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2. Nutritional requirements in India


2. Nutritional requirements in India

In the present endeavour to. find the status of food and nutrition security in India, it is necessary to first examine the 'standards' against which such security is to be judged. At the conceptual plane, it can, be stated that a country can be said to have achieved complete food and nutrition security if each and every person in that country is able to consume a minimum quantum and quality of various ingredients of what I would like to call 'an adequate and balanced diet' on a regular basis. Availability and affordability of such diet, backed by health and educational services in an environmentally sustainable scenario will then enable each member of the society to live a 'good' life; each individual personality getting an opportunity to flower to one's full potential. However, it is a matter of intense international debate as to what should be considered an adequate and balanced diet for different groups of individuals in a society, "The World Bank (1986) used FAD/WHO norms for reference individuals for 'moderate' activity for specific countries/regions. A large variation in defining 'adequate' food exists, ranging between 1400 and 2800 calories and therefore, is subject to value judgment. (Maxwell et.al., 1992). "The poor in rural areas who do heavy physical work in the field need much higher calorie intake than for moderate activity which can swell the number of food insecure substantially." (Bapna, 1993).

It is actually not easy for experts to exactly lay down nutrient requirements and quantities of various ingredients separately for various population and activity groups. Requirements of special categories like infants, mothers etc. have to be separately looked into. In any case, standards setting for any human activity is indeed a very difficult task. Diversity in agro-climatic conditions; food habits; life styles and spiritual/philosophical inclinations condition the nutritional intakes, apart from the 'measurable physiological needs' of the human body. To go on to determine the averages, experts have to depend on sample surveys which suffer from their inherent limitations. At the same time, an average balanced diet made up of various food items has to be prescribed so that a country could plan to produce or procure these.

In India, it is the Indian Council of Medical Research (ICMR) that sets up Nutrition Advisory Committees or Expert Groups and recommend the "Dietary Allowances" in respect of energy (Calories), proteins, fats, minerals, iron, vitamins etc. for various age groups within the population including special groups like infants, pregnant/nursing mothers, children etc. and at the same time recommend dietary allowance by activity groupings also. These Committees/Expert Group also recommend weighted average per capita requirements for the population of the country as a whole, to enable the policy-makers plan for production or procurement of the required quantities of various foodstuffs. The first Nutrition Advisory Committee of ICMR had made its recommendations way back in 1944. The recommendations have been reviewed, up-dated and amended ever since, generally at intervals of ten years. Such reviews and revised recommendations have been made in 1958, 1968, 1978, 1984 and 1990. The 1984 Recommendations had specially observed that "RDA (Recommended Dietary Allowance) for Indians are being revised and updated at intervals of about 10 years in view of the changes in our concept of human requirements of several nutrients as a result of studies carried out during the previous decade" (ICMR pub. 1984).

The most recent recommendations available are those made by the Expert Group of ICMR in 1990. The concerned publication (ICMR pub. 1990) can be seen for details but the recommendation made in respect of the two important nutrition requirements i.e. energy and protein are given below:

Table 2 ENERGY ALLOWANCE FOR ADULTS

Category

Reference body
Weight Kg.

Activity

Energy Allowance
K.Cal

       

Man

60

Sedentary

2425

   

Moderate

2875

   

Heavy

3800

Woman

50

Sedantary

. 1875

   

Moderate

2225

   

Heavy

2925

Table 3 PROTEIN ALLOWANCES FOR ADULTS

Category

Body Weight

Protein requirement in g.

 

Kg.

Per Kg.

Per day

Man

60

1.00

60

Woman

50

1.00

50

The energy and protein requirements are given separately for various age groups like adults, infants, children and special categories like pregnant and nursing mothers. Although the ICMR Expert Group also recommends dietary allowances for other nutrients like fat, iron, calcium, vitamins etc. and we will have an occasion to refer to these later on, we may discuss only energy and protein recommendations in details here since these are the most important nutrients which need to be tackled first. Height, body-weight and physical activity are three important determinants of energy requirement. It may also be mentioned that the 1990 report of the Expert Group recommended an upward revision in the 'reference body weight of adult man and woman in order to harmonise the body weights of adults with those of well-to-do and normally growing children and also taking into consideration the expanded weights for their heights. This was important since "the national goal of any country would be to provide adequate nutrition and health to its population so that they attain their full genetic potential in growth and development". (ICMR, 1990).

Recommendations on energy requirements are vital because they have a direct bearing on the status of poverty, which in India, is defined by per capita incomes that will enable a person to achieve daily intake of 2400 K.Cal in rural areas and 2100 K Cal in urban areas. While proportion of people living below the poverty 'line' can be adjudged against these standards, we need to have a weighted average of energy requirement for the entire population so that nation can plan for production and availability of at least that much energy giving foodstuffs. The ICMR Expert Group (1990) has concluded that on the basis of the present recommended dietary allowance (RDA), it ought to be 2200 Kcal per capita per day.

As regards recommendation on the weighted average protein requirement, the Expert Group (1990) has suggested 50 gins/capita/day. This again, just like weighted average energy requirement, is based on recommended dietary protein allowance of different groups, which constitutes the absolute safe levels. Thus, while many individuals with intakes below RDA are not necessarily at risk, those with intakes of RDA norms or higher are certainly not at risk. The Expert Group also recommended that a PE percentage between 8 and 12 would meet the protein requirements of any group, provided its energy needs are fulfilled.

