Food

1
Food Nutrition Security

• M.H. Suryanarayana
• Indira Gandhi Institute of Development Research,
  Mumbai
• INDIA

2
Food Nutrition SecurityImportance(contd.)

• Importance
• Human Development
• Efficiency productivity of labor, the only
  asset of the poor
• Wages incomes
• Undernourished population - poor

3
Food Nutrition SecurityImportance

• Different World Food Summits avowed to reduce
  hunger
• One of the Millennium Development GoalsMDGs
• Incidence of hunger to be reduced by half during
  1990-2015

4
Nutrition Security

• Nutrition Essentially an investment
• To realize MDGs Poverty alleviation, education,
  health, gender equality (cont.)
• Malnutrition is a poverty outcome good nutrition
  is a solution to poverty
• Nutrition facilitates learning hence, achieve
  universal primary education
• Girls nutrition promotes gender status
  incentives for small family size Gender equality
  and empowerment
• 60 U5 mortality is due to malnutrition hence,
  nutrition would reduce child mortality
• 20 of maternal deaths iron deficiency anemia
  Hence, important to improve maternal health

5
Nutrition Security

• Nutrition Essentially an investment
• To realize MDGs Poverty alleviation, education,
  health, gender equality
• Nutrition improves immunity, HIV related
  infection, decelerates progression from HIV to
  AIDS To combat HIV/AIDS, malaria other
  diseases
• Facilitates environmental sustainability because
  its conservation is low priority for the
  under-nourished

6
Policy Relevance

• Micro Perspective
• Health and nutritional outcomes
• Labor productivity
• Wages and earnings hence, incomes
• Deprivation and human development

7
Policy Relevance

• Macro
• Human capital of the society implications for
  productivity, incomes and deprivation
• Million Development Goals

8
Food Security Definition

• World Food Summit, 13-17 November 1996, Rome
  Italy World Food Summit Plan of Action
• Food security exists when all people, at all
  times, have physical and economic access to
  sufficient, safe and nutritious food to meet
  their dietary needs and food preferences for an
  active and healthy life.

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Food Security

• Dimensions
• Availability
• Access
• Stability of food supply and access (weather,
  prices, conflicts, political manipulation, etc.
  can affect them adversely)
• Safe and Health food use

10
Food Insecurity

• Occurs when
• Food is available but is not nutritionally
  adequate
• When not everyone get enough to eat
• Food is available but households cannot buy
  because of high prices or high costs of
  transportation, do not meet local preferences
• Food is inedible

11
Policy Imperatives

• Capacity of families, households, communities To
  be improved
• Education, Health care and AIDS-prevention
• Targeted social protection programs, cash
  transfers, school-based food programs etc
• Sustainable livelihoods in both rural and urban
  areas
• Prioritise issues related to food security and
  fair trade

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Measurement Issues

• Developed Countries
• Macro Perspective
• Little scope for structural change hence, for
  misinterpretation of estimates and finings

13
Developed Countries Macro Perspective

• Economic access Per capita income distribution
  parameters like poverty estimates
• Physical access (i) Per capita food grain
  availability (Production ? stocks net trade
  seeds wastage) (ii) per capita food
  consumption (iii)per capita calorie intake etc.

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Nutrition Security

• Concepts Data Sources

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Food Deprivation

• Under-nourishment
• Prevalence of undernourishment in total
  population
• Proportion of the population in a condition of
  undernourishment.
• Undernourishment
• Condition of people whose dietary energy
  consumption is continuously below a minimum
  dietary energy requirement (MDER) for maintaining
  a healthy life and carrying out a light physical
  activity.

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Depth of Hunger

• Intensity of food deprivation
• Measures the extent (absolute) shortfall of food
  from the minimum food needs in terms of dietary
  energy
• Given by (minimum dietary energy - the average
  dietary energy intake of the undernourished
  population)
• Intensity
• Low lt 200 kilocalories per person per day
• High if gt 300 kilocalories per person per day.
• The greater the deficit, the greater the
  susceptibility for health risks related to under
  nutrition.

