document is a contract between Myra and Company (MaC) and Utpal Ganguly to serve as a consultant. Some key details:
- Utpal Ganguly will provide consulting services as outlined in Attachment A from April 1 to June 30, 2015.
- Ganguly will be paid Rs. 2,134 per day, up to a maximum of Rs. 1,40,847 for the quarter.
- Ganguly is an independent contractor, not an employee. He must perform his services with confidentiality and avoid conflicts of interest.
- The contract can be terminated by either party with 30 days notice but MaC can terminate immediately for any breach of contract terms.
CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdfSachin Sharma
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
Strengthen the bond between children and caregivers, peers, and other adults.
Support Learning and Development:
Aid cognitive and language development through engaging and meaningful conversations.
Teach Social Skills:
Encourage polite, respectful, and empathetic interactions with others.
Resolve Conflicts:
Provide tools and guidance for children to handle disagreements constructively.
Encourage Independence:
Support children in making decisions and solving problems on their own.
Provide Reassurance and Comfort:
Offer comfort and understanding during times of distress or uncertainty.
Reinforce Positive Behavior:
Acknowledge and encourage positive actions and behaviors.
Guide and Educate:
Offer clear instructions and explanations to help children understand expectations and learn new concepts.
By focusing on these objectives, communication with children can be both effective and nurturing, supporting their overall growth and well-being.
English Drug and Alcohol Commissioners June 2024.pptxMatSouthwell1
Presentation made by Mat Southwell to the Harm Reduction Working Group of the English Drug and Alcohol Commissioners. Discuss stimulants, OAMT, NSP coverage and community-led approach to DCRs. Focussing on active drug user perspectives and interests
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
Mental Health and well-being Presentation. Exploring innovative approaches and strategies for enhancing mental well-being. Discover cutting-edge research, effective strategies, and practical methods for fostering mental well-being.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
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The story of Dr. Ranjit Jagtap's daughters is more than a tale of inherited responsibility; it's a narrative of passion, innovation, and unwavering commitment to a cause greater than oneself. In Poulami and Aditi Jagtap, we see the beautiful continuum of a father's dream and the limitless potential of compassion-driven healthcare.
India Home Healthcare Market: Driving Forces and Disruptive Trends [2029]Kumar Satyam
According to the TechSci Research report titled "India Home Healthcare Market - By Region, Competition, Forecast and Opportunities, 2029," the India home healthcare market is anticipated to grow at an impressive rate during the forecast period. This growth can be attributed to several factors, including the rising demand for managing health issues such as chronic diseases, post-operative care, elderly care, palliative care, and mental health. The growing preference for personalized healthcare among people is also a significant driver. Additionally, rapid advancements in science and technology, increasing healthcare costs, changes in food laws affecting label and product claims, a burgeoning aging population, and a rising interest in attaining wellness through diet are expected to escalate the growth of the India home healthcare market in the coming years.
Browse over XX market data Figures spread through 70 Pages and an in-depth TOC on "India Home Healthcare Market”
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The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
The Ultimate Guide in Setting Up Market Research System in Health-TechGokul Rangarajan
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
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VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
Air Ambulance Services In Rewa works in close coordination with ground-based emergency services, including local Emergency Medical Services, fire departments, and law enforcement agencies.
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Solution manual for managerial accounting 18th edition by ray garrison eric n...rightmanforbloodline
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
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Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
1. C BK
MICRO-NUTRIENT SECURITY FOR
INDIA–PRIORITIES FOR
RESEARCH AND ACTION
Indian National Science Academy
Bahadurshah Zafar Marg
New Delhi-110 002
2. PREFACE
About a year back INSA had given a more formal shape to its activities aimed at
recommending governmental action and informed public debate on issues involving
science and technology. This was done by forming a Science Policy Cell within INSA
with a mandate to strengthen and systematize this important area of INSA’s work in
the realm of public policy.
This report is the first printed product of this newly formed cell.
It offers a set of recommendations for action and urgent research on
Micronutrient Security for India. It was prepared jointly with the Science and Society
section of INSA under the leadership of Dr Mahtab S Bamji, the Vice president for
Science and Society at INSA and a very distinguished Nutritionist.
She has prepared the report after numerous drafts based on consultations with
other experts in the country through meetings and electronic correspondence.
April 2011 R RAJARAMAN
Vice President INSA
and Incharge, Science Policy Cell
3. Published by Dr Alok Moitra, Executive Secretary on behalf of Indian National Science Academy,
Bahadurshah Zafar Marg, New Delhi and printed at Angkor Publishers (P) Ltd., Noida-201301,
Mobile: 9910161199, E-mail: angkor@rediffmail.com.
