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We have enough food but our kids our starving

September 20, 2007

The developed world has been fortifying their processed foods for ages, but can you believe it, we in India haven’t done it yet!! Our economy is growing at 8-9 percent but this job hasn’t been done yet. India had been warned of the necessity of doing it by the UN as iron deficiency in particular can cause growth retardation, both physical and mental.

Only Gujarat seems to have taken this issue seriously. The state has been fortifying edible oil and wheat flour (both processed foods) for some time now to remove deficiencies of micro-nutrients. I am no fan of Mr Narendra Modi (the Chief Minister of Gujarat) but now food fortification is on the anvil even in chocolates and milk, which are part of the mid-day meal scheme for poor school children and I think thats wonderful!

Yesterday I read read that Maharashtra was planning to follow Gujarat’s example and was planning to fortify the common man’s stable food pav (bun) with folic acid and iron…well, I wonder what had stopped them from doing it until now!

India has the highest number of malnourished kids in the world
It has been known for some time that India has the highest number of malnourished children in the world. Almost half of the kids under five are underweight and I have given a few details for different states in this post. Even in a relatively better developed state like Kerala, 29 percent of the kids are underweight, so you can imagine how bad it is in other states!
Why should so many kids be malnourished? Surely it is not just due to lack of food?
Well, as this article has mentioned, that “the poor public distribution system, official apathy and ignorance — besides poverty — are the main reasons for us being an undernourished people.”
So, food provided in government schemes often doesn’t reach the right people…but that is not the only issue. Renuka Chowdhury, the minister of state for women and child development said in a recent interview to the DNA (not available online) that the poor knowledge of nutrition at the national level is a problem. Apparently our babus do not know the abc’s of nutrition! I am sure no one is very surprised, as a lot of our politicians are uneducated.

Lack of nutritional knowledge at an individual level
However I feel that there is another aspect, the lack of knowledge of nutrition at an individual level, even amongst the educated and amongst those who can afford to buy better food. Many Indians consume a high proportion of rice, edible oil and sugar, all of which are processed foods not in their natural form and this causes deficiencies. Also a lot of people, inspite of a processed food diet, refuse to eat vitamins, as they believe that vitamins are not as good as actual food! Off and on we keep reading articles in the media about how vitamins can never substitute for good food, and as people assume that their own diet is good they do not bother with vitamins!

A lot of the the better-off kids are eating more maida (white, refined flour) which is devoid of nutrition, in the form of noodles, pasta, pastries and buns, and none of this is fortified in India. And about vegetables and fruits, the poor kids can’t afford too many of them, and and the rich kids don’t like them!

There is also the problem of food taboos, and superstitions associated with food…like don’t eat this fruit if you have a cold, or don’t eat X if you are pregnant….and so on. Its time we checked up on all our food taboos, and found out whether these taboos have a scientific basis or not. The fact that there are different food taboos in different states and in different parts of the world is an indication that these are based on culture and tradition, and not scientific facts.

So, while it is a fact that a certain section of the population 1) do not get enough to eat, and that 2) a large percentage of food meant for public distribution gets stolen, and that 3) there is a lack of a national nutritional programme to fortify commonly consumed foods, it is also a fact that we as individuals need to increase our knowledge about nutrition.

Perhaps public awareness campaigns might help. And social workers and corporates could help in this campaign.

The fact that one state (if there is any other state besides Gujarat please let me know) now has a government sponsored fortification programme means that we have started off in the right direction. Maharashtra and Delhi are both planning to follow suit, and this means the start of a good trend.

It is indeed a pity that India has enough food, but people are malnourished! But at the same time the fact that we have enough food means that we can look forward to a day when not a single child will be malnourished!

(Photo copyrighted to me)

Related Reading: Chemicals in our daily food
How healthy are the instant noodles which are advertised as being ‘healthy?’
How healthy are the so-called ‘healthy’ ready-made soups?

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26 Comments leave one →
  1. September 20, 2007 10:29 am

    The fear of being labeled ‘communal’ probably prompted you to quickly issue a disclaimer that ‘I am not a fan of Narendra Modi’. People, I think, feel guilty in praising Modi even for the good work he is doing. This is a systemic disorder of targeting anyone who attempts to be a Hindu leader although it’s fair to enough to label yourself a Muslim leader or a Christian leader.