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Food Needs

•  Minimum dietary energy requirement (MDER)
• For a specific age and sex group, the amount of
  dietary energy per person is that considered
  adequate to meet the energy needs for minimum
  acceptable weight for attained-height maintaining
  a healthy life and carrying out a light physical
  activity.
• For the entire population, the minimum energy
  requirement is the weighted average of the
  minimum energy requirements of the different age
  and sex groups in the population.

18
Food Consumption

• Nutrients Dietary Energy, Protein and Fat
• Dietary Energy, Protein, Fat Consumption
• Amount of food, in kcal per day, for each
  individual in the total population.
• Dietary protein consumption per person
• Amount of protein in food, in grams per day, for
  each individual in the total population.
• Dietary fat consumption per person
• Amount of fat in food, in grams per day, for each
  individual in the total population.

19
Food Consumption

• Energy
• Kilocalorie is a unit of measurement of dietary
  energy
• One kcal equals 1 000 calories and one kJ equals
  1 000 joules.
• In the International System of Units (ISU), the
  universal unit of dietary energy is the joule
  (J). One kcal 4.184 kJ.

20

• Food Deprivation
• Depth of Hunger
• Food Needs
• Food Consumption
• Data source
• FAO Statistics Division

21
Nutritional Status Children

• Prevalence of underweight in children under five
  years (U5)
• Moderate underweight Proportion of children U5
  with weight lt that of 2 standard deviations below
  the median of weight-for-age of the WHO reference
  population
• Severe underweight Proportion of children U5
  with weight lt that of 3 standard deviations below
  the same median

22
Nutritional Status Children

• Prevalence of stunting in children U5
• Moderate Proportion of children U5 with height
  or stature less than that of 2 standard
  deviations below the median height or
  stature-for-age of the WHO reference population
• Severe Proportion of children U5 with height or
  stature less than that of 3 standard deviations
  below the same median

23
Nutritional Status Children

• Prevalence of wasting in children U5
• Moderate Proportion of children U5 with weight
  less than that of 2 standard deviations below the
  median of weight-for-height or stature of the WHO
  reference population
• Severe Proportion of children U5 with weight
  less than that of 3 standard deviations below the
  same median

24
Nutritional Status Children

• Prevalence of overweight in children U5
• Moderate Proportion of children U5 with weight
  greater than that of 2 standard deviations above
  the median weight-for-height or stature of the
  WHO reference population
• Severe Proportion of children U5 with weight
  greater than that of 3 standard deviations above
  the same median

25
Children - Stunting, Underweight, Wasting,
Overweight

• Data sources
• WHO. 2004. Global Database on Child Growth and
  Malnutrition
• World Bank. 2004. World Development Indicators.

26
Nutritional Status Adults

• Body Mass Index (BMI)
• An index of weight-for-height
• Weight in kilograms divided by the square of the
  height in meters (kg/m²)
• Generally used to classify underweight,
  overweight and obesity in adults
• Also called Quetelet index after Adolphe Quetelet
  (1796-1874)

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Nutritional Status Adults
International Classification BMI(kg/m²)            Cut-off points
Underweight lt 18.50
Normal range 18.50 24.99
Overweight gt 25.00
Overweight (pre-Obese) 25.00 29.99
Obese gt 30.00
28
Adults - Underweight, Overweight, Obesity

• Data sources
• The WHO Global Database on Body Mass Index (BMI)

29
Health

• Life expectancy at birth (years)
• Number of years a newborn infant would live if
  prevailing patterns of mortality at the time of
  birth were to stay the same during the lifespan.
• Child mortality rate
• Probability of dying between birth and exactly
  five year of age, expressed per 1000 live births.
• Infant mortality rate
• Probability of dying between birth and exactly
  one year of age, expressed per 1000 live births

30
Life expectancy at birth, under five mortality,
infant mortality

• Data sources
• Life expectancy at birth World Bank. 2005. World
  Development Indicators
• Child mortality rate UNICEF. 2005. Child
  mortality.
• Infant mortality rate UNICEF. 2005. Infant
  mortality.