4. CONTENTS
Preface … i
Introduction … 1
Magnitude of the Problem of Micronutrient Deficiencies in India … 2
Dietary Aetiology of MN Deficiency in India … 2
Consequences of Micronutrient Deficiencies … 3
Strategies for Increasing Access to Micronutrients — Current Response … 5
and Research Opportunities
Micronutrient Supplementation … 5
Food Fortification … 7
Food–Food Fortification—Dietary Diversification … 9
Enhanced Production to Consumption of Millets and Pulses … 10
Plant Foods as Speciality Foods for Protection against Chronic Diseases … 10
Economic Logic … 10
Food Analysis … 11
Food Storage and Processing … 11
Bioavailability and Stability of Micronutrients in Processed Foods … 11
Nutrition Security and Climate Change … 11
Monitoring, Surveillance and Management Information System for … 12
Early Detection
Nutrition and Health Education … 12
Conclusion … 12
Summary Table of Recommendations for Research and Action … 13
References … 18
Reviewers … 19
5. 1
MICRO-NUTRIENT SECURITY FOR INDIA–PRIORITIES FOR
RESEARCH AND ACTION
Introduction
Recently, the Indian National Science Academy (INSA) brought out a position paper
on “Nutrition Security for India–issues and the way forward” based on deliberations
in a symposium and subsequent discussions. This policy paper has been prepared as
an off-shoot of the earlier effort, to focus specifically on priorities for research and
action, for addressing the issue of micronutrients (MN) deficiencies — the hidden
hunger. (INSA, 2009 www.insa.ac.in). It is beamed at researchers, funding agencies
and policy makers and planners.
Malnutrition in India, particularly among women, children and adolescents is
an emergency needing immediate attention if the country has to have inclusive
growth and development. Health portfolio tends to concentrate on infectious
diseases (vaccination, oral rehydration, treatment of infections), and non-
communicable diseases like cancer and cardiovascular diseases. Important as these
are, nutrition cannot be subsumed under these. Nutrition has to be the basis of
judging national development. Without good nutrition, neither communicable nor
non-communicable diseases can be controlled. Malnutrition is the worst form of non-
communicable disease and is an important risk factor for chronic diseases at a later
date. Maternal malnutrition has multigenerational adverse effects on human health
and development.
Nutrition Security implies ‘Physical, economic and social access to balanced
diet, clean drinking water, safe environment, and health care’. Nutrition literacy and
leadership at all levels is needed to understand and act. After 63 years of
independence, India has among the highest incidence of under-nutrition in the
world1. Almost 50% of children under 5 are under weight (weight for age) and
stunted (height for age). Over 30% of adults are also undernourished. Besides
deficiency of calories and protein, deficiency of micronutrients (MN) (vitamins and
minerals) is rampant2,3,4. MN deficiency is referred to as the hidden hunger since
often times it is not an obvious killer or crippler, but extracts heavy human and
economic cost. Though anthropometric deficits are attributed to protein calorie
malnutrition, MN deficiencies contribute significantly, because MNs are needed for
utilisation of proteins and calories and to fight infections from a young age.
MN deficiency has a complex aetiology. Besides poor diet (due to poverty,
ignorance, low agricultural productivity, and cultural factors); inadequate access to
safe drinking water, clean disease-free environment, and health- care outreach also
6. Micro-Nutrient Security for India2
contribute. Infections result in loss of appetite, impaired absorption and utilisation of
nutrients, particularly micronutrients. Environmental xenobiotics also impair MN
utilisation. The present paper specifically focuses on feasible approaches and
research needed to improve dietary access to MN.
Magnitude of the Problem of Micronutrient Deficiencies in India
Among the MN deficiencies, iron deficiency anaemia (IDA) is the most serious
public health problem2,3,4. Estimates of IDA in women and children have varied from
50-70%; pregnant women being particularly susceptible. Iodine deficiency disease
(IDD) is another worrisome public health problem3. Though, its magnitude has
declined in recent years after the introduction of iodised salt, the problem still
persists, and not confined to the Sub Himalayan regions as earlier thought.
Fortunately, some of the severe vitamin-deficiency diseases such as beri beri
(thiamine-vitamin B1 deficiency), pellagra (niacin deficiency), and scurvy (vitamin C
deficiency) have disappeared. Blindness due to vitamin A deficiency and rickets due
to vitamin D deficiency remain as clinical rather than public health problems.
However, milder clinical manifestations and biochemical (sub-clinical) evidence of
these deficiencies is rampant. Also osteoporosis in adults, particularly women after
menopause due to calcium and vitamin D deficiency is common.5
Functional significance of sub-clinical MN deficiencies needs to be established.
Dietary Aetiology of MN Deficiency in India
Repeated diet surveys done by the National Nutrition Monitoring Bureau (NNMB)
(National Institute of Nutrition, ICMR) in 9 states of India and some other surveys,
indicate, the following2.
Cereal-pulse based Indian diets are qualitatively deficient in micronutrients
particularly iron, calcium, vitamin A, riboflavin and folic acid (hidden hunger), due
to low intake of income-elastic protective foods such as pulses, vegetables
particularly green leafy vegetables (GLV), fruits, and foods of animal origin. In
recent years, there has been substantial erosion of area under cultivation of coarse
grains and millets and share of these nutritious grains in total cereals produced and
consumed6.
More than 70% of preschool children consume less than 50% RDA of iron,
vitamin A and riboflavin.
Within a family dietary deficits are more marked for preschool children due to
inequitable distribution of food. This is because of lack of awareness of children’s
nutritional needs, and inability of child to articulate. While income cannot be blamed
if the family has enough food for adults, time constraint on the mother who has to go
out to work to supplement the family income, is a factor.
7. Micro-Nutrient Security for India 3
In recent years concern has been expressed about the inadequate intake of other
micronutrients such as zinc, vitamin D, calcium and vitamin B12.
More research is needed to establish the extent of dietary deficiency and requirement
of these nutrients.
