COMMON NUTRITION PROBLEMS

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COMMON NUTRITION PROBLEMS IN INDIA
Dr. K.VIJAYARAGHAVAN DIRECTOR RESEARCH, SHARE
INDIA (MEDICITI INSTITUTION) Sr. Dy. Director,
NIN (Retd)
ltdrk.vijayaraghavan_at_gmail.comgt
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MOTHER AND CHILD SURVIVAL
MMR 407/100,000 live births IMR
58/1000 live births Child Mortality 19.5/1000
Children Rate(1-4 years)
Gujarat 53
Vijayaraghavan
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NUTRITION PROBLEMS IN INDIA
WHO IS AT RISK??
PREGNANT WOMEN LACTATING WOMEN INFANTS PRESCHOOL
CHILDREN ADOLESCENT GIRLS ELDERLY SOCIALLY
DEPRIVED (SC ST Communities)
.
Vijayaraghavan
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NUTRITION PROBLEMS IN INDIA
WHAT ARE THE COMMON PROBLEMS?

• WOMEN
• POOR WT. GAIN
• DURING PREGNANCY
• CED
• MICRONUTRIENT DEFICIENCIES

• CHILDREN
• LOW BIRTH WEIGHT
• GROWTH FALTERING
• PEM
• MICRONUTRIENT DEFICIENCIES

• FLUOROSIS, LATHYRISM

• DIET RELATED CHRONIC DISEASES
• OBESITY, CARDIOVASCULAR
• DISEASES, DIABETES

Vijayaraghavan
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PREVALENCE OF LBW IN S.E ASIAN COUNTRIES
Vijayaraghavan
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FACTORS MODIFYING PREVALENCE OF LBW

• INSTITUTIONAL DELIVERIES
• ANCs (Minimum gt5)
• QUALITY OF ANC
• Includes
• No.of ANCs, TT, Weight, BP, Examination of
  Blood, Examination of Urine

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Source Shanti Ghosh
Source Shanti Ghosh et al, 1978
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Source Leela Iyengar Apte, S,V.,1970
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Source Leela Raman Rajalakshmi,1974
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NUTRITIONAL DISORDERS IN CHILDREN

• PROTEIN ENERGY MALNUTRITION (PEM)
• . CLINICAL FORMS
• . SUBCLINICAL UNDERNUTRITION
• MICRONUTRIENT DEFICIENCIES

Vijayaraghavan
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CLINCAL FORMS of PEM

• KWASHIORKOR
• OEDEMA
• IRRITABILITY
• GROWTH FAILURE
• DISCOLOURED HAIR

Vijayaraghavan
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CLINCAL FORMS of PEM

• MARASMUS

EXTREME WASTING SKIN AND BONES MONKEY/OLD MAN
FACIES
Vijayaraghavan
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SUB-CLINICAL FORMS OF PEM
Vijayaraghavan
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UNDERNUTRITION IN INDIA
ADULTS (Females)
PRESCHOOL CHILDREN
Based on NCHS weight for age
Based on BMI
Vijayaraghavan
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VIJAY00
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DISTRIBUTION WEIGHT FOR AGE IAPGujarat
Gr. II
Gr. I
Gr. III
Gr. IV
Normal
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WEIGHT FOR AGE SD CLASSIFICATION - GUJARAT
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VITAMIN A DEFICIENCY
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KERATOMALACIA
BITOT SPOT
V A D
BILATERAL BLINDNESS
Vijayaraghavan
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WHO Criteria for Public Health Significance- VAD

• Minimum Prevalence () in children lt6 yrs
• BITOT SPOTS 0.5
• NIGHT BLINDNESS 1.0
• CORNEAL LESIONS 0.01
• CORNEAL SCARS 0.05
• Serum Retinol lt10 ?g/l 5.0

Vijayaraghavan
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VITAMIN A DEFICIENCY () IN INDIA
24-71 MONTHS
Vijayaraghavan
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VITAMIN A DEFICIENCY
Districts() with X1B gt0.5
Average prevalence () 2.1
Based on surveys in 126 Dts. by NIN and NNMB
Vijayaraghavan
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NUTRITIONAL DEFICIENCY SIGNS IN PRESCHOOL
CHILDREN
Vijayaraghavan
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Vijayaraghavan
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ANAEMIA
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Vijayaraghavan
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PREVALENCE OF ANAEMIA -ADOLESCENT GIRLS
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ANAEMIA IN FEMALES

• PREVALENCE OF ANAEMIA IS VERY HIGH IN BOTH THE
  GROUPS
• NO CHANGE NOTICED OVER TIME IN THE PREVALENCE

Pregnant Women
Adolescent girls
Vijayaraghavan
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IODINE DEFICIENCY DISORDERS
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IODINE DEFICIENCY DISORDERS
GOITRE
239 OF 282 DTs. SURVEYED ENDEMIC 167 millions
AT RISK ?
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PREVALENCE OF GOITRE IN 6-12 Yr CHILDREN -
Gujarat
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DIETARY INTAKES
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HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS
VIJAY00
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HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS
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NUTRIENT INTAKES AMONG INDIAN WOMEN
Source NNMB, 2000
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NUTRIENT INTAKES IN PREGNANT WOMEN RDI
Source NNMB,2000
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NUTRIENT INTAKES (per day) IN CHILDREN
NNMB, 2000
Vijayaraghavan
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DETERMINANTS OF MALNUTRITION
MATERNAL MALNUTRITION START WITH A
HANDICAP(LBW) FAULTY CHILDFEEDING
PRACTICES DIETARY INADEQUACY FREQUENT
INFECTIONS LOW PURCHASING POWER LARGE
FAMILIES HIGH FEMALE ILLITERACY TABOOS AND
SUPERSTITIONS
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Factors Affecting Nutritional Status
High illiteracy Unemployment/ Underemployment
Large families Low purchasing power
Ignorance High dependence
rate False food beliefs Inadequate intakes Low
Procurement of foods Poor
PDS High cost Low availability of foods Low
production Reduced work Malnutrition of
foodgrains output Poor environment Morbidity
Absorption of nutrients
Low Appetite Poor utilization of services
poor coverage of
immunization Improper health services
poor infrastructure
Lack of resources
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INTERVENTIONS IN OPERATION

• DIRECT
• CONVERGENCE OF SERVICES (RCH)
• INTEGRATED CHILD DEVELOPMENT SERVICES
• IRON AND FOLIC ACID DISTRIBUTION
• MASSIVE DOSE VITAMIN A PROGRAMME
• PRIMARY HEALTH CARE PROGRAMME
• HEALTH AND NUTRITION EDUCATION

• INDIRECT
• POVERTY ALLEVIATION PROGRAMMES
• ENVIRONMENTAL SANITATION
• PROTECTED WATER SUPPLY
• LITERACY PROGRAMME

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THANKS NAMASKAR