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Poverty

• Poverty rate / Headcount Index
• National poverty rate / headcount index
• Percentage of the population living below the
  national official poverty line.
• Urban poverty rate / headcount index
• Percentage of the urban population living below
  the urban poverty line.
• Rural poverty rate / headcount index
• Percentage of the rural population living below
  the rural poverty line.
• Data sources
• World Bank. 2004. World Development Indicators.

32
Global Hunger Index

• IFPRI Index

33
Global Hunger Index

• Objectives
• Rank countries
• Compare international experience for policy
  guidance.
• Draw global attention

34
Global Hunger Index

• Sample
• Based on 120 developing and transitional
  countries countries
• Compares 88 only
• Three indicators
• Un-weighted average as an index

35
Indicators
Indicator Purpose to measure
1 of calorie deficient / under-nourished population Hunger
2 children underweight U5 Malnutrition of children, the most vulnerable to hunger
3 U5 mortality rate () Child deaths caused by malnutrition disease
36
Hunger Index ScaleSource IFPRI
Index Classification Color Code
30.0 Extremely alarming
20.0 29.9 Alarming
10.0 19.9 Serious
5.0 9.9 Moderate hunger
4.9 Low hunger
37
Country Classification n 120Source IFPRI
38
Global Trends 1990 - 2008

• Hunger (Global index) decreased by less than
  one-fifth
• 1990 18.7
• 2008 15.2
• Performance by indicator
• underweight children declined by by 5.9 points

39
Regional Profile 2008

• Status Alarming
• Sub-Saharan Africa 23.3
• South Asia 23.0
• Ten countries (highest levels of hunger) nine
  are in Sub-Saharan Africa
• Ten best performers since 1990 None from
  Sub-Saharan Africa

40
Country ProfilesSource IFPRI
Best score Mauritius, followed by Jamaica, Moldova, Cuba, and Peru
Worst score Democratic Republic of Congo (DRC), followed by Eritrea, Burundi, Niger, and Sierra Leone
Most progress Kuwait, Peru, Syrian Arab Republic, Turkey, and Mexico
Regress DRC, North Korea, Swaziland, Guinea-Bissau, and Zimbabwe
41
Country Profiles Source IFPRI
Highest proportion of population with calorie deficiency Eritrea 75 DRC 74
Highest prevalence of underweight children (a measure of malnutrition) India, Yemen, and Timor-Leste more than 40
Highest child mortality (under 5) rate Sierra Leone 27 Angola 26
42
Poverty Profile Source IFPRI
43
Where Do The Poor Live? Source IFPRI
44
Global Index Scale Source IFPRI
Index Classification Color Code
30.0 Extremely alarming
20.0 29.9 Alarming
10.0 19.9 Serious
5.0 9.9 Moderate hunger
4.9 Low hunger
45
2008 Global Hunger Index Source IFPRI
46
Progress Regress Source IFPRI
47
GHI-Winners and Losers 1990 2008 Source IFPRI
48
Global Food Price Crisis Source IFPRIs
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Dietary Energy Consumption
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Child Nutritional Status
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Food Price Crisis and Political Stability
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Global Policy Response

• Special Program for Food Security
• National Program for Food Security (NPFS)
  country driven solution to eradicate hunger
  within local population
• Regional Programs for Food Security (RPFS)L
  Involves regional economic organizations to
  promote regional integration among neighboring
  countries in order to maximize the impact of
  national programs
• Since 1995, US 770 million invested in
  FAO-designed food security programs

57
Global Policy Response

• Special Program for Food Security
• FAO flagship initiative to halve the number of
  poor by 2015.
• Seeks to ensure food security for the poor
  households
• It is a multidisciplinary and holistic approach
  to all aspects of food security
• It is focused o low income food deficit
  countries, where majority of chronically
  undernourished live.
• At present over 800 million food insecure in the
  world 86 live in 106 countries participating in
  the SPFS
• Launched in 1994, initially SPFS sought to
  augment food production to reduce hunger and
  malnutrition
• After 2002 World Food Summit, SPFS shifted focus
  from pilot projects to national programs
  regional programs to address food insecurity