Consequences of Micronutrient Deficiencies
Apart from human suffering due to morbidity and mortality, malnutrition in general
and MN deficiencies in particular have a high economic cost. `Productivity losses
due to poor nutrition are estimated to be more than 10% of lifetime earnings for
individuals, and 2-3 % of GDP to the nation. Cost of treating malnutrition is 27 times
more than the investment required for its prevention’7. According to a panel of
Nobel laureates, of the top 10 priorities selected for advancing global welfare using
methodologies based on the theory of welfare economics, in Copenhagen Consensus,
2008, 5 were in the area of nutrition − micronutrient supplements, micronutrient
fortification, biofortification, de-worming and other nutrient programmes at school
and community level8. These are also needed to achieve the millennium
development goals.
Iron Deficiency Anaemia (IDA)
Moderate and severe IDA adversely affects immunity (resistance to fight infections),
cognitive and motor development, physical performance (and hence productivity)
and reproductive health: (premature birth, low birth weight and perinatal
mortality)9,10. It is estimated that anaemia is the direct cause of maternal deaths in
20% and contributory cause in another 20%. Apart from dietary deficiency,
helminthic infections, inhibitors of iron absorption, in the diet and repeated
pregnancies (in women) also contribute.
Iodine Deficiency Disorder (IDD)
Goitre is the clinical manifestation of iodine deficiency disorder. The functional
consequences are: permanent brain damage, (cretinism, - mental retardation, and
deaf mutism), reproductive failure, and decreased child survival. Milder deficiency
also adversely affects mental development9,10.
Vitamin A Deficiency
The earliest ocular manifestation of vitamin A deficiency (VAD) is night blindness,
and Bitot spots on the white of the eye. Severe vitamin A deficiency leads to
keratomalacia (ulceration and sloughing of the cornea) and total blindness. Though
kerotamalacia is no longer a public health problem, night blindness is prevalent
particularly in pregnant mothers and subclinical deficiency (low Serum levels of
Vitamin A), is still encountered. In addition to the ocular manifestations, vitamin A
8. Micro-Nutrient Security for India4
deficiency has been shown to cause growth retardation, decreased resistance to
infections, and even death9,10. Opinion regarding efficacy of vitamin A
supplementation in reducing mortality even in populations with sub-clinical vitamin
A deficiency is however divided11,12,13.
B-Complex Deficiencies
Though there is marked dietary, biochemical and clinical evidence of riboflavin
(vitamin B2) deficiency (metabolically a very important vitamin), it has not received
adequate attention because its deficiency is neither a killer nor a crippler. Impaired
psychomotor performance in school children and adults and impaired reproduction
in animals associated with riboflavin deficiency has been reported9.10,14. There is
evidence of dietary and biochemical folic acid deficiency in India9,10. It can cause
megaloblastic anaemia due to impaired red cell maturation. Folic acid deficiency has
also been implicated in congenital malformation (neural tube defects), Folic acid
supplementation in early pregnancy or even pre-pregnant state has been shown to
prevent it. Folic acid deficiency leads to raised levels of serum homocysteine – an
independent risk factor for cardiovascular disease (CVD)9,10,15,16. Fragmentary
evidence suggests that Indians do tend to have high levels of homocysteine which
responds to treatment with folic acid16. Till recently, vitamin B12 deficiency was not
considered to be a problem in India since its daily requirement is only 1 microgram.
However, reports of vitamin B12 deficiency in developing countries like India and its
link with homocysteinaemia, besides megaloblastic anaemia, have started
appearing17. Both folic acid and B12, besides vitamin B6 and B2 are required for
homocysteine metabolism.
In view of the rising incidence of CVD in India, B- complex vitamin deficiency needs
to be taken more seriously and its link with homocysteinaemia and CVD needs to be
investigated. Research is also needed to examine the role and dosage of folic acid for
prevention of neutral tube defects- which are not uncommon in India. A balance of
folic acid with vitamin B12 has to be ensured.
Vitamin D Deficiency
Main function of vitamin D is in bone calcification by facilitating calcium absorption
and maintaining blood calcium levels. Since generation of vitamin D in the skin from
its precursor 7-dehydrocholesterol is through exposure of skin to sunlight, adequacy
of vitamin D in a tropical country like India was assumed. However, recent studies
suggest existence of vitamin D deficiency in all age groups in India. As mentioned
earlier, osteoporosis associated with calcium and vitamin D deficiency is common in
post-menopausal women. Low levels of vitamin D are also associated with chronic
diseases like certain malignancies, and chronic inflammatory and autoimmune
diseases like type 1 diabetes, and impaired resistance to infections5,9,10. However,
according to a recent review “Health—benefits often reported in the media—were
9. Micro-Nutrient Security for India 5
from studies that provided often mixed and inconclusive results and could not be
considered reliable”.5
Research is needed to determine the dietary requirement of vitamin D to ensure
adequate vitamin D status.
Vitamin C Deficiency
Vitamin C is a powerful antioxidant. Dietary vitamin C deficiency does exist, but
severe clinical manifestation (scurvy) has become rare. Vitamin C is an iron
absorption promoter and hence its deficiency can contribute to IDA. Antioxidants
delay degenerative diseases9,10.
Zinc Deficiency
Zinc is essential for growth and development. Zinc supplementation has been
reported to help linear growth, reduce severity and duration, of diarrhoeas, and
respiratory infections and reduce child mortality.10
The magnitude and consequences of zinc deficiency in India need to be determined.
