COMMON NUTRITION PROBLEMS IN INDIA
description
Transcript of COMMON NUTRITION PROBLEMS IN INDIA
![Page 1: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/1.jpg)
COMMON NUTRITION PROBLEMSIN INDIA
Dr. K.VIJAYARAGHAVAN
DIRECTOR – RESEARCH,
SHARE INDIA (MEDICITI INSTITUTION)
&
Sr. Dy. Director, NIN (Retd)
![Page 2: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/2.jpg)
MOTHER AND CHILD SURVIVAL
MMR 407/100,000 live births
IMR* 58/1000 live birthsChild Mortality 19.5/1000 ChildrenRate(1-4 years)
Vijayaraghavan
*Gujarat 53
![Page 3: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/3.jpg)
NUTRITION PROBLEMS IN INDIA
WHO IS AT RISK??
PREGNANT WOMENLACTATING WOMENINFANTSPRESCHOOL CHILDRENADOLESCENT GIRLSELDERLYSOCIALLY DEPRIVED(SC & ST Communities)
.
Vijayaraghavan
![Page 4: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/4.jpg)
WOMEN• POOR WT. GAIN DURING PREGNANCY• CED• MICRONUTRIENT
DEFICIENCIES
CHILDRENLOW BIRTH WEIGHT
• GROWTH FALTERING• PEM• MICRONUTRIENT
DEFICIENCIES
NUTRITION PROBLEMS IN INDIA
WHAT ARE THE COMMON PROBLEMS?
FLUOROSIS, LATHYRISM
DIET RELATED CHRONIC DISEASES OBESITY, CARDIOVASCULAR DISEASES, DIABETES
Vijayaraghavan
![Page 5: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/5.jpg)
PREVALENCE OF LBW IN S.E ASIAN COUNTRIES
33
30
23
2018
16
11
7.2
0
5
10
15
20
25
30
35
PE
R C
EN
T
Nepal
India
Mya
nmar
Mal
dives
SriLan
ka
Bhutan
Indones
ia
Thaila
nd
Vijayaraghavan
![Page 6: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/6.jpg)
FACTORS MODIFYING PREVALENCE OF LBW
• % INSTITUTIONAL DELIVERIES
• # ANCs (Minimum: >5)
• QUALITY OF ANC
Includes: No.of ANCs, TT, Weight, BP,
Examination of Blood, Examination of Urine
![Page 7: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/7.jpg)
INFANT MORTALITY AND BIRTH WEIGHT
1000
615
238
59 21 180
200
400
600
800
1000
1200
<1 1-1.5 1.5-2 2-2.5 2.5-3 >3
BIRTH WEIGHT (KG)
IMR
/1000
Liv
e-b
irth
s
Source : Shanti Ghosh
Source: Shanti Ghosh et al, 1978
![Page 8: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/8.jpg)
30.830.2
15.5
0
5
10
15
20
25
30
35
PE
R C
EN
T
CONTROL IRON FOLIC ACID
GROUPS
IFA SUPPLENTATION AND LBW
Source: Leela Iyengar & Apte, S,V.,1970
![Page 9: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/9.jpg)
SUPPLENTATION OF IRON / FOLIC ACID
AND BIRTH WEIGHT
2890
26502567
2400
2500
2600
2700
2800
2900
3000
CONTROL IRON FOLIC ACID
GROUPS
BIR
TH
WE
IGH
T (
g)
Source: Leela Raman & Rajalakshmi,1974
![Page 10: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/10.jpg)
NUTRITIONAL DISORDERS IN CHILDREN
• PROTEIN ENERGY MALNUTRITION (PEM) . CLINICAL FORMS
. SUBCLINICAL UNDERNUTRITION
• MICRONUTRIENT DEFICIENCIES
Vijayaraghavan
![Page 11: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/11.jpg)
CLINCAL FORMS of PEMCLINCAL FORMS of PEM
KWASHIORKOR
• OEDEMA+• IRRITABILITY+• GROWTH FAILURE+• DISCOLOURED HAIR+
Vijayaraghavan
![Page 12: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/12.jpg)
CLINCAL FORMS of PEMCLINCAL FORMS of PEM
MARASMUS
EXTREME WASTING
“SKIN AND BONES”
MONKEY/OLD MAN FACIES
Vijayaraghavan