58
MDGs

1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for developmentFood
   Nutrition SecurityImportance

59
Thank you

• surya_at_igidr.ac.in

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Data source

• http//www.fao.org/es/ess/faostat/foodsecurity/ind
  ex_en.htm

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• Food intake indicators
• Average energy intake ( 2350 kcal/d
  Provisional)
• Average food intake of major food groups
• Daily per caput protein intake (1 g/kg BW)
• Percentage of energy from protein ( 12-15 of
  total dietary energy)
• Daily per caput carbohydrate intake ( 350-370
  g/d)
• Percentage of energy from carbohydrates (60
  - 65 of total dietary energy)
• Cont.

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• Daily per capita fat intake
• Percentage of energy from fat (25-30 of total
  dietary energy)
• Percentage of protein from animal source
• (at least 25)
• Percentage of protein from vegetable source
• Dietary Energy Supply (DES)
• Percentage of undernourished population

64
Nutritional Norms These norms refer to
quantitative threshold or cut-off values to
assess the the nutritional status of a population
under review. Malnutrition can occur at any stage
of ones life cycle accordingly there are
different indicators to assess nutritional status
of population of different age and gender groups.
65
1. Intra-uterine Undernutrition Low Birth Weight
(LBW) Malnutrition can begin from intra-uterine
life Thic could be mainly be due to maternal
malnutrition. Maternal malnutrition during
pregnancy retards the growth and development of
the foetus. The foetus therefore is born with
birth weight lower than normal.  When the birth
weight of a full-term foetus is below a cut-off
level, the newborn is termed as a LBW
baby. According to WHO, the cut-off value for
birth weight is 2.5 kg. (India 21.5 babies are
LBW (NFHS III p. 226). Therefore, babies born
with birth weight lt2.5 kg are LBW babies.
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LBW babies a bad start in life. Poor chances
of survival less resistance to diseases, hence,
frequent infection, and severe malnourishment  Hig
h infant mortality rate
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2. Childhood Malnutrition The consequences of
malnutrition are most severe if it happens very
early in life. Malnutrition from this time in
life onward has long lasting effects on
subsequent growth, morbidity, cognitive
development, educational attainment and
productivity in adulthood. For these reasons,
nutrition status of young children, particularly
those aged below 5 years, has been shown to be
one of the most sensitive indicators of food
security, vulnerability and overall
socio-economic development of a country.
68
Several anthropometric indicators have been
identified for assessment of nutrition status of
U-5 children. These are Stunting, Wasting and
Underweight. The Z-score classification of these
indicators is most widely used.
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A. Stunting (low height-for-age) Undernutrition
for a long time retards the growth of a child by
height. The child is shorter than for its age.
This is called Stunting. For this, both height
and age are to be known.   The child is said to
be of normal height, if its height-for-age is
within 2 standard deviations (-2SD) of the median
height-for-age of a reference population. In
India children (0-59 months) Below 3SD is 23.7
and Below 2SD is 48 (p. 271)
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If the height falls below 2SD (lt-2SD) but within
3 SD below the reference median (-3SD), then the
child is classified to moderately stunted.   If
the height falls below 3 SD of the reference
median (lt-3SD), then the child is classified as
severely stunted.
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The classification can be summarized as
follows   Stunting Height-for-age up to 2SD
Normal Height-for-age lt-2SD to 3SD
Moderate Height-for-age lt-3SD
Severe
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B. Wasting (low weightfor-height)  Acute,
short-term malnutrition does not affect the
height, but the body weight. This is seen as
Wasting of the body, i.e. loss of body mass
compared to the body size. Weight-for-height is
therefore a useful indicator for assessing body
wasting. For this, age does not need to be
known.
