Diet and Nutrition Situation and Time Trends in India

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Diet and Nutrition Situation and Time Trends in
India
Dr. B. Sesikeran, MD, FAMS Director National
Institute of Nutrition, I.C.M.R. Hyderabad 500
604 E-mail sesikeran_at_gmail.com
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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
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Prevalence of Low Birth Weight in India and
South-east Asian Countries

Source WHO/SEARO 2000
23 (NFHS 2)
Increase in Institutional Deliveries
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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

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Average Daily Food Intake ( RDA) among
1-3 Year Children By Gender
Percent RDA
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Median Intake of Nutrients (as RDA) Among
1-3 year children By gender
Percent of RDA
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Average Daily Food Intake ( RDA) among
4-6 Year Children By Gender
Percent RDA
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Median Intake of Nutrients (as RDA)
Among 4-6 year
children By gender
Percent of RDA
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Prevalence () of Undernutrition Among 1-5 yr
children According to SD Classification (ltMedian
- 2SD) By Gender
Percent
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Prevalence of Undernutrition among lt5 years
children according to Weight for Age
(IAP classification)
Faulty BF
Faulty Complementary feeding
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INFANT AND YOUNG CHILD FEEDING PRACTICES (NFHS
3)
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MICRO-NUTRIENT

DEFICIENCIES
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Prevalence () of Bitot spots among 1 - lt5 year
children
Boys 0.9 Girls 0.6
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Prevalence () of Bitot Spots among 1 - lt5 yrs.
Children
WHO cut-off level (0.5) of Public Health
significance
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Definition of Anemia
AGE / PHYSIOLOGICAL GROUP Gender Hb (g/dl)
6 months 6 Years Boys Girls lt11
6 14 Years Boys Girls lt12
? 14 Years Men lt13
? 14 Years Women lt12
Pregnant Women Pregnant Women lt11
WHO, Nutritional Anemia - TRS No. 405, Geneva
1968.
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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
Mean SE
10.7 1.99
12.6 2.09
gt 6 months
lt 6 months
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Prevalence () of IDD among 6 11 Year Children
Source MND-NNMB, Tech Rep 22, 2003
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PREVALENCE () OF IDD AMONG CHILDREN (12 years
old)
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Percent of Households consuming salt having
adequate Amount (15 ppm) of Iodine
By spot test
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Time Trends
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Average Intake of Foodstuffs (per CU/day) as
of RDI by Period of Survey
Percent
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Average Intake of Foodstuffs (per CU/day) as
of RDI by Period of Survey (contd.)
Percent
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Average Intake of Nutrients (per CU/day) as of
RDI by Period of Survey
Percent
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Average Intake of Nutrients (per CU/day) as of
RDI by Period of Survey (Contd.)
Percent
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Distribution () of Children by Undernutrition
and Period of Survey
Percent
UNDERNUTRITION (lt Median - 2SD)
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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
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Prevalence of overweight and obesity among
school-age boys aged 5-17 years by global region
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30
25
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Prevalence ()
15
10
5
0
Europe
Americas
Worldwide
Asia-Pacific
Near/middle East
Sub-Sahara Africa
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PREVALENCE () OVERWEIGHT AND OBESITY AMONG
CHILDREN VARIOUS STUDIES
Author Year Age groups (yr) Number of subjects Prevalence () Prevalence ()
Author Year Age groups (yr) Number of subjects Overweight Obesity
Mohan B 2004 11- 17 2467 11.6 2.6
Khadilkar Y 2004 10 15 1228 19.9 5.7
Chatwal J 2004 9 15 2008 14.2 11.1
Subramaniam V 2003 10 15 707 10.0 6.0
Laxmaiah A et al 2004 12 - 17 1208 04.6 1.6
Chatterji P 2002 4 18 5000 29.0 6.0
Kapil U 2002 10 16 870 24.7 7.4
Ramchandran A 2002 13 18 4700 16.8 3.1
Pandey S Vaidya R 2001 3 - 17 2439 15.1 15.3
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Prevalence of Overweight/Obesity and Physical
Activity (NIN Study)
Category Category N Overweight/ Obese P value
TV viewing (hrs/day) None 143 5.6 a b P lt 0.05
TV viewing (hrs/day) lt 3 hrs/day 730 4.9 a b P lt 0.05
TV viewing (hrs/day) ? 3hrs/day 335 9.3 b P lt 0.05
Participation in outdoor games (hrs/week) None 526 8.4 a P lt 0.004
Participation in outdoor games (hrs/week) lt 6 hrs 228 6.6 a P lt 0.004
Participation in outdoor games (hrs/week) ? 6hrs 416 5.1 b P lt 0.004
Participation in HH activities (hours/day) None 221 18.6 a P lt 0.001
Participation in HH activities (hours/day) lt 3 hrs 233 4.7 b P lt 0.001
Participation in HH activities (hours/day) ? 3hrs 716 3.9 b P lt 0.001
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Overweight/Obesity Vs Lifestyle practices (n941)
Variable Overweight/ Obese Adolescents Normal Adolescents P value
Consumption of Soft drinks 21.0 16.0 p lt 0.05
Consumption of soft drinks ?300 ml/day 16.7 9.0 p lt 0.05
Prevalence of Hypertension (JNC VII) 8.3 3.7 P lt 0.05
Laxmaiah et al 2007
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Prevalence of Overweight in relation to activity
score.

• Prevalence of Overweight was higher in lower
  tertile of physical activity. Trend ?2 45.6, P
  lt0.001.

Overweight
Tertiles of activity score
Ramachandran et al 2002
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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.

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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.

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Thank you