Pre-school malnutrition in India

Preschool malnutrition places a heavy burden on India. Poor nutrition during preschool can hamper a child`s physical and mental growth for the rest of his or her life. It is during these preschool years that the foundation for attaining the full genetic potential for optimal growth and development is laid through right nutrition. Compromised nutrition due to hidden hunger (underlying micronutrients deficiency) may prove to be detrimental.

During the preschool phase of life, due to sub-optimal nutrition the child is vulnerable to frequent infections and illnesses. Inadequate nutritional intakes resulting in deficiencies are common in preschoolers because of a lack of sufficient animal source foods, and have been associated with delayed child development.¹ Malnourished preschoolers are not able to realise their full potential as grown-ups.

The problem

In India, around 43% of children under the age of five are suffering with malnutrition and 48% are suffering with stunting.² Malnutrition includes over-nutrition, nutritional deficiencies and under-nutrition which impairs health, intellectual activity, adaptive behaviour, education, productivity and well being and can sometimes lead to death. ³

According to the National Family Health Survey – 3 (NFHS – 3), more than 6,000 Indian children below the age of five die every day due to malnourishment or lack of basic micronutrients such as vitamin A, iron, iodine, zinc or folic acid. Also in NFHS-3 Vitamin A deficiency has been implicated in the causation of at least 330,000 child deaths annually in India, also 79.2% of children under the age of three are Anaemic and 46% of children in India are underweight. Good nutrition is the cornerstone for survival, health, and development; well-nourished children perform better in school, grow into healthier adults, and are able to give their own children a better start in life. (UNICEF, 2006) 4

Micronutrient deficiencies or popularly called the ‘hidden hunger’ are one of the important causes of malnutrition in pre-schoolers. Due to micronutrient deficiencies, one million children die before the age of five and 100,000 infants are born with preventable physical defects each year. (Global Alliance for Improved Nutrition [GAIN]) 4

Factors for malnutrition

Dr. Vashist, Consultant Paediatrician from Moolchand Hospital says, “Malnutrition in pre-schoolers is due to several factors like lack of awareness about nutrition, micronutrient deficiencies, reduced bioavailability of micronutrients, inadequate or inappropriate food intake, childhood diseases etc. Indian urban settings also see over-nourishment in kids. Excessive intake of junk food, picky/fussy eating etc deprives them of the goodness and nutritional value of several food items.”

Malnutrition due to micronutrient deficiencies brings about serious deficiency disorders in pre-schoolers. Children have a greater need for vitamins, minerals and other micronutrients and hence are more vulnerable to developing deficiency diseases. Since micronutrients are essential for optimal mental and physical growth and development of children, a deficiency of these elements can cause lifelong damages to a child’s health. Diets poor in micronutrients can cause illness, blindness, premature death, impaired mental development, and susceptibility to infectious diseases, particularly among children in developing countries. It also causes reduced productivity later in life. (UNICEF/The Micronutrient Initiative, 2004) 4

The solution

To address malnutrition in pre-schoolers a combination of interventions are required, which involve improved food availability and micronutrient bioavailability, adequate consumption of nutritious food, food fortification, increased awareness amongst caregivers about nutrition, and if required then pharmaceutical supplementation.

Along with a healthy, balanced diet food fortification and nutritional supplementation are effective ways to deal with the problem of malnutrition. In case of dietary gaps fortified and supplementary foods ensure that the minimum dietary requirements of the child are met. The objective of food fortification is to maintain the nutritional quality of foods, keeping nutrient levels adequate to help fulfil nutrient requirements.

Dr. Vashist further adds, “Since children are the foundation of any nation hence malnutrition among kids should be given prime importance as a health issue. Children tend to become fussy eaters as they grow up and hence providing supplementary food or beverages can give them the lacking nutrients. Addressing the issue of micronutrient deficiencies causing malnutrition at large can pertinently solve the problem of pre-school malnutrition in children.”

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