Transforming food systems to address malnutrition in India


The urgency of food system transformation is now irrefutable with poor diet becoming the main contributor to the global burden of diseases. Poor nutrition is leading to reduced earning potential and increased costs for healthcare. Thus, food systems need to focus, more intentionally, on increasing productivity and storage of foods rich in minerals and vitamins. Tarun Vij, Country Director, Global Alliance for Improved Nutrition (GAIN) India, New Delhi reveals more about the need to overcome the shortfall of nutritious food to Indian children in interaction with NuFFooDS Spectrum.Edited excerpts;

How can the food system be improved in the country and globally?


Food systems need to focus more intentionally on increasing productivity and storage of foods rich in minerals and vitamins. Reduction in wastage of fresh food across storage, transport, and trade must be prioritised. Promoting the increased consumption of fresh fruits, vegetables, and legumes through making healthy, safe, and fresh foods more affordable and accessible for all but especially for vulnerable low-income populations is important. In 2021, the United Nations is convening the Food Systems Summit (UNFSS) as part of the Decade of Action to achieve the Sustainable Development Goals (SDGs) by 2030. The UNFSS will bring together stakeholders from across the globe on one platform to deliberate and act for leveraging their local food systems to deliver progress on all 17 SDGs.


Five action tracks have been identified, which include: 

  • Ensuring access to safe and nutritious food for all
  • Shifting to sustainable consumption patterns
  • Boosting nature positive production
  • Advancing equitable livelihoods
  • Building resilience to vulnerabilities, shocks and stress


What are the shortfalls in children’s diet and the role of affordability in India?


The Global Hunger Index (2020), places India at the 94th spot among 107 countries. NFHS 5, (2019 -2021) which has data from 22 states, indicates that only nine states showed a decline in the number of stunted children, ten in wasted children and six in underweight children. In the remaining states, the percentage of stunted, wasted and underweight children increased or remained unchanged. 


The shortfalls in diets of Indian children are quite evident from the first Comprehensive National Nutrition Survey (CNNS), which revealed that only 6.4 per cent of India’s children aged less than two years got a minimum acceptable diet, less than 9 per cent of children aged 6-23 months received iron-rich foods and only 5 per cent of children aged 2 to 4 years consumed Vitamin A-rich fruits and vegetables. Due to the absence of appropriate diet diversity, the intake of micronutrients is very low. 


Access to safe and nutritious diets is a challenge for poorer sections of the population and it disproportionately impacts the health and nutrition status of children. Findings from a recent International Food Policy Research Institute (IFPRI) study corroborates this statement, which states that 45-64 per cent of the rural poor cannot afford a nutritious diet that meets India’s national food-based dietary guidelines. 


The Government of India is tackling the problem of specific deficiencies of micronutrients (iron, iodine, and Vitamin A) through prophylactic programmes, such as ‘Anaemia Mukt Bharat’ and the Vitamin A prophylaxis programme. In addition, supplementary food is also provided under Integrated Child Development Services (ICDS) (one meal for children between six months and six years) and Mid-Day Meal (MDM) programmes (one nutritious meal up to class VIII). 


Still, diversity of diet is a limitation, due to the unaffordability of fresh fruits, vegetables, egg and milk for economically weaker sections. Micronutrient deficits can have consequences of reduced cognitive ability and the overall health and wellbeing of children. Promoting dietary diversity at the family level complemented with the provision of fortified staple food under the ICDS and MDM programmes can provide a way forward.


What are your expectations from the government in transforming the food system in India?


A focus on food and agriculture policies on securing diet quality, especially for the poor and vulnerable, is a crucial first step to make fruits, vegetables, pulses, nuts, and seeds more available, affordable, and safer for all consumers. The provision of nutritious and fortified staples through safety-net programmes holds much potential and we are already witnessing the recognition of the same in several states.


Curbing the marketing of unhealthy foods, particularly that targeting children, is necessary. Concerted efforts are needed in creating consumer awareness generation for better dietary choices (less sugar, less salt and less trans fats). Finally, we need better national, state and district level data on food safety, food loss and waste for informed decision making.


With the COVID-19 pandemic raging and a need for having a good immunity arising, how is GAIN positioned to bring a change in providing healthy nutritious and fortified foods?


The deficiency of micronutrients such as Vitamins A, B, C, D and trace elements (zinc and iron) increases susceptibility to infection. Large-scale fortification of staple foods is a proven strategy for mitigation of micronutrient malnutrition and particularly more relevant as we grapple with the health and nutrition consequences of COVID-19.


GAIN’s efforts to support the scale-up fortification of staple foods led by the Food Safety and Standards Authority of India (FSSAI), and supported by state governments and development sector organisations in collaboration with the private and public sector, is making available essential micronutrients such as Vitamins A & D through fortified edible oil and milk; Vitamin B-12, iron and folic acid through fortified wheat flour and rice; and iodized salt with iron, to the extent of 25 per cent to 30 per cent of the RDA. At present, we are reaching 884 million people through one or more fortified staples. It is also heartening to know that recognising the potential impact, FSSAI released a draft notification on mandatory fortification of edible oil and milk in India in December 2020.


What will be GAIN’s five-year strategy for the Indian and global market?


Recognising that workplaces are an important part of our food system environment, GAIN is setting up the Workforce Nutrition Alliance (WNA) along with the Consumer Goods Forum (CGF) to support employers to adopt and expand nutrition programmes in workplaces and impact three million employees in their organisations and supply chains by 2025. 


GAIN, as part of the alliance, will work to promote four key pillars: access to healthy food at work, nutrition education/ behaviour change communication, health checks and breastfeeding support.


GAIN has large-scale food fortification (LSFF) as its priority agenda since 2011. We have played an instrumental role in promoting and scaling up LSFF programmes in the country through open market commercial channels and the government safety net programmes.


GAIN’s Commercialisation of Biofortified Crops programme, in partnership with Harvest Plus, is working in six Indian states initially to promote the production and consumption of naturally bred, mineral-rich varieties of wheat (rich in Zinc) and pearl millet (rich in Iron). 


GAIN is also working with global tea brands, tea estate managements, the Indian Tea Board and local tea associations and local communities to demonstrate effective interventions to improve awareness, demand, and supply of nutritious foods for tea estate workers and their families.


Sanjiv Das




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