For the purpose suitable indicators have to be developed to assess zinc deficiency.
Strategies for Increasing Access to Micronutrients — Current Response and
Research Opportunities
Basically there are four types of approaches to augment MN intake.
1) Pharmaceutical supplements, 2) Food fortification 3) Biofortification and 4) Food-
food fortification (dietary diversification).
Micronutrient Supplementation
National Nutritional Anaemia Control Programme (NACP)
In this programme supplements containing 100 mg of elemental iron + 500 µg folic
acid are given to pregnant women for 100 days during pregnancy; 20 mg elemental
iron and 100 µg folic acid are given daily to preschool children for 100 days in the
year.9,10. Recently adolescent girls have also been included as part of the life cycle
approach with same dose as pregnant women, and weekly once administration
throughout the year. Unfortunately despite scientific basis for the programme, iron-
folic acid supplementation has failed to have an impact on the incidence or severity
of anaemia, allegedly due to 1) lack of awareness regarding its importance and
consequently poor compliance and 2) poor outreach in a vast country like India.
NFHS 3 survey shows less than 20% full compliance in pregnant and lactating
women.4 3) Uniformly giving one tablet of IFA (which is meant for preventing
anaemia in non-anaemic women) regardless of the severity of anaemia.
10. Micro-Nutrient Security for India6
Screening of all pregnant women for anaemia and treatment of anaemic women
besides the prophylactic treatment with iron, folic acid has been recommended to
reduce the prevalence and severity of anaemia in pregnancy. .
Suggestions for Research to Improve NACP
Public-private-NGO partnership may have a role in improving the outreach.
Absorption of non-haeme Iron from the diet is only 3-5%. The challenge is to
translate filling of iron stores in to improvement in haemoglobin.
Research is needed to find out socio-cultural, behavioural factors and
administrative bottle neck to improve the efficiency of NACP.
All pregnant women should get Hb estimation done using reliable method and
anaemic women treated with appropriate route and dose of iron, folic acid.
Children coming to hospital for any illness and undernourished children should
be screened and those found anaemic should be appropriately treated.
Prevalence of iron, folic acid and B12 deficiency in non anaemic and anaemic
pregnant women in different regions of the country should be assessed to find out if
the current practice of prescribing iron and folic acid without B12 is appropriate.
Efficacy of present regimen of giving uniformly one tablet of iron –folic acid needs
re-evaluation and replaced with treatment after screening.
Since nutrients, besides iron and folic acid, are also involved in haemoglobin
synthesis/formation of red blood cells/absorption of iron, inclusion of MN like
vitamins B12, C, B2, and zinc may improve the efficacy of the oral supplements.
Clinical research in a hospital setting with appropriately worked out dose and
schedules for multi-vitamin supplements Vs IFA supplements should be conducted..
Massive Dose Vitamin A Supplementation to Prevent Nutritional Blindness
In this programme children between 6-60 months are given 200,000 IU of vitamin A,
every six months as prophylactic dose. The rationale is: vitamin A being fat soluble,
is stored in the liver and a massive dose would ensure adequate storage to last for at
least 6 months. This programme also suffers from the infirmity of the other
programmes viz., poor outreach, inadequate and irregular supplies. As mentioned
earlier the severity of vitamin A deficiency has reduced despite inefficient operation
of this programme and several eminent nutrition scientists have raised doubts about
its continuation11,12,13. However, as of now, this programme should continue in areas
where vitamin A deficiency is a public health problem (incidence of Bitot spots more
than 0.5%).
According to the Annual Report of Micronutrients Initiatives India, an
International Non Government Organization, out of 32 Million US Dollars available
11. Micro-Nutrient Security for India 7
in the Annual Budget 2009-2010, more than 20 Million US Dollars were spent on
Vitamin A Procurement and Interventions. A meager sum of 2.5 Million US Dollars
was spent on Iron interventions (Umesh Kapil, personal communication). Children
with VAD should be identified and should be administered VA. The present
Universal VAS approach needs to be reviewed.
There is need for operation/translational research to improve efficiency of the
programme
Food Fortification
Iodised Salt
Food fortification is a powerful method of reaching out a deficient nutrient to
populations, provided the vehicle used for fortification is consumed by the poorest
of the poor. In India salt is the only such vehicle and it has been effectively used for
reaching out iodine. This is one successful programme in the country3,9, but its
efficiency has to be improved in terms of stability of iodine in the salt, pricing, and
outreach. Private companies tend to seek easy urban markets even if the problem is
more acute elsewhere.
Iron Fortified Iodised Salt (IFIS, also called Double Fortified Salt-DFS)
This technology was developed by the National Institute of Nutrition, Hyderabad to
address the dual problem of iron and iodine deficiency.9,10,18. Government order for
its production has been released. Its efficacy has been tested in small scale studies.
Systematic programme for scaling up is needed to examine the effectiveness of DFS
in preventing iron and iodine deficiency and replacing iodised salt with IFIS.
Evaluation of DFS should be done by an independent agency rather than ICMR.
Iron Fortified Wheat Flour (Atta) and Rice
Since staple grains are consumed in substantial quantity, their fortification makes
sense. In some countries wheat flour is fortified with iron and other micronutrients.
Doubts have been raised about bio-availability of iron from wheat 'atta’ because of
high phytate (inhibitor of absorption) content. The inhibitory effect of phytate may
be bypassed by some potential compounds like Na-Fe-EDTA and or enzyme
phytase. The higher cost of this salt may be off-set by better bioavailablity and hence
lesser dose of fortification.