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The child is said to be of normal
weight-for-height, if its weight-for-height is
within 2 standard deviations (-2SD) of the
median weight-for-height of a reference
population.   If the weight-for-height falls
below 2SD (lt-2SD) but within 3 SD below the
reference median (-3SD), then the child is
classified as moderately wasted.   If the
weight-for-height falls below 3SD of the
reference median (lt-3SD), then the child is
classified as severely wasted.
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The classification can be summarized as
follows   Wasting Weight-for-height up to
2SD Normal Weight-for-height lt-2SD to
3SD Moderate Weight-for-height lt-3SD
Severe In India of children below
3SD w/h is 6.4 and below 2SD is 20 .
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C. Underweight (low weight-for-age)   This is a
composite indicator of long-term and acute
short-term malnutrition. The body weight may be
lost from malnutrition for a long time. The child
is then low weight-for-age. Weight may also be
lost from acute, short-term malnutrition. In this
case also, the child is low weight-for-age.
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The child is said to be of normal weight-for-age,
if its weight-for-age is within 2 standard
deviations (-2SD) of the median weight-for-age of
a reference population.   If the weight-for-age
falls below 2SD (lt-2SD) but within 3 SD below the
reference median (-3SD), then the child is
classified as moderately underweight.   If the
weight-for-age falls below 3SD of the reference
median (lt-3SD), then the child is classified as
severely underweight.
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The classification can be summarized as
follows   Underweight Weight-for-age up
to 2SD Normal Weight-for-age lt-2SD to
3SD Moderate Weight-for-age lt-3SD
Severe In India below, 3 SD is 16 and
below 2 SD is 42.5 (p. 271)
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D. Mid-upper-arm Circumference (MUAC) Between the
ages of 1 and 5 years, there is very little
change in a normal childs arm circumference. Thus
, this measurement gives a simple anthropometric
measure of wasting which is almost
age-independent. The degree of severity of
malnutrition in children on the basis of MUAC is
given below.  MUAC gt14 cm Normal
12.5 14.0 cm Mild/moderate wasting
lt12.5 cm Severe wasting
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3. Maternal malnutrition The most common
nutritional problem in women, especially the
poor, is chronic energy deficiency (CED). CED
is measured by height as well as by Body Mass
Index (BMI).
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A. Height lt145cm is indicative of chronic CED.
 India, such women (15-49 years) are 11.4
percent (p.304) BMI is derived by dividing weight
(in kg) by height squared (in meters).  
Weight (kg) BMI ----------------------(kg/m2)
Height2 (meter) Women (15-49) with BMI
lt18.5 are 36 (p. 304) Men (15-54) with BMI
lt18.5 are 34 (p. 306)
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B. BMI is widely used to assess nutritional
status of children above 10 years of age and the
adults as follows   BMI gt30
Obese 25.1 30.0
Overweight 18.5 - 25.0 Normal lt18.5
Malnourished lt16.5 Severely
malnourished
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C. Mid-upper arm circumference (MUAC)   As with
children, MUAC can be used to grade the degree of
body wasting in adults.   Appropriate cut-off
points of MUAC for adults are given below.
Male 23 cm lt23 cm Normal Malnourished
Female 22 cm lt22 cm Normal Malnourished
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4. Micronutrient malnutrition   The most widely
prevalent micronutrient malnutrition problems are
vitamin A deficiency, iodine deficiency and iron
deficiency.
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A. Vitamin A deficiency   Chronic dietary vitamin
A deficiency first leads to night blindness and
then, in untreated cases, to total
blindness.  Sub-clinical vitamin A deficiency is
present in a much larger population than clinical
blindness.  Serum retinol (vitamin A) level is a
dependable indicator for sub-clinical vitamin A
deficiency.
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The cut-off value for serum retinol is given
below   Serum retinol 20 µg/100 ml
Normal   Serum retinol lt20 µg/100 ml Vitamin A