    I have expressed my opinion here. Please do not take it personally.

  2. September 20, 2007 11:22 am

    Not at all Harish! But if you ask me, I hate Modi. I absolutely detest him! For obvious reasons. I am also against ALL Hindutva parties, and it is possible that this is so because I am not religious. I also do not like Advani, but admire Vajpayee greatly.
    However I have no fear of expressing my opinons, otherwise I would never have written about various sensitive topics that I write about on this blog.
    You see Harish, whatever one writes people will always be around to denounce it! As long as its an opinion. I always express my opinon, although in a gentle, polite way.🙂
    I get a fair amount of hate mail, even then. they are not always polite, like you.
    Now I will probably get hate mail from Modi’s admirers! But I repeat, I detest the man and the man’s policies. I hope I am allowed to hold that opinion!.

  3. Oemar permalink
    September 20, 2007 11:34 am

    Well the above 2 comments seem to be off the topic, so I ll leave them as it is… coming back to the post, yes its great to see Gujrat implementing these long overdue measures. And I wish many more states take cue from this move and implement the same. During the past 10 years or so of bustling Indian economy, either something or someone has been missed…. the poor seem to have been bypassed by the economic boom and some basic principles of a “good life” seems to have been forgotten – like stricter laws on child labour, woman traficking, food and health care, education as a fundamental right and nutrition for children etc… But its good to see states beginning to recognise these issues, though slowly and steps being taken to tackle it. I am hopeful.

  4. September 20, 2007 11:47 am

    ‘I get a fair amount of hate mail, even then. they are not always polite, like you.’

    Mine was in no way a hate mail, I assume.🙂

    Yes, sure, everyone has a right to hold his/her opinion. Otherwise what’s democracy? Obviously, much of the blogosphere exists because of people who have opinions to express and they are allowed to do so.

  5. September 20, 2007 12:24 pm

    I have a couple of thoughts on this:

    1. The experiences from other developed countries show that nutritional awareness is necessary but not sufficient for ensuring good nutrition in the population.

    This can be explained by what is termed the ‘knowing-doing’ gap in management lingo. Even those who know basic principles of nutrition do not always follow them.

    In case of India with its delectable cuisines and variety of possibilities – some Western friends are amazed at my 20-something spice jars – it is an even bigger challenge to address.

    On my annual pilgrimage to India, I am still astounded by how many Indian households – these are well-educated, professional people – are still copiously using ghee in their daal, eating sugary and fatty sweets on a daily basis, adults using full-fat milk when skim will suffice (especially going by the sizes of their midriffs, so their arteries do not bear thinking about!), and the general over-cooked gunk that passes for vegetables.

    Why, I do not even have to go to India. I see even desi friends here in the UK practising things ‘just the way my mother used to’!

    2. Public health experiences also show that unhealthy behaviours occur in clusters. Poor eating goes hand in hand with things like alcohol abuse, smoking, lack of exercise and so on.

    NHANES data from the US shows that while the awareness of principles is good, just 3% of the population actually follow the 4 basic rules – eat more fruit and veg, do not smoke, get some exercise, and monitor your weight.

    It is compounded in India by mass illiteracy, lack of public health systems, and poverty.

    I would not say the messages are not effectively disseminated. India’s public interest messages are very creative and Indian advertising even now probably the best in the world.

    So it will take several forces in private and public sectors to deliver good nutrition in India.

    PS: Even the public health communities did not discuss malnutrition and obesity together until recently. That is changing of course (I also write a well-read obesity blog on the multiple facets of obesity and that is also the case study of my PhD: obesityheadlines.blogspot.com

    PPS: I also clicked on your surprise post and there is a lot to say there too but perhaps it is more important to act. I am exploring with my sister-in-law, a physician, the possibilities of a public health charity to improve the state of health awareness. More plans tbc

  6. vish permalink
    September 20, 2007 12:25 pm

    Hi Nita,

    I have given the link to the mid-day meal scheme run very successfully in Tamil Nadu for so many decades. This scheme is an ‘irreveresable’ one in Tamil Nadu and a very sensitive issue. This has also provided employment opportunities to many people and you can see the other benefits in the following link.

    http://en.wikipedia.org/wiki/Mid-day_Meal_Scheme

    I have also seen the success of the ‘Akshayapatra’ program in Karnataka. It is even more effective as they (ISKCON) are looking into the ‘nutrients’ and other things that are important for the growing kids.