For more than a half the population in India, rice is the staple. Fortification of
rice has been tried by mixing fortified extruded grains from rice flour with rice (Ultra
rice). More research is needed to make this technology cost-effective and
acceptable.19
Programmatic studies are needed to examine the effectiveness of fortifying cereals
with iron.
12. Micro-Nutrient Security for India8
Fortification of Cereal Products with Folic Acid
In many countries, cereal products are fortified with folic acid to reduce the
incidence of neural tube defects. Folic acid fortification, perhaps along with vitamin
B12 may also reduce serum homocysteine levels.
In view of the rising incidence of CVD in India, this strategy needs to be researched.
Fortification of Oil with Vitamins A and D
Gujarat has taken the initiative. Impact studies are needed. Fortified oil should be
packed in dark bottles to cut off UV radiation, and prevent oxidation of vitamin A
Vehicles like sugar or soya sauce used in some countries are not suitable for India.
Fortification of Food for Supplementary Feeding
India has large feeding programmes like supplementary feeding of preschool
children through ICDS and school children through Mid Day Meal. Opinion of
nutritionists is divided about fortifying these foods with MNs – sprinklers
(micronutrient powder- MNP), spreads.
Well planned field research to examine efficacy, feasibility and cost of fortification
vs. enrichment with MN rich foods, of meals for supplementary feeding need to be
undertaken. Impact of Golden rice rich in provitamin A, ultra rice rich in iron and
other MN and red palm oil in feeding programmes needs to be researched for
feasibility, acceptability and cost effectiveness.
Food fortification is suitable only for prevention of MN deficiencies and not for
treating severe forms of the disease. Food fortification programme for country
should consider the Recommended Dietary Allowances (RDA) of different nutrients
for Indians, the types of foods to be fortified, nutrients to be added and the
percentage of the RDA to be supplied through fortification etc. to avoid excess
intakes by the rich and deficient intakes by the poor. Fortified foods should be
affordable by the poorest of the poor, and reach the unreachable in a vast country
like India.
Bio-fortification
Enriching germplasm with MNs through conventional breeding methods, molecular
breeding and genetic engineering is a promising method for increasing dietary
access to MNs. Bio-fortification is a sustainable intervention being a seed- based
technology. There is no recurring cost, once the varieties are developed and adopted.
It can benefit the farmer as well as the consumer if the cost of seed is kept low and
not exploited by seed companies. Bio-fortified plants grow better. Potential
nutritional impact of iron biofortificaion in India seems to be encouraging.20 “The
Harvest Plus: bio-fortification challenge programme is an interdisciplinary, global
alliance of research and implementing institutions21,22. India is part of this. It
13. Micro-Nutrient Security for India 9
includes: β carotene (pro-vitamin A)- rich sweet potato, and cassava, zinc and iron–
rich rice, wheat, maize, pearl millet, and beans. DBT network project on bio-
fortification of rice, wheat and maize is currently being implemented by ICAR
Institutions and state agriculture universities and National Institute of Nutrition.
Golden Rice rich in pro-vitamin A; high- iron rice (high ferritin gene from
mangrove); are examples of transgenic technologies.”
For conventional breeding or molecular breeding to improve the MN content of
foods, sufficient within species diversity with appropriate gene pool would be
necessary. Also this approach is slow. GM route with genes from other plant species,
preferably edible varieties, is faster and with suitable safe guards regarding safety to
health, protection of biodiversity, and cost; is a useful option for a country like India
While the conventional strategies of food fortification and plant breeding to improve
nutritional quality should be pursued, the GM technology despite some concerns
needs to be vigorously investigated. This technology has received support from
many science academies of the world including Indian academies.
Food–Food Fortification—Dietary Diversification
The problem of MN deficiency can to a great extent be addressed by encouraging
dietary diversification and household access to MN-rich foods.
Overall emphasis of agriculture, horticulture and livestock breeding has been to
ensure calories, income and export. MNs are not on the antenna of agriculture
planning. Decentralised planning to ensure district, village and household level
adequacy of MN- rich foods is required. India being a vast country, long distance
transport of perishable foods like vegetables and animal products may not be
feasible. Promotion of homestead gardens even in urban areas, with emphasis on
MN- dense varieties, back- yard poultry, dairy, fish ponds etc is needed.
Operation research to study the impact of such a strategy needs high priority. Farm-
based approaches are low-cost, and sustainable if the community is empowered.
While it may be difficult to meet the requirement of some nutrients like iron and
riboflavin through low-cost diets, there is ample supply of β carotene (pro-vitamin
A) in nature in green leafy vegetables and yellow orange fruits and vegetables. This
wealth needs to be exploited through education and advocacy. Low bio-availability
of beta carotene is an issue. Food habits may be hard to change.
Research is needed to establish the factor for conversion of β carotene to vitamin A
and improve its bioavailability. Red palm oil is an important source of β carotene
and can be used in supplementary feeding programmes if supply and acceptability
can be assured.
Absorption and utilisation of micronutrients is influenced by competition
between nutrients, (particularly minerals and trace elements), and other biotic
14. Micro-Nutrient Security for India10
(microorganisms, helminthic) and a-biotic (chemical agents like phytates, tannins,
xenobiotics etc).