deficiency   Serum retinol lt10 µg/100 ml
Severe vitamin A deficiency
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B. Iodine deficiency   Chronic dietary iodine
deficiency first leads to enlargement of the
thyroid gland such that it is not yet visible.
This goiter is called Grade 1 goitre.   In
untreated cases, Grade 1 goiter develops into
Grade 2 goitre, which now becomes visible.
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As with vitamin A deficiency, sub-clinical (also
called biochemical) iodine deficiency is present
in a larger population than goiter.  Urinary
iodine level is an internationally accepted and
widely used indicator of iodine
deficiency. Iodine content of salt being used by
hhlds Rural (Urban) 60 (30) percent inadequate
or zero, inadequate defined as lt15ppm (p.297)
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The cut-off vale for urinary iodine is given
below   Urinary iodine excretion (UIE) 100
micrograms/litre Normal   Urinary iodine
excretion (UIE) lt100 micrograms/litre Iodine
deficiency   Urinary iodine excretion (UIE) lt20
micrograms/litre Severe iodine deficiency
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C. Iron deficiency and iron deficiency
anaemia   Chronic dietary iron deficiency first
leads to depletion of iron stores of the body (in
the form of ferritin in liver). This is called
iron deficiency.  Serum ferritin lt12 mg/100ml
Iron deficiency Anemia in India Men (15-54)
24.2 , Women (15-49) 55.3 using above 12 mg
benchmark (p. 313) Children Any anemia (lt11
g/dl) 79 (p. 291)
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When the iron store falls below such level that
it cannot support haemoglobin synthesis,
haemoglobin level begins to fall. If haemoglobin
falls below a critical level, then it is
anaemia. The severity of anaemia depends on how
low is haemoglobin level. This can be measured by
determining haemoglobin concentration in whole
blood. The biochemical indicators of iron
deficiency and anaemia are as follows  
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The critical levels of haemoglobin (gm/L) vary
according to different age and sex groups and
also various physiological conditions
Group Normal Mild anaemia Moderate anaemia Severe anaemia
Children (6 - 59 Mo) 110 100 109 70 - 99 lt70
Children (5 - 11 Yr) 115 100 - 114 70 - 99 lt70
Children (12 - 14 Yr) 120 100 - 119 70 - 99 lt70
Male 15 Yr 130 100 - 129 70 - 99 lt70
Female 15 Yr 120 100 - 119 70 - 99 lt70
Pregnant women 110 100 - 109 70 - 99 lt70
Lactating mothers 120 100 - 119 70 - 99 lt70
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• Basic health indicators
• Immunization rate for measles, tuberculosis,
  diphtheria, poliomyelitis and tetanus
  (one-year- olds)
• Prevalence of infectious diseases and epidemics
  (malaria, cholera, AIDS and other)
• Access to safe water (rural and urban)
• Rural access to safe water
• Urban access to safe water

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• Access to adequate sanitation
• Infant mortality rate
• Under five mortality rate
• Maternal mortality rate
• Percentage of all cases of diarrhea in children
  under five of age treated with oral rehydration
  salts and/or recommended home fluids
• Infants 0-6 months exclusively breastfed
• Infants 6-9 months breastfed with complementary
  food
• Infants at 20-23 months, still breastfed

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• Reproductive health indicators
• Percentage of pregnant women immunized against
  tetanus
• Percentage of births attended by trained health
  personnel
• Percentage of pregnant women aged 15-49 years
  with anaemia
• Total fertility rate
• Fertility rate in adolescents
• Contraceptive prevalence

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Dimensions methods for assessing food security
and undernutrition
Methods Availability of food Access to food Consumption of food Utilization of nutrients
FAO Method
Household income expenditure surveys
Individual food intake surveys
Anthropometry
Qualitative measures of food insecurity
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ASSESSMENT OF FOOD INSECURITY
FIVIMS

• Based on existing national and sub-national
  information systems related to food security
• Responds to the information needs of different
  user groups/Action programs within the country
• Operated and controlled by the country involved
  (except perhaps during complex emergencies)
• Country driven and user focused, designed in
  response to the needs of national decision-makers
  (with guidance on best practices)

