Malnutrition in All Its Forms

India is facing nutrition paradox. While on one hand there are children who suffer from the effects of undernutrition, there are other children who suffer from obesity. There has also been a misconception for the longest time that the problem of malnutrition mainly persists in rural areas only.

In order to comprehensively study the actual state of nutrition among the children of the country, and to frame data-driven policy measures, the government of India has released the first-ever Comprehensive National Nutrition Survey.

According to the survey, malnutrition among children in urban India is characterised by relatively poor levels of breastfeeding, higher prevalence of iron and Vitamin D deficiency as well as obesity. On the other hand, rural parts of the country see a higher percentage of children suffering from stunting, underweight and wasting and lower consumption of milk products. The survey has also pointed out that 83% of children between 12 and 15 months continued to be breastfed. However, a higher proportion of children in this age group residing in rural areas are breastfed (85%) compared to children in urban areas (76%). Thus, breastfeeding is inversely proportional to household wealth and other factors influencing this trend may include working mothers who have to travel long distances to reach their workplace.

Because of these reasons, it also noted that rural children receive meals more frequently in a day at 44% as compared to 37% of urban children. However, a higher proportion of children residing in urban areas (26.9%) are fed an adequately diverse diet as compared to those in rural areas (19%).

Children and adolescents residing in urban areas also have a higher (40.6%) prevalence of iron deficiency compared to their rural counterparts (29%), which has been accounted to a better performance of the government’s health programmes in rural areas.

Children in urban areas are also overweight and obese as indicated by subscapular skinfold thickness (SSFT) for their age. While 14.5% of children in the age group of 5 to 9 years in cities had higher SSFT than 5.3% in rural areas, 10.4% of adolescents surveyed in urban areas in the age group of 10-19 had higher SSFT than 4.3% in rural areas.

Wealthier households in urban areas and sedentary lifestyle of children may also be responsible for higher deficiency of Vitamin D in urban areas (19%) as compared to rural areas (12%), though the study shows that 74% of children living in cities consume dairy products as compared to 58% in rural areas.

Rural children lag in intake of zinc which causes diarrhoea, growth retardation, loss of appetite and impaired immune function. Among children aged 1-4 years, zinc deficiency is more common in rural areas (20%) compared to urban areas (16%).

Rural areas also witness higher prevalence of stunting (37% in rural versus 27% in urban), underweight (36% in rural versus 26% in urban) and severe acute malnutrition (34.7% in rural areas for children in 5-9 years versus 23.7% in urban areas and 27.4% in urban areas for adolescents in 10-19 years versus 32.4% in rural areas).

NITI Aayog is currently working towards framing a strategy to deal with problems that have come to light through this survey. However, the non-government organisations, corporate community and the aware individuals need to use the findings of this data to ensure optimum utilisation of resources in order to minimise malnutrition in any form.