These influences have to be researched to improve utilisation of dietary MNs.
Treatment with phytases and tannases needs to be considered.
Bioavailability studies to examine the interaction within nutrients, and between
nutrients and promoters, inhibitors and xenobiotics (biotic and abiotic), have to be
planned.
Enhanced Production to Consumption of Millets and Pulses
MN rich coarse grains and millets are being forgotten. They are referred to as orphan
grains, but with the threat of global warming, they may well be the grains of the
future. There is 2-3 fold gap between optimal productivity of millets and farm-level
productivity. Apart from being high in proteins, pulses are also rich in MN. Their
production and consumption is on the decline.
Productivity of these grains has to be increased through research and robust
extension effort. Agriculture research needs to give high priority to millets and
pulses – a production to consumption strategy. Some of the World Bank funded
National Agriculture Innovation Projects (NAIP) are attempting to do that.
Plant Foods as Speciality Foods for Protection against Chronic Diseases
This is a vast field for research since plant foods are rich in health giving
phytochemicals-nutraceuticals. Some nutrients like vitamin C, E, Se also have
antioxidant properties.
Economic Logic
World Bank has compared the benefits of MNs (iron) supplementation vs. Food
fortification in terms of 1) cost per life saved, 2) productivity gained- a measure of
efficient use of resources and defined as least cost discounted method of reducing
clinical deficiency in the population and 3) social benefit cost- DALY or healthy life
years saved. For saving life at least cost, targeted iron supplementation to pregnant
women is more effective than iron fortification of flour or other staple. However, for
enhanced productivity delivered by a programme and social benefit cost, iron
fortification is most cost effective. (For details see, Hunt23)
Similar analysis is needed in the Indian context. Farm-based interventions are
believed to have high benefit-cost ratio in terms of economic cost. They also help the
farmer and empower the community.
15. Micro-Nutrient Security for India 11
Food Analysis
India is rich in biodiversity with lots of local foods with potential benefits in terms of
MN as well as health-promoting phytochemicals. Food analysis labs equipped to do
co-ordinated MN analysis with proper quality control should be set up in agriculture
universities and home science colleges which have the expertise and country-wide
research programmes to analyse local foods and identify MN rich foods should be
started so that their production and consumption can be enhanced.
Food Storage and Processing
Almost 30% of farm food perishes due to lack of storage facilities and value addition.
Development of suitable storage structures not only for grains but also for
vegetables, fruits and animal products and promoting those which are already
available is urgently needed. There are indigenous time-tested traditional
technologies for storage. Those have to be re-discovered and promoted.
Value addition should not take away food from the poor. Both, high-end and
low-cost, processed foods need to be developed with public private partnership,
with the triple objectives of reducing wastage, generating employment and
enhancing nutrition value and security.
Bioavailability and Stability of Micronutrients in Processed Foods
While minerals are reasonably stable during processing, vitamins, particularly
vitamins A and C are sensitive to light and heat. Microencapsulation is done to
increase the stability, but that increases the cost. Low-cost technologies to increase
the bioavailability and stability of MNs in processed foods are needed to make
processed foods accessible to all sections of the society.
Nutrition Security and Climate Change
Rise in temperature due to climate change is associated with increase in atmospheric
carbon dioxide. While the latter helps to increase plant growth if there is enough
supply of other nutrients in the soil, in tropical climate, further temperature rise has
an adverse effect. It is suspected that apart from plant growth, climate change may
also affect the nutrient composition (protein and minerals) in foods. No information
is available on vitamin content of foods and climate change. 24
Impact of climate change on productivity and nutrient composition of major food
items in India needs to be researched.
16. Micro-Nutrient Security for India12
Monitoring, Surveillance and Management Information System for Early
Detection
India needs a robust monitoring and surveillance programme in nutrition for early
identification of the problems and capacity building to tackle them in a decentralised
way. For every frank case of deficiency, there are dozens of others who suffer from
subclinical deficiencies which contribute substantially to human suffering, medical
expenses and economic cost.
Sensitive biochemical and functional tests to detect such deficiencies, using new
knowledge of molecular and cellular biology and state of the art instruments need to
be developed
Nutrition and Health Education
Behavioural Change Communication (BCC) programs to targeted audience can
improve both nutrition and health status. Nutrition education for professionals-
(agriculture, medical, social scientists and others), needs to be strengthened.
Innovative strategies need to be developed and tested not only to improve
knowledge and attitudes but practices as well. Behavioural modification modules
are needed. Nutrition education policy is nonexistent. Awareness among school
children, teachers, consumers and women has to be enhanced. Women empowerment
is essential to improve diets and health. Nutrition component of medical and
agriculture curricula needs to be strengthened.
Conclusion
The current mindset of looking at food security only in terms of energy security has
to change. Pumping cereals alone to quench hunger will not ensure nutrition and
health. The goal should be to ensure a balanced diet adequate in macro- and
micronutrients. Laboratory, clinical, and community (operations) -based research is
needed to ensure MN security. An optimum mix of food-food fortification, (dietary
diversification), biofortification, and early detection and effective treatment of
clinical deficiencies needs to be worked out. Extension methodology has to be
robust. Media support for creating awareness and compliance is important. The
most important low-cost intervention is following WHO guidelines for breast
feeding- early initiation, exclusive breast feeding for 6 months and complimentary
feeding with continuation of breast feeding up to 1 year. This requires media blitz to
educate the community.
