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Food Security and Nutrition Security are closely interrelated and may appear in a vicious cycle in some cases. There are an estimated 925 million hungry people in the world and around 1.4 billion people live on less than $1.25 a day. A considerable portion of these chronically and clinically undernourished people are living in India who are suffering from lack of food and nutrition security. FAO clearly mentioned that “There is much more to health than carbohydrates”. A country like India should run both Food Security and Nutrition Security side-by-side to reach the target.
“Control food and you control the people,” former US Secretary of State Henry Kissinger once said. If one considers the criticism surrounding the UPA government’s food security Act, one would wonder if the critics feel this is one of the inspirations for the legislation, which of course has some genuine intentions and poor-friendly features to a certain extent.
Most of the criticism on the food security measure is political – “populist measure which is not going to help poor, at whom it is actually aimed” – and from the economic angle – “can the country afford the cost involved in providing food security and will the benefits really percolate to the deserving masses.”
What is missing in this political gaga is the scientific angle of nutrition security. The political, and even economic, pundits have overlooked the angle of actual quantum of benefits to stakeholders as far as nutrition is concerned.
The food security gives right to subsidised foodgrain to 67% of India’s population. It entitles 75% rural and 50% urban population to 5 kg of foodgrains (rice, wheat and coarse) per month. Pregnant women and lactating mothers entitled to nutritious meals and maternity benefit of at least Rs 6,000 for six months.
However, experts claim that an increase in food supplies does not necessarily translate into improved nutrition. “For nutrition in food to be absorbed by the body, its bioavailability should increase,” says Dr Nupur Krishnan, Director, Bio-Logics Nutrition Clinic.
Despite food-based social safety net programmes launched earlier and run for a long time, malnutrition levels continue to exist and children die. It is many times attributed to corruption and inefficiency in the implementing machinery. Similar doubts people have for nutrition security through food security. “I would have said yes (to a statement that food security would bring nutrition security) if it was any other country where ethics and honesty go hand-in-hand. In India, I cannot say a full hearted yes because we all know there is going to be corruption and by the time food reaches the poor, it could perhaps be most unhealthy, diluted foodgrain and will perhaps result in epidemics,” according to Dr Villoo Morawala-Patell, Chairman and Managing Director, Avesthagen.
“A true Public Private marriage can bring nutrition security. Most Food companies are adopting the best practices and bringing good quality food to the market.” |
Actually, food security is expected to incorporate nutritious food as per the definition of food security made by the World Food Summit at Rome in 1996. The definition said, “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.”
How the food security can take forward the nutrition security or the nutrition balance agenda is a crucial point that is not much debated yet. The traverse from food security to nutrition security is the most important journey and it will be better if we move fast to traverse this path. It is essential to remember that the need for a Food Security Act was triggered by an urgent need to fight malnutrition and hunger.
But, the problem of malnutrition, that includes even over nutrition, and nutrition security is much widespread. It is not only connected with poverty and food security, though it looks like that. It is not restricted to only one class of society, i.e., poor and below poverty line, as it appears to be. Undernourishment and malnutrition are issues that have plagued society’s different socio-economic segments due to varied reasons. It is leading to serious health problems.
More than 2.3 billion people world over – almost one-third of the world population – are estimated to have been affected by obesity, diet-related chronic diseases and under-nutrition, making them global public health priorities. Like its major contribution to the world population, India’s contribution is a lot in the statistics of these diseases and malnutrition also. At least one out of every 10 kids in the city is obese and the rate is higher – five out of every 10 children – among elite, high income groups, said a report by leading endocrinologists from Ahmedabad.
Doctors blame ‘excessive nutrition’ for the problem among 90% children suffering from obesity while only in 10% cases genetic disorder is the cause. The percentage of prevalence of obesity is five times more among children from high-income group families than the general percentage.
The problem is so serious that World Health Organisation (WHO) has now declared obesity as ‘global epidemic’. Another serious global health and development challenge, particularly for low-income group countries, is under nutrition. In addition to its impact as a major risk factor for disease and mortality, under nutrition has significant societal implications, including decrease in educational attainment and productivity and increase in healthcare spending.
According to a study in 2010 by Barry M Popkin, University of North Carolina Interdisciplinary Obesity Programme, of the women in the age group of 20 to 49 in rural areas that are underweight and overweight in selected developing countries, in India underweight women were almost 50% while about 4 to 5% were overweight.
Growing problem of obesity is creating a major group in society that is facing health problems linked to overweight and lack key nutrients they need to be healthy. Obese people in many countries, even in rural areas, are outnumbering the underweight people. But efforts for nutrition security, for long-term, have to look into the underlying causes of malnutrition — poverty, food insecurity, low education, limited healthcare and poor hygiene.
