What makes India one of the most micronutrient deficient countries in the world?

Dr Nikhil Bangale, Head – Medical Affairs, Consumer Health Division, Bayer India

Hidden hunger, also known as micronutrient deficiencies (MiNDs), is the umbrella term used to represent the lack of essential vitamins and minerals required from the diet to sustain virtually all normal cellular and molecular functions. The hazards of undernutrition are turning into a measurable nit, similar to the tremendous nutrition transition in India. MiNDs have risen alarmingly in prevalence among a substantial portion of Indians, according to scientific findings, (more than one-in-three individuals are deficient in one or more micronutrients worldwide) regardless of whether they are overweight or underweight.

Prevalence of MiNDs in India

Current risk of ‘hidden hunger’ is severe in India due to serious deficiency risks across an array of essential micronutrients. Results suggest a widespread (> 80% total Indian population) risk of deficiencies in calcium, vitamin A, B12, and folate, with more localized deficiencies in iron, zinc, and vitamin B6.The prevalence of serum zinc deficiency in India is > 20%, which indicates a public health significance. According to the recent doctor consensus led by Bayer Consumer Health Division, more than two billion people suffer from MiND globally, with nearly half living in India. Even ‘healthy’ individuals are at risk of MiND due to sedentary behavior, and lifestyle-related factors.

Particularly, in Indian women, vitamin D deficiency and low intake of calcium are responsible for the high prevalence of osteoporosis. Indian females also have high MiNDs due to less consumption of nutrients than males in their diet (p < 0.001). A community-based cross-sectional study also showed a significantly lower intake of vitamins A, B1, B2, B3, B12, zinc, folate, and iron in Indian women than men.


Causes of MiND:

Micronutrient intakes vary significantly between diet inadequacy, Indian dietary patterns, losses due to food processing/cooking, and food impurities. HCPs claim that the urban Indian populace does not consume enough micronutrients to meet the recommended dietary allowance (RDA). These insufficient micronutrient intakes can be due to several reasons such as the changing Indian dietary patterns prompted by a host of factors including agricultural, economic, lifestyle, health and nutrition transitions, increased micronutrient requirements not met during pregnancy and lactation, diseases, advancing age, infections, or surgery.

Importance of micronutrients:

Micronutrients are required only in small quantities but are essential for physical and mental functioning as even mild to moderate MiNDs can affect a person’s well-being and mental functioning. Unlike energy-protein undernourishment, health impacts of MiND are not always acutely visible; thus termed ‘hidden hunger. ’Around 90% HCPs strongly agreed that MiNDs further increase the risk of other diseases like diabetes, hypertension, osteoporosis, asthma, depression, neurological disorders, cardiovascular disorders, endocrine disorders, etc. in healthy adults.

Plugging the Daily Gap of MiNDs with Multivitamin/Mineral Supplements

Based on the health survey responses of 220 HCPs in urban India (Mar-Apr 2021), 74% Indian doctors/nutritionists positively inclined to prescribe multivitamin/mineral supplements to fulfill micronutrient deficiencies (as per RDA) in daily Indian diet. The majority of HCPs concurred that taking multiple vitamins can help boost one’s immunity by acting synergistically and in combination.

To make up for micronutrient deficits (as per RDA) in the typical Indian diet, 74% of Indian doctors and nutritionists are inclined to recommend multivitamin/mineral supplements. According to scientific evidence, taking supplements with micronutrients decreased fatigue (iron, vitamins B1 and D), enhanced activity and a feeling of vigour (vitamin B1), better exercise tolerance (magnesium), and improved physical capacity/performance and recovery.

Benefits of Natural or Herbal Ingredients to Boost Immunity

Compelling evidence suggests that natural/herbal ingredients stimulate and help in maintaining a healthy immune system. Natural/herbal ingredients modulate immune functions by immunostimulation/immunoregulation for the control and prevention of infections. It is postulated that a stimulated immune system fights better against any impending infections and exerts indispensable effects on stress- and infection-induced immunosuppression. Natural/herbal ingredients modulate immune functions by multiple pharmacological effects for the control and prevention of infections.

Natural ingredientsPharmacological properties of Natural ingredients
TulsiAdaptogenic, immunomodulatory, antimicrobial, cardioprotective, anit- inflammartory, anti- viral, anti- fungal, anti- bacterial and hepatoprotective actions; Enhances immune responses by phagocytic activity and index with rise in lymphocyte count, neutrophil count and antibody titer.
TurmericAnti-inflammatory activity of curcumins in both acute/ chronic cases of inflammation; Protein antioxidant to lower lipid peroxidation in cells by sustaining activities of antioxidant enzymes (catalases, superoxide dismutase and glutathione peroxidase) at higher levels
AshwagandhaAnti-inflammatory, antitussive and antioxidant agents. Enhances Nitric Oxide (NO) synthase activity of macrophages to increase their microbe killing power. Stimulatory effect on immune system, enhanced antibody, red blood cells levels, and an increased number of white blood cells to devour germs. Marked increase in primary and secondary antibodies and also cell-mediated immune response to possess immunostimulatory properties.
ShatavariAntioxidant, immunomodulatory, anti-inflammatory, anti-bronchitis, anti-dyspepsia and potential broad spectrum antibiotic properties.
GiloyBoosts immune system by immunomodulatory and cytoprotective activities through various non-specific immune mechanisms. Potent immunostimulatory properties through augmentation of antibody production
AmlaAntimicrobial and antiviral actions. Antioxidant action. Cardio protective action and wound healing. Anti-inflammatory and immunomodulatory. Interferes with adhesion of C. albicans to buccal epithelial cells and denture acrylic surfaces in vitro. Antimicrobial effect by inhibiting adhesion and synergistic increase in zone of inhibition against Staphylococcus with amoxicillin by agar diffusion and disk diffusion methods. Antibacterial and larvicidal acitivitySignificant reduction in mean colony count of Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae by tube dilution method.

Image credit- shutterstock

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