  7. September 20, 2007 12:46 pm

    Oemar, yeah, proper food is a basic need and if we can’t provide it to our people inspite of economic growth, we will be the laughing stock of the world!

    Harish.🙂

    Shefaly, that was a very informative comment. Thank you. Yes, I agree that in India people insist on sticking to traditional ways of eating (ghee consumption) even though their lifestyles have changed drastically.

    Vish, thanks for the link Yes, there are midday meal schemes in other states, but no fortification with nutrients. Unfortunately, white rice is not a nutritionally rich food and that is what many poor people eat. What we need is mass-scale fortification of the refined foods which have become a part of our daily life. Even the refined edible oils that we consume today are nutritionally very poor when compared to unrefined oils that our ancestors consumed. I for one use unfiltered oil, which though not as nutritious as unrefined, is still better than refined oil. But for guests i keep refined oils, as people find it difficult to bear the smell of unfiltered oils. I myself cannot bear the smell of unrefined oils!

  8. September 20, 2007 1:18 pm

    Corruption has hit Govt.’s Free school meals programmes also.. fake attendance and lot of under-the-table deals going on.. Having so much fund allocated – Are they montoring it really well?? More than Malnutrition it’s “empty stomach” a much worrying factor.. for some people there is barely enough to eat!

  9. wishtobeanonymous permalink
    September 20, 2007 1:42 pm

    I always try to suppress the urge to read blogs and to even comment, but I am very addicted to your informative blog and I just can’t help not commenting on some. So here’s mine – in the US, whole foods is the rage. You have whole grain bread, whole grain flour, whole grain pasta etc. and I think almost all foods are fortified with folic acid and iron. The FDA is a very powerful entity and all companies have to follow their guidelines as to a minimum daily value of nutrients. Does India have a similar entity in the central government (as I am extremely ignorant of such matters)? Do we have food rules/laws by some govt. org. that companies have to follow? Well, I know that even if there are laws governing food, there is no strict enforcement of the laws.
    I am glad to hear the news about Gujarat, Delhi and Maharashtra. I hope the South and other states follow suit.

  10. September 20, 2007 2:14 pm

    Bharat, yeah lots of kids go hungry too, because of these thieves who swallow up the money allocated! Its a shame.

    wishtobeanonymous. thanks for those words.🙂
    About a similar body to the FDA, yes we very much have one in India, but there is absolutely no requirement to write the nutrition values on the foods. It is only compulsory to list ingredients, and that too in descending order of their presence, not their absolute values. I have written a post on this here. It is basically about additives in food, but I have done a comparision with developed countries. In India the FDA is mostly concerned with spurious drugs, and the food part has been neglected. But the laws that are present for the foods are mostly for food contamination, and ofcourse there are regulations as to what can or cannot be present…but the nutritional values aspect has been neglected. Some companies do it voluntarily, some of the foreign companies.

  11. September 20, 2007 3:59 pm

    now that u have
    Sonia or Modi who is better ?

    very nice post good observation
    sadly forget fortification it will be a miracle if at least 52% of intended food for mid day meal is not pilferred and defective unedible food served instead

    one more thing the politicians and even judges to some extent just dont care they have all the facilities
    sea facing penthouse bungalows etc
    their live happily in their shell cut off from common peoples problem – giving lip service whenever needed
    problems = more issues to fight elections

  12. September 20, 2007 4:19 pm

    I’d read somewhere that up to 60% of fresh farm produce in India is wasted and becomes stale by the time it reaches the markets.

    While it is obvious to ponder over the link between economic status and nutrition, I also wonder about the link between infrastructure and malnutrition.

