As per the Human Development Report prepared by United Nations Development Programme (UNDP), the premier city of India, Mumbai has a very high rate of malnutrition irrespective of whether children were in slums or from upper middle class societies (1). As per the report, 45.4% of children below 5 years are stunted and 15.9% were severely stunted. Wasting was present in 16.2% and 32.6% were underweight (1). The primary reason is that children in slums do not have access to proper food and children from upper middle class do not eat proper food. Intake of nutrient empty food (with little vitamins and minerals) seems to be a major factor due to drastic changes in dietary habits and intake of palatably tasty but nutrient poor food (1). Food such as biscuit, pastas, pizza, French-fries, wafers, vada pav, samosa, pastries, oily food do not provide enough minerals and vitamins that are required for daily intake though they may provide the calories. Overcooking the food also destroys the vitamins and minerals. The other common problems of malnourished children are due to their mothers being undernourished before they start their pregnancies. This leads to low birth weight babies and later malnutrition in these children as they are unable to provide care for their infants (3). To provide high quality care, mothers need to ensure proper breast feeding and complementary feeds to their children.
While quantity of food is measured by its calorie content, the quality of food is determined by its vitamin and mineral content. At least 45 elements and compounds are needed by human cells, absence of any one of them can lead to illness (2). No single food offers all 45 nutrients and thus the importance of eating a balanced diet. Advances in the science of chemistry gave birth to scientific nutrition, concerned with elemental compounds of food and complex chemical processes by which food is put to use (2).
India is in a state of this nutritional transition where urbanization has contributed to shift in diet and obesity is on rise with micronutrient deficiency and protein energy malnutrition continues to be present in rural India and nutrition access poor households.
However, in India supplementary feeding schemes in form of mid-day meal program, fortification of food such as iodized salt are already available to promote normal growth and development in children. However supplement of other micronutrients such as vitamin A, C, D, iron, zinc and other essential vitamins and minerals is needed to prevent childhood malnutrition which can be overcome by eating a balanced diet and by micronutrient supplements.
Thus, in India over time the nature of nutritional problems have evolved. Obesity with micronutrient deficiency has appeared as an important nutritional disease in addition to under nourishment. The problem of iron and vitamin A deficiency along with other micronutrients still persists in preschoolers. With advances in technical, agricultural and scientific nutrition, they are key factors in the process to correction towards these nutritional deficits.
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