This particular phenomenon of overweight population growing in society was explained in Indian Council for Medical Research (ICMR) report of 2009 on ‘‘Nutrient requirements and recommended dietary allowances for Indians’’. It said, “India, being a country in developmental transition, faces dual burden of pre-transition diseases like under nutrition and infectious diseases as well as post-transition, lifestyle-related degenerative diseases such as obesity, diabetes, hypertension, cardiovascular diseases and cancer.” It added, “Currently, India is in nutrition transition with 10% rural adults and 20% urban adults suffering from over nutrition leading to an emerging double burden of malnutrition.”
Agreeing with this observation, Rajesh Kumar, CEO, Sami Direct, warns, “In India we are dealing with two types of problems at the same time – over nutrition and malnutrition. Both needs to be addressed with a lot of awareness and structured efforts in a continued fashion before it shapes up into a major epidemic.”
Not only India, but many countries now have a ‘double burden’ of malnutrition, obesity and diet-related chronic diseases. Inadequate nutrition during early development (in the womb) results in metabolic programming increasing the risk of obesity and diet-related chronic diseases later in life. Both of these challenges are affected by the quantity and quality of food.
The cost of malnutrition is considered to be very high. It generates a vicious cycle of poor health, high death rates, poor quality of life, decreased mental capacity and reduced worker productivity. Productivity losses are estimated at more than 10% of lifetime earnings for individuals and 2-3% of gross domestic product for the nation. This clearly shows that nutrition balance is not only important for a healthy and productive life, but also for continued economic growth and development.
If government can adopt the preventive route then they can save millions of dollars as healthcare cost. |
But nutrition security is a very complex and multidimensional issue. Various factors like poverty, inadequate food consumption, inequitable food distribution, improper infant and child feeding and care practices, limited access to quality health, education and social services and equity and gender imbalances on one hand, mainly affecting the people from lower strata of society. While factors like poor sanitary and environmental conditions, wrong eating habits, lack of proper knowledge about nutritious food and lifestyle are affecting across society.
“We need to start working on nutrition education so as to make people aware about factual scientific information about nutrition. Myths and misconception regarding nutrition should be eradicated from the society,” suggests Dr Krishnan.
“Whatever food or functional food we eat, does not mean that body gets it all. Many consumers don’t know this. Organizations can collaborate
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What causes malnutrition? It generally results from lack of either protein or micronutrients such as iodine, Vitamin A or iron, which boost immunity and healthy development. William Prout, an English doctor and chemist, identified three principal constituents of food – protein, fat and carbohydrates – that came to be known as macronutrients.
Dr Morawala-Patell claims that malnutrition is generating large swathes of human bodies with not real, proper, physical, emotional, intellectual drive. “This would result in a very poor work force and perhaps unrest of the frustrated masses,” she fears.
Food security is concerned with questions relating to the food supply, but nutrition status depends not only on suitable food but also on good basic health services and, particularly for children, adequate care. Developing countries desperately need nutritional interventions and social protection policies to guide them through the current economic crisis, ensure nutrition security and safeguard vulnerable population.
Ensuring food and nutrition security is a challenge for India, given its huge population and high level of poverty and malnutrition. Food as well as nutrition security is broadly characterized by three pillars: availability, accessibility, and absorption. The absorption clearly indicates that there are gaps in linking the three pillars.
One more important factor is cleanliness. According to Dr Krishnan, “We have a large number of middle class population that prefers street food. We need to educate restaurants and street food vendors about food safety and improving nutritional value of their products.”
There are varied ways to bring in nutrition security. In case of infants, one way could be optimal breastfeeding as it is an important measure to prevent obesity and under nutrition. But if one observes cycle of food, then it would be realised that any step for food as well as nutrition security would begin with agriculture. The country would require to produce adequate foodgrains from its agricultural sector or import it, may be at a heavy cost, to provide it to the population. Should poor be given subsidy or not, and if yes, at what rate and how – these all are subsequent issues once adequate food is available for distribution. And then comes the issue of making the country nutrition secured by ensuring supply of nutrition rich food.
Union agriculture minister Sharad Pawar feels increasing agriculture production is the solution for this problem. In a statement, on the recent World Food Day on October 17, he said, “The only long term solution to ensuring food and nutritional security in the country lies in increasing production and productivity in the agriculture sector with diverse and integrated farming systems to provide nutritious diets to each and every citizen.”