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Identifying nutritionally vulnerable groups
Prevalence degree of low food intake National
coverage of food insecurity and vulnerability
through FIVIMS WHO is food insecure? WHERE are
they? WHY in that condition? Access to food
availability, access, health and care Use of food
and nutrition indicators
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Methods of assessing dietary intake

• National food supply data
• Household data
• Individual data (Food records, 24 hr dietary
  recall, dietary diversity, diet histories,food
  habit questionnaires, combined methods
• Selecting most appropriate dietary data
  collection method
• RAP - rapid assessment procedure ( focus groups
  to gather information on food behaviours, beliefs
  and intakes)

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Issues for dietary assessment methods

• Dietary assessment may be collected at national,
  HH or individual
• Assessment of food composition at the national
  level is generally based on FBS
• At HH /individual level it provides useful
  information on nutritional adequacy

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National and household level consumption surveys

• Preferred source of food consumption surveys (
  provide more information than FBS)
• Provide consumption characteristics of specific
  vulnerable groups including those from urban
  /rural populations
• Various types of methods used for HFCS

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Food consumption data needs

• type of food consumed (raw, processed, cooked,
  preparation practices)
• how much (serving size)
• how often
• by whom (e.g. young ,elderly, immunocompromised)
• affected by factors such as
• season
• region / culture
• wealth / socio-economic factors
• age
• sex

102
Conclusions

• Need to use core indicators linked to food
  insecurity nutrition outcomes
• Identify food and nutrition vulnerability through
  information on food consumption patterns need
  to obtain information on intra household
  distribution of food for accurate assessment of
  individual intakes
• Knowledge of HH food allocation patterns and
  underlying reasons for food / diet related
  behaviour, so that effectiveness of nutrition
  interventions can be improved.
• Differential nutritional status associated with
  differences in morbidity or illness or other
  factors within HHs provides valuable information
  on food distribution

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Eleventh Plan on Food SecurityEstimates
Interpretations

• M.H. Suryanarayana
• Indira Gandhi Institute of Development Research
• Mumbai

104
11th Five Year Plan on Food Security

• Sustained solution to morbidity
• All the more so,
• Stagnant incomes of the poor
• Perverse changes in consumption patterns
  decline in cereal share
• Trend reduction in average cereal consumption

105
11th Five Year Plan on Food Security

• Trend reduction in calorie intake 8 in rural
  India - 3 in urban India between 1983 and
  2004-05
• Average calorie intake fall increasingly short of
  official poverty line norms 2400 kcals rural
  India 2100 kcals urban India

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11th Five Year Plan on Food Security

• Consequences - Nutritional outcome parameters
  like low birth weights of newborn babies,
  anthropometric measures

108
Review

• Estimates of consumption patterns
• Averages at current prices conceal rather than
  reveal dynamics of change
• Reflect changes in relative prices and not real
  changes in consumption patterns
• Current price estimates exaggerate the extent of
  changes

109
Review

• Cereal share, of course, has declined though not
  to the extent as revealed by current price
  estimates
• Per capita cereal expenditure increased for the
  bottom three decile groups but not quantities
  dynamics of agricultural development
• Calorie intake increased for the bottom decile
  groups decreased for the top ones convergence at
  a lower level

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Consequences

• Incidence of calorie deficiency increased by
  conventional norms but no so by convergence
  norms.

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What is the evidence by disaggregate population
groups?
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What is the evidence in terms of household
perception on adequacy of food consumption?
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Raises important questions

• What would be an appropriate measure of food
  security?
• Objective estimates of food consumption /calorie
  intake relative to exogenous norms?
• Subjective perceptions of adequacy of food
  consumption?
• How do we verify these two questions?
• How far measures of association would validate
  these measures?

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What is the evidence?

• Estimates of bivariate associations either do not
  make sense or are insignificant
• Association subjective estimates of food adequacy
  and objective estimates of average calorie intake
  inverse (rural) insignificant (urban)
• Objective estimates of calorie deficiency and IMR
  insignificant (rural) negative and
  significant (Urban)
• What do they mean? What are the implications for
  methodology and policy?

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Thank You

• surya_at_igidr.ac.in