17. Micro-Nutrient Security for India 13
Summary Table of Recommendations for Research and Action
The following table attempts to prioritize the suggestions made as priority 1+ (very
high), which has evidence-based strength and need immediate action and scale up.
Priority 1, (high) has some evidence, but needs more research. Priority 2 (moderately
high) needs more evidence and research inputs. Research areas have been grouped
under: 1.Translational and operation research other than agriculture, 2 Laboratory,
clinical and controlled field research (other than agriculture), 3. Agriculture. The
term agriculture includes horticulture, livestock and fisheries. Nutrition being a
complex and multidimensional subject, inputs are needed from various areas and
hence the wish list is long.
S No. Research area Type of Research Agency Priority
Translational, Operation Research other than Agriculture
1 Improve the efficiency of
micronutrient
supplementation
programmes- NACP,
Massive dose vitamin A
supplementation , iodised
salt distribution
Multi-dimensional
investigations to find out
administrative and
outreach bottlenecks and
socio cultural, behavioural
factors
Efficacy of present regimen
of giving uniformly one
tablet of iron –folic acid
needs re-evaluation and
replaced with treatment of
anaemia with higher dose
after screening.
Health ministry
should contract it out
to a good
management
research group
ICMR
I+
2 Replace iodised salt with
iron fortified, iodised salt
(double fortified salt)
Study the effectiveness,
and acceptance in a scaled-
up programme
ICMR, Ministry of
health, Ministry of
civil supplies, private
sector, home science
colleges
1+
18. Micro-Nutrient Security for India14
S No. Research area Type of Research Agency Priority
3 Nutrition monitoring,
surveillance and
management information
system(MIS)
Put in place effective
system for early detection
of nutritional problems in
the community
Ministry of health in
collaboration with
ICMR, Dept. of
women and child
development and
Department of space,
home science
colleges
I+
4 Infant and child feeding-
promotion of breast and
complimentary feeding
according to WHO norms
Large scale awareness
programme through media
blitz
Ministry of health,
HRD, I&B, Space,
home science
colleges etc
I+
5 Fortification of cereals-
wheat flour and rice with
iron
Investigate the
effectiveness, outreach,
and cost benefit ratio.
ICMR, CSIR, DST,
DBT, Ministry of
health, Ministry of
food processing
industries,
international
agencies
I
6 Nutrition education,
extension and training
1Strengthen nutrition
component of medical and
agriculture curricula.
2. Nutrition education at
all levels
Ministries/depts. of
health, women and
child development,
agriculture, human
resource
development, I & B,
space
I
7 Fortification of oil with
vitamins A and D- Gujarat
experiment
Investigate the
effectiveness/ cost benefit
ratio, stability of the
fortificants. Learn from
Gujarat
Gujarat state
government, ICMR,
ministry of health,
II
Laboratory, Clinical and Controlled Field Research other than Agriculture
1 Multi nutrient pill
containing besides iron and
folic acid, zinc, and
vitamins B12, B2 and C for
anaemia prophylaxis
Controlled laboratory and
clinical trials to examine
the efficacy, and cost
benefit,
ICMR I+
19. Micro-Nutrient Security for India 15
S.No. Research area Type of Research Agency Priority
2 Bioavailability studies to
examine interaction within
nutrients and between
nutrients and promoters
and inhibitors- biotic and
abiotic
Select research studies at
institutional level
ICMR,ICAR,CSIR,
DST,DBT
I
3 Bioavailability of beta
carotene from plant foods-
Conversion factor for beta
carotene to vitamin A in
Indian context. Effect of
vitamin A deficiency
Controlled laboratory and
clinical studies
ICMR, CSIR, DBT I
4 Role of B-vitamins
deficiencies in aetiology of
raised levels of
homocysteine–an
independent risk factor for
CVD. Genetic
predisposition
Controlled laboratory and
clinical studies
ICMR, CSIR, DBT I
5 Development of non-
invasive methods for
assessing MN status. eg.
Dry blood spot method
Laboratory studies in
select well equipped
institutions.
ICMR,ICAR,CSIR,
DST,DBT
I
6 Ready to cook, MN
fortified foods suitable for
institutional meals-ICDS,
MDM, and homes.
Comparison with food-
food fortification with
vegetables, fruits and
products like red palm oil
Field studies to compare
chemical fortification with
food- food fortification
ICMR,ICAR,CSIR,
DST,DBT, Ministry of
food processing
industries, NGO, Home
science colleges
II
7 Assessment of the
magnitude of deficiency
and requirement of less-
recognised MN like zinc,
vitamin B12, an vitamin D
by developing appropriate
laboratory tests
Laboratory studies in
select well equipped
institutions.
ICMR, CSIR, DST,DBT II
20. Micro-Nutrient Security for India16
S No. Research area Type of Research Agency Priority
8 Functional significance of
subclinical MN deficiencies
Laboratory/clinical
studies in select well
equipped institutions.
ICMR, CSIR, DST,DBT II
9 Plant foods containing
nutraceuticals as speciality
foods
Laboratory and clinical
studies in select
institutions.
ICMR, CSIR, DBT,DST II
10 Bioavailability and stability
of MN in processed foods
Laboratory and field
studies
CSIR,DST,DBT Ministry
of food processing
industries
II
Agriculture, (including horticulture livestock research)
1 Increased
production to
consumption of
pulses, coarse
grains and millets
Agriculture extension work to
bridge the productivity gap where
products exist.