Some other experts in the field too have similar feelings. “Prime challenge in making nutrition affordable and accessible to all is to create crop varieties which are nutritious. We need to improve nutrition profile of staples like wheat and rice so that more people can get access to nutritious food,” according to Rajashree Menon, SBU – Head, Neuvithrah Nutrition Pvt Ltd.
However, one of the major factors, experts fear, that is going to affect agriculture production – quantity as well as quality wise – is climate change. It may not only reduce production, making substantial distribution difficult, but will also decline quality of the food leading to problem of under nutrition across all classes. A changing climate could even make current crops less nutritious, by altering the relative protein content in major staple foods.
In such a situation, while ensuring more production despite problems like lesser water availability and effects of climate change, investing in agricultural science to make crops more nutritious is also vital.
Another way to overcome the problem is to make scientific nutrition available through nutraceuticals, suggests Menon. But for that “the country needs more manufacturing facilities and those facilities need to import good quality source material which increases the product cost. Thus, we need more R&D in this field to bring down the cost. There is also need for making research in the nutrition field available to professionals and to study importance of micronutrients in Indian context. We should focus on developing right and scientific combination of micronutrients,” she adds.
One more problem leading to under nutrition is ‘nutrition transition’ as people are shifting away from traditional diets and generation of knowledge about good diet due to varied reasons including migration from traditional places of living.
Dr Morawala-Patell’s suggestion is the government must work with private sector for distribution of good food, where there will be accountability. She says, ”Also new functional food should be created and disbursed to the public in small sachets where the Government pays the company the cost and overheads. This has to be done on a war footing.”
India’s food security measure surely has a long-term plan of making the country nutrition secured. But widespread and hard efforts are needed to reduce that period and make the country nutrition secured as soon as possible. This is very much essential considering the number of malunourished children suffer and die each year, the number of women become anemic and have to pass the life in anguish, the number of grown-ups unable to work due to weakness leading to productivity losses in one class of people. And equally essential as in the other classes, economically in better position, the problem of under nutrition or over nutrition is leading to serious diseases like obesity, blood pressure, cardiac related problems and other diseases.
The task is difficult and complex. The legendary French leader Charles de Gaulle had described the problem of governance in a ‘foody’ manner when he said, “How can you be expected to govern a country that has 246 kinds of cheese?” If a country with 246 kinds of cheese is finding it difficult to be governed, India with 246 kinds of societies, people, castes and problems across its length and breadth will find it more difficult. Governance though complex requires to be solved.
“We, who are involved with food and nutrition domain, know that Nutrition Security is part and parcel of Food Security, but this important link is miserably missing in newly introduced Food Security Bill in India. India is moving to market-oriented production, which promises higher returns to labour, but also incur greater risks for food security due to the less land is available for growing food crops. India need ambitious programs to re-orient its agricultural R&D priorities to make them more nutrition-sensitive involving government bodies with long-term industry partnership.” |
“In India we are dealing with two types of problems at the same time 1) Over nutrition 2) Mal nutrition. Both needs to be addressed with lot of awareness and structured efforts in a continued fashion before it shapes up into a major epidemic. |
“Food security and nutritional security should be treated separately. Most of the time it is assumed that food security will ensure nutritional security which cannot happen because food security means adequate food for everybody. But the issue with ‘quality of food’ is not covered under the food security. So I believe that both food and nutritional security should be treated separately. But alot of efforts are being made at national and international level to address food security issue.Nutritional security is something different, where there is an issue of malnutrition, which is a big problem in our country. We have statistical data available regarding malnutrition. Considering the gravity of malnutrition and its impact during pregnancy and after delivery…we need to address this issue independently.” |
“Prime challenge in making nutrition affordable and accessible to all is to create crop varieties which are nutritious themselves. We need to improve nutrition profile of staples like wheat and rice so that more people can get access to nutritious food. We need to declog the public distribution system and increase its efficiency.At the same time the country needs more manufacturing facilities for nutraceuticals to make scientific nutrition available more easily. However, manufacturing facilities in the country need to import good quality source material which increases the cost of the product. We need more R&D in this field so that the cost can be brought down.” |
Essential nutrients: Protein
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Is Nutrition Security attainable by providing Food security alone? Are these two terms synonyms?
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Recommendations of Coalition for Sustainable Nutrition Security in India |
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Per capita consumption of foodgrains and edible oils in different countries and regions |
Center to set up committees of Food Secretaries for implementation of NFSA |
What is National Food Security Act? |
-MilindKokje
(With inputs from Narayan Kulkarni, Bangalore and Nikita Apraj, Mumbai)