The Impact Of Dietary Habits On Nutritional Status Of Children In India

1. The Impact Of Dietary Habits On Nutritional Status Of Children In India Dr. B. Sesikeran, MD, FAMS Director National Institute of Nutrition (Indian Council of Medical Research) Hyderabad – 500 604 E-mail: sesikeran@gmail.com

2. Infant Mortality Rate (Per 1000 Live Births) in India and South-east Asian Countries Source : WHO/SEARO 2000 58 * * * SRS, Registrar General of India, 2004

3. Prevalence of Low Birth Weight in India and South-east Asian Countries * Source : WHO/SEARO 2000 23 (NFHS 2) * Increase in Institutional Deliveries

4. Uttar Pradesh Gujarat Madhya Pradesh West Bengal Maharashtra Orissa Andhra Pradesh Karnataka Kerala Tamilnadu NATIONAL NUTRITION MONITORING BUREAU (Estd: 1972) • Objectives of NNMB • Assessment of Nutritional status of various communities by adopting standardized procedures and techniques • Periodical evaluation of National Nutrition programs operation in India

5. Average Daily Food Intake (% RDA) among 1-3 Year Children : By Gender Percent RDA

6. Median Intake of Nutrients (as % RDA) Among 1-3 year children : By gender Percent of RDA

7. Average Daily Food Intake (% RDA) among 4-6 Year Children : By Gender Percent RDA

8. Median Intake of Nutrients (as % RDA) Among 4-6 year children : By gender Percent of RDA

10. Prevalence (%) of Undernutrition Among 1-5 yr children According to SD Classification (<Median - 2SD): By Gender Percent

11. Prevalence of Undernutrition among <5 years children according to Weight for Age (IAP classification) Faulty BF Faulty Complementary feeding

12. INFANT AND YOUNG CHILD FEEDING PRACTICES (NFHS 3)

13. MICRO-NUTRIENT DEFICIENCIES

14. Madhya Pradesh 1.4 Orissa 0.3 West Bengal 0.6 Maharashtra 1.3 Andhra Pradesh 1.2 Pooled: 0.7% Karnataka 0.7 < 0.5 %  0.5 % Tamil Nadu 0.5 Kerala 0 Prevalence (%) of Bitot spots among 1 - <5 year children Boys: 0.9% Girls 0.6%

15. Prevalence (%) of Bitot Spots among 1 - <5 yrs. Children * WHO cut-off level (0.5%) of Public Health significance

16. Distribution (%) of 1- 5 Yr. Children with Blood Vit. A Levels of < 20 G/dL, Median Dietary Intake of Vit. A (as % RDA) and Extent of Coverage for Suppl. of Massive Dose Vit. A – By State Source: NNMB-MND Survey : 8 States, 2003

17. Definition of Anemia WHO, Nutritional Anemia - TRS No. 405, Geneva 1968.

18. AETIOLOGY OF IDA DIETARY FACTORS LOW INTAKE OF DIETARY IRON • ABSORPTION • DIETARY FACTORS • Promoters • Inhibitors • HOST FACTORS • Iron Status • Health Status • INFECTIONS & INFESTATIONS • Malaria • Hook Worm • Schistosomiasis HAEMORRHAGIC CONDITIONS IRON DEFICIENCY • PHYSIOLOGICAL CONDITIONS • Menarche • Pregnancies with Lack of adequate interval • HAEMOLYTIC DISORDERS • Sickle Cell Disease • Thalassemia IRON DEFICIENCY ANAEMIA

19. Prevalence (%) of Anaemia by Age, Gender & Physiological Groups 10.2 0.03 11.2 0.03 11.0 0.03 9.9 0.03 10.6 0.03 10.7 1.99 12.6 2.09 Mean ±SE > 6 months < 6 months

20. Computed from NNMB data, rural survey, 2001

21. Computed from NNMB data, rural survey, 2001

22. Madhya Pradesh 4.3 West Bengal 9.0 Orissa 0.1 Maharashtra 12.2 Andhra Pradesh 3.8 Pooled: 3.9 Karnataka 1.9 < 5 % > 5 % Tamil Nadu 0 Kerala 0.6 Prevalence (%) of IDD among 6 – 11 Year Children Source: MND-NNMB, Tech Rep 22, 2003

23. PREVALENCE (%) OF IDD AMONG CHILDREN (≤12 years old)

24. Percent of Households consuming salt having adequate Amount (≥15 ppm) of Iodine * By spot test

25. Distribution (%) of Children by Undernutrition and Period of Survey Percent UNDERNUTRITION (< Median - 2SD)

26. Trends in poverty line estimates and Prevalence of Undernutrition among 1-5 yr. Children (According to SD Classification Using NCHS Standards) Source :- BPL : Economic survey and NNMB Surveys

27. overweight obese Prevalence of overweight and obesity among school-age boys aged 5-17 years by global region 35 30 25 20 Prevalence (%) 15 10 5 0 Europe Americas Worldwide Asia-Pacific Near/middle East Sub-Sahara Africa

28. PREVALENCE (%) OVERWEIGHT AND OBESITY AMONG CHILDREN: VARIOUS STUDIES

29. Prevalence of Overweight/Obesity and Physical Activity (NIN Study)

30. Various practices among overweight and non-overweight urban Adolescents in Andhra Pradesh NIN-WHO Technical Report 2007

31. Overweight/Obesity Vs Lifestyle practices (n:941) Laxmaiah et al 2007

32. Conclusion • Despite rapid progress in the area of food production, the intake of food and nutrients continues to be deficient, both in terms of quantity and quality • Prevalence of LBW is about 30%, and about 55% of preschool children are underweight and 50% are stunted. • Even though, the prevalence of undernutrition is significantly declining over a period of 3 decades, still the current prevalence is exceptionally high. • MNDs such as IDA VAD and IDD continues to be of public • health problem. • The coverage for vitamin A and IFA tablets supplementation was poor

33. Conclusion (Contd..) • The prevalence of overweight and obesity is significantly increasing over a period of 3 decades even among rural population, which is the major independent risk factor for metabolic syndrome. • Prevalence of overweight and obesity is considerably high, especially when Asian cut of levels were used (≥23 BMI). • India is passing through a critical phase i.e. ‘double burden of disease’. • One fourth of our rural adults are suffering from hypertension About 5-6% of the adults have IGT/DM.

34. Thank you