Research to increase productivity
ICAR, Central and
state agriculture
universities, Home
science colleges,
ICMR
I+
2 Food- food
fortification-
dietary
diversification
through
decentralised
agriculture
planning, including
homestead
production.
Field trials to examine the impact of
village- level and household
production of vegetables, fruits,
dairy, and poultry, fish using
improved varieties, on household
food security.
ICAR, Central and
state agriculture
universities, Home
science colleges,
ICMR, NGOs
I+
3 Biofortification
using conventional
and molecular
breeding-
Research and development. Scaled
up field trials with products
available.
DBT, ICAR, Central
and state agriculture
universities
I+
4 Genetic engineering
to develop
micronutrient -
enriched food
grains, vegetables
and fruits
Research for health and environment
safety etc
Develop new products.
ICAR, Central and
state agriculture
universities
I
5 Golden rice to
improve vitamin A
nutrition
Validation studies ICMR,ICAR,DBT I
21. Micro-Nutrient Security for India 17
S No. Research area Type of Research Agency Priority
6 Development of
storage and
packaging methods
to preserve the MN
content of foods,
and prevent
infestation.
R&D work, identification of time
tested traditional methods.
Promotion of methods already
developed
ICAR, Home science
colleges
I
7 Analysis of local
foods for
micronutrients and
health promoting
phytochemicals.
(These can also be
resource for
molecular breeding
studies)
A large scale multi-centric effort
using quality control at reference
laboratories
Select institutions
from ICAR,
agriculture
universities, home
science colleges with
NIN and CFTRI as
reference laboratories
II
8 Impact of climate
change on
productivity and
micronutrient
content of staple
foods
Controlled simulation studies in
agriculture institutions and select
laboratories
ICAR, DBT,
Agriculture
universities
II
22. Micro-Nutrient Security for India18
References
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2. National Nutrition Monitoring Bureau (NNMB), Prevalence of micronutrient deficiencies;
Technical report No.22, National Institute of Nutrition, ICMR, 2003
3. National Nutrition Monitoring Bureau (NNMB), Diet and nutrition status of populations and
prevalence of hypertension among adults in rural areas;. Technical Report No 24. National Institute
of Nutrition, ICMR, 2006
4. National Family Health Survey (NFHS-3), International Institute of population Sciences, Mumbai,
India, 2005-2006; Jan.2011, 96 (1):.
5. Ross C, Manson JE, Abrams SA et al. The 2011 Report on dietary reference intakes for calcium and
vitamin D from the Institute of Medicine: What clinicians need to know; J Clin Endocrinol Metab, 96:
53-58, 2011
6. Research and development in millets. Present status and future strategies. National seminar on
millets-2010; Directorate of sorghum research, Hyderabad, November, 2010.
7. Coalition for sustainable nutrition security for India, Leadership agenda, 2010;
http://www.nutritioncoalition.in/publication.asp
8. Copenhagen Consensus, 2008. http://www.copenhagenconsensus.com/Home.aspx.
9. Textbook of human nutrition, 3rd ed. (2010). Editors: Bamji MS, Krishnaswamy, K and Brahmam
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Reviewers
Dr C Gopalan, President, Nutrition Foundation of India, New Delhi
Professor MS Swaminathan, Chairman – MS Swaminathan Research Foundation, Chennai
Professor PN Tandon, President, National Brain Research Centre, New Delhi
Professor MS Valiathan, National Research Professor, Manipal University, Manipal
Professor G. Padmanabhan, Platinum Jubilee Chair, and Hon. Professor, IISc, Bangalore
Dr T Ramasami, Secretary, Department of Science and Technology, New Delhi
Professor RP Sharma, INSA Sr. Scientist, RCPB, ICAR, New Delhi
Professor Akhilesh Tyagi, Director, NIPGR, New Delhi
Professor Jacob John, Former Professor, CMC, Vellore
Dr Kamala Krishnaswamy, Former Director, National Institute of Nutrition, Hyderabad
Dr Vinodini Reddy, Former Director, National Institute of Nutrition, Hyderabad
Dr Prema Ramachandaran, Director, Nutrition Foundation of India, New Delhi
Professor V Prakash, Director, CFTRI, Mysore
Dr B Sivakumar, Former Director, National Institute of Nutrition, Hyderabad
Dr B Sesikaran, Director, National Institute of Nutrition, Hyderabad
Dr GNV Brahmam, Scientist F, National Institute of Nutrition, Hyderabad
Dr M Raghunath, Scientist E, National Institute of Nutrition, Hyderabad
Dr K Madhavan Nair, Scientist E, National Institute of Nutrition, Hyderabad
Dr S Ranganathan, Former Head, Isotope Division, National Institute of Nutrition,
Hyderabad
Professor Umesh Kapil, Department of Gastroenterology and Human Nutrition Unit, AIIMS,
New Delhi
Dr Tara Gopaldas, Former Professor, Dept. of Food and Nutrition, MS University, Baroda
Professor Subhadra Seshadri, Former professor and Head, Dept. of Food and Nutrition, MS
University, Baroda
Professor Venu Seth, Lady Irvin College, New Delhi
Professor Anura Kurpad, Dean St. Johns Research Centre, Bangalore
Dr Klaus Kraemer, Editor, Sight and Life, Switzerland