We will have an occasion to discuss in details the requirement and availability picture of energy and protein as brought out by the National Nutrition Monitoring Bureau (NNMB) of the National Institute of Nutrition through their surveys during 1975-79 and repeat surveys during 198890, as also by the Working Group set by the Ministry of Agriculture (April 1994) based on production and availability of various foodstuffs. At this stage, it can be mentioned that while NNMB has used per consumption unit requirement of 2400 Kcal of energy and 60 gms of protein, the Working Group in Agriculture has used the weighted average per capita requirement of 2200 Kcal energy & 50 gms of proteins.

Balanced Diets

Composition of balanced diet is the end result of the RDAs. The balanced diet is, in a way, the practical prescription for consumption of a basket of food items, which is likely to provide all the required nutrients to the human body. It was the Advisory Committee of the ICMR (1984) that had reviewed the matter in detail and formulated a new set of recommendations with regard to balanced diets for Indians based on the concept of 'least cost'. As compared to the previous recommendations on balanced diets, lower quantities of pulses and green leafy vegetables have been recommended without of course, sacrificing the nutrients contents to make the recommended diet more practical and acceptable. The report has given details of balanced diets for adult man, adult woman, children, boys and girls separately & activity wise but those for adult man and woman are given below:

Table 4 RECOMMENDED BALANCED DIETS

 

Adult Man

Adult Woman

Bood Items

Sedentary

Moderate
at work

Heavy
work

Sedentary

Moderate
work

Heavy
work

Cereals

460

520

670

410

440

575

Pulses

40

50

60

40

45

50

Leafy Vegetables

40

40

40

100

100

100

Other-do-

60

70

80

40

40

100

Roots & Tubers

50

60

80

50

50

60

Milk

150

200

250

100

150

200

Oils & fats

40

45

65

20

25

40

Sugar & Jaggery

30

35

55

20

20

40

The 1984 report, recognising that the average per capita requirement of foodstuffs is one of the important considerations from the practical point of view in estimating national food supplies, gave this per capita requirement as under:

Table 5 PER CAPITA REQUIREMENT OF FOOD (gins/day) AT THE NATIONAL LEVEL

Foodstuff

Physiological

Retail

Production

Cereals

396

436

490

Pulses

43

47

53

Leafy Vegetables

58

64

72

Other-do-

45

49

55

Roots & tubers

40

44

0

Milk

200

220

248

Fats & Oils

31

34

38

Sugar/Jaggery

31

34

38

It is against the above recommended requirement of food items that we have to judge the food and nutrition security of India. However, any narrow value judgments might not be easy to pronounce because of the great diversity inherent in all aspects of life in this highly populous subcontinent type of country. The climatic variations ranging from tropical climate to snow bound areas on one hand and from desert to hot-humid sub-tropical climate on the other, the country presents a bewildering diversity making the task of prescribing an average standard that much difficult. However, the scientific methods of surveys and studies undertaken by the experts on a continuous basis can make the above mentioned averages quite useful guide for the nutritional surveillance and planning.

An extremely important consideration in India is of course, the prevailing poverty. This country's richness till 16th century or so which had earned it the title of the "golden bird", also became its undoing. It attracted invaders repeatedly, culminating in a long spell of British rule. Along with industrial revolution of Britain, India turned into a backyard, a supplier of raw material with sharp decline in workforce engaged in manufacturing. These centuries saw growing poverty and frequent famines, many taking tolls in millions. The last famine before independence in 1943 is known to have resulted in death of around 3.5 million people. With such a background, when even two square meals were not available to millions of households, the availability of basic cereals itself became an important goal to be achieved when the country became independent. It is, therefore, very important to first examine the status of availability and consumption of cereals, which in any case account for 75 to 80 percent of the dietary energy. Then comes the availability and consumption of pulses which are the main source of proteins in a country where the population is predominantly vegetarian. Finally, the availability of fats and oils, milk, vegetable, sugar, vitamins etc.

It is, therefore, proposed to examine the production, availability and consumption of cereals in India in quite a detailed manner. The role of the price policy and public procurement in increasing the agricultural production will also be examined. The fluctuations in foodgrains production will, inter alia, be examined as it seriously affect the food security. The Public Distribution System (PDS), which is one of the most important instruments in providing food security, will also be discussed in some detail to examine its evolution, its shortcomings and reforms needed to make it a sharper instrument in providing food security to poor households. Since poverty is the root cause of undernourishment, the status of poverty and alleviation programmes also need to be examined in detail as these improve the purchasing power of the poor households and consequently enhance their access to food. The data on availability and consumption of other nutrients is not as exhaustive as foodgrains but whatever data is available will be analysed for examining the status of intake of other nutrients.

It has also to be appreciated that recommended dietary intakes are given for the individuals. However, it is almost impossible to divide the consumption of a household amongst all its members with any degree of accuracy. The normal practice, therefore, is to take a household as a unit of food and nutrition security exercise. In the NNMB surveys on consumption of food amongst households chosen for survey, all the food consumed by the family as a whole is taken into account and converted into nutrients by referring to food composition Tables of Indian Foodstuffs. In the weighment method, all raw material used for cooking by the family during the day is weighed whereas in 24 -furs recall method, amount of cooked food consumed by the formally is assessed. The individuals constituting the family are converted into consumption units (CU) and per CU per day intakes calculated. Thus household food security becomes the bottom line even though in some cases, there may not be a just sharing of the food.

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