    //But if you ask me, I hate Modi. I absolutely detest him!//
    Thanks! Refreshing to read such an unequivocal opinion coming from you!🙂

  13. Shefaly permalink
    September 20, 2007 4:40 pm

    Nita:

    Your other post linked here is interesting but I think the key issue is that there is no transparency in the processes behind regulations. For instance, you ask ‘who sets these safe limits?’.

    Law making/ regulation making is like sausage making i.e. not pretty. But in most developed countries several publications from the government, from academics, from interest groups etc put a lot of information out in the public domain.

    Where is that eco-system in India?

    And where is the demand?

    Information on health issues in the public domain is very poor quality and what is worse, when one does write about it in forums where it should generate a dialogue, it generates personal and irrelevant comments as I saw in my writing about health issues on the Indian Economy blog. (I am still a guest writer but will resume a bit later).

    It will be good to hear more on this issue.

    Thanks.

  14. September 20, 2007 6:52 pm

    Prax, thats a good one, Modi or Sonia? You are giving me a choice between the devil and the deep sea. I choose neither!!

    Mahendra, I think you could have possibly read about that on my blog🙂 coz I did write about it. ofcourse, there is an important link between infrastructure and nutrition, but our infrastructure is corrupt. 😦

  15. wishtobeanonymous permalink
    September 20, 2007 7:45 pm

    Some (educated) people in India are afraid to even eat vegetables because they have been tainted with pesticides/insecticides. Can we have a public interest litigation citing the negligence towards the general public? I hope your blog is being read by people of power who are honest or willing to change and I hope they do something to curtail hunger, poverty, illnesses and millions of other ills happening in our society.
    Nita, do you think there is hope for our country? 100 years from now, will our society remain the same? Will people still go hungry? Will people still be apathetic towards others? Atleast the middle class is aware of their rights as far as basic needs are concerned, but I don’t think the poor even know that it is their right to have their daily food and water.

  16. September 20, 2007 8:34 pm

    wishtobeanon, you bet there is hope. do you know that when i was in school, more than 30 years ago, i believed that india would one day be a superpower! people laughed then but now no one laughs, though people do disbelieve! i don’t know why i felt that…!
    we are going to be up there one day my friend, and even if you and me are not alive it doesn’t matter! We are going to change…more and more people are getting into the middle-class and frankly I don’t think it will even be 100 years…I would say another 50.🙂
    as to whether some imp people read my blog, I always wish for that…but i don’t know. many many read, as is evident to me from the stats, but not everyone comments. well known people will generally avoid it!

  17. wishtobeanonymous permalink
    September 20, 2007 9:42 pm

    A nice news/article: Learning vegetable farming first hand: http://www.hindu.com/2007/09/20/stories/2007092050950200.htm

  18. September 20, 2007 9:51 pm

    ” not everyone comments. well known people will generally avoid it!”
    But I do comment, Nita!😀

  19. September 20, 2007 9:59 pm

    And, incidentally (since this is my fave food), pasta is not supposed to be maida. Pasta is originally 100% wheat (durum), and is rich in minerals and B vitamins, too. Unfortunately, this pasta is more expensive than the local ones, which are made of flour.

    True Rambodoc, the imported variety is much healthier. But most people can’t afford it I guess!

  20. September 20, 2007 10:48 pm

    Shefaly, just retrieved your second comment!
    anyway the points you raised are valid and India has a long way to go. People here don’t as a routine even check expiry dates on products and shops do stock expired goods! even when i was in tanzania, a less dev country than india, i saw shopkeepers being careful to keep the near to expiry date products separately! the law comes down heavily on them otherwise!
    awareness about health and nutritional issues is not very high here and therefore no demands.
    you should see the shoddy food sold by unauthorised people here, use of unauthorized colors is rampant here by small shops…we are awaiting some new food laws here, they are on the anvil, lets see when that happens. supposed to have happened by now, but not this session of parliament.
    another post of mine on poor food packaging might interest you.

  21. September 20, 2007 11:40 pm

    Nita, there’s one organization I know of in India that’s working to reclaim the foods and grains that have been forgotten (like ragi, sattu, jhangora, brown rice). While the Indian diet is pretty balanced in some ways (wide variety of fresh vegetables and fruits) we do tend to eat some processed food like maida and white sugar which combined with sedentary lifestyles, can lead to health problems in the long run. The organization is called Navdanya and their website is : http://navdanya.org/organic/index.htm

    Here in the US, there are many organizations that are working to make urban gardening popular. One organization that I’ve been involved with is called the Food Project: http://www.thefoodproject.org/ – they grow organic produce that involves youth and also donate part of their produce to food pantries. As there’s more information and more organizations like Navdanya sprout up, I’m hopeful that conditions will change.

    I do believe that the problem is one of inequity and disparity in distribution rather than insufficient food.

  22. September 21, 2007 12:30 am

    nicely said🙂
    i expected a nice response and am happy to get one
    very diplomatic😉

    i prefer modi to an extent not for his lineage or policy but mainly bcause he is not a hypocrite and speaks his mind something rare in the breed called politicians
    to me he is a necessary devil if i have to put it in ur way.

  23. September 21, 2007 12:52 am

    Nita wrote:

    Also a lot of people, in spite of a processed food diet, refuse to eat vitamins, as they believe that vitamins are not as good as actual food…

    Let’s be careful here. There’s no incontrovertible evidence that vitamin supplements help grow anything other than the coffers of the companies that produce and market them. The same goes for fortification. Michael Shermer, a skeptic whom I admire (no surprise there :)), observed in an article that he wrote in the Scientific American,

    When I was bike racing in the 1980s, I went through a period of megadosing vitamins and minerals that produced brightly colored urine but no noticeable performance difference. The testimonials behind such nutritional claims are powerful, but the science is weak. The fact that the field is fraught with fads and ever changing claims for “X” as the elixir of health and longevity does not bode well.

    It is not very clear, how our genetic makeup, food intake, lifestyle, and the environment interact, to develop a healthy body. There are no silver bullets here. I am reminded of a discussion I had with a doctor friend of mine, where I asked her about the nutritional effects of mixing foods, both while cooking and while eating. I asked her, for example, the effect of tamarind, a common ingredient in rasam, sambar, and kootu, on the glycemic index (important in diabetes and related illnesses) of rice – as you may know, all of these are mixed with rice in South Indian dishes. Acids, I was told, lowered the rate absorption and conversion of carbohydrates into sugars, and hence the glycemic index of rice.

    That nutritional awareness should be promoted is a sensible advice, but what I often find in the media are mindless restatements of dietary promotions from developed countries – a lot of hot air, if you asked me.

  24. September 21, 2007 7:24 am

    TRF, I am aware of the school of thought which is against vitamins, but I can only agree with it if one’s diet itself is balanced, not otherwise. In fact this school of thought does assume that you are eating a decent enough diet.
    There was an interesting article in Time mag on how supplements have been responsible for the growth in height of Americans, if i find the ref I will add it here…
    you see originally (like Amit mentioned) our diet was very good and in fact in a few villages they do eat brown rice, but mostly this original diet has changed to a processed food diet.
    Actually I have read several articles in the media which are against vitamins and I have written to them that writing this without a disclaimer (that one needs a balanced diet) is misleading.

    Amit, you are absolutely right. Originally our Indian diet was excellent…it has deteriorated over the years.

  25. Vasudevan permalink
    September 21, 2007 1:09 pm

    1. Last 20 year (two green revolutions we finished). But we don’t know how to distribute food.

    Exporting food items are international Standard. But domestic foods are not following any Rules. Other countries exporting after they consumed Quality food. But India, it’s deferent.

    2. Our farmers are not following Cyclic Cultivation. We follow same method next 10 Year our farming lands will be no more. Swami Nathan foundation introduced new pulses with high nutrition with small amount of food to eat.

    3. 90% of India’s health problems are unlike food production
    .
    4. In India, a family spends 15-25% of their income for food. They spend more for luxury goods.

    5. climate and geographical position of India also problem for under weigh children
    We need more food then Europe and North America

    Vasudevan, thanks for your response and the information – Nita

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