![Page 13: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/13.jpg)
SUB-CLINICAL FORMS OF PEM
UNDERNUTRITION WEIGHT FOR AGE
WASTING WEIGHT FOR HEIGHT
STUNTING HEIGHT FOR AGE
Vijayaraghavan
![Page 14: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/14.jpg)
UNDERNUTRITION IN INDIA
PRESCHOOL CHILDREN ADULTS (Females)
48.546.5
5
CED NORMAL OBESE
40.6
8.9
44.3
6.2
NORMAL GRADE I GRADE II GRADE III
Based on BMI
Vijayaraghavan
Based on NCHS weight for age
![Page 15: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/15.jpg)
78.6
57.7
76.5
62.3
18.1 18.5
0
10
20
30
40
50
60
70
80
PER
CEN
T
Height Weight Weight for Height
TIME TRENDS IN ANTHROPOMETRIC PARAMETERS (<Median-2SD)NNMB
1975-79
1996-97
VIJAY’00
![Page 16: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/16.jpg)
DISTRIBUTION WEIGHT FOR AGE – IAPGujarat
32.537.9
21
7.2 1.40
5
10
15
20
25
30
35
40
PE
R C
EN
T
GRADES OF UNDERNUTRITION
Normal Gr. I Gr. II Gr. III Gr. IV
![Page 17: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/17.jpg)
WEIGHT FOR AGE– SD CLASSIFICATION - GUJARAT
0
5
10
15
20
25
30
35
40
%Boys
Girls
Pooled
![Page 18: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/18.jpg)
VITAMIN A DEFICIENCY
![Page 19: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/19.jpg)
BITOT SPOT KERATOMALACIA
BILATERAL BLINDNESS
V
A
D
Vijayaraghavan
![Page 20: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/20.jpg)
WHO Criteria for Public Health Significance- VAD
Minimum Prevalence (%) in children <6 yrs
• BITOT SPOTS 0.5• NIGHT BLINDNESS 1.0• CORNEAL LESIONS 0.01• CORNEAL SCARS 0.05• Serum Retinol <10 g/l 5.0
Vijayaraghavan
![Page 21: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/21.jpg)
VITAMIN A DEFICIENCY (%) IN INDIA
AGE GROUP SOURCE X1B XN*
PRESCHOOLCHILDREN
ICMR, 2001 0.7 1.03
NNMB 0.7 -
NIN- SURVEYS 2.1 -
PREGNANT WOMEN
ICMR, 2001 - 2.8
* 24-71 MONTHS
Vijayaraghavan
![Page 22: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/22.jpg)
VITAMIN A DEFICIENCY
Districts(%) with X1B >0.5%
Average prevalence (%)
2.155 45
Based on surveys in 126 Dts. by NIN and NNMB
No VAD VAD
Vijayaraghavan
![Page 23: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/23.jpg)
1.71.8
5.7
0.7 0.7
5.7
0.20.7
2.1
0
1
2
3
4
5
6
1975-79 1988-90 1996-97
PERIOD OF SURVEY
PEM
X1B
RIBO. DEF.
NUTRITIONAL DEFICIENCY SIGNS IN PRESCHOOL CHILDREN
Vijayaraghavan
![Page 24: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/24.jpg)
0
50
100
%
% RDI
DISTRIBUTION OF MICRONUTRIENT INTAKES IN CHILDREN - %RDI
Vitamin A 86.3 3.2 1.4 9.1
Iron 82.5 8.6 2.1 6.8
Riboflavin 71.4 15.9 4.1 8.6
<70 70-90 90-100 >100
Vijayaraghavan
![Page 25: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/25.jpg)
ANAEMIA
![Page 26: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/26.jpg)
61
79.4
82.5
84.1
87.2
91.4
94.9
96.8
84.6
20
30
40
50
60
70
80
90
100
%
H.P. M.P. A.P. BIHAR MAHA. ASSAM RAJ. J&K POOLED
PREVALENCE OF ANAEMIA IN PREGNANT WOMEN
Vijayaraghavan
![Page 27: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/27.jpg)
87.1
87.7
91.891.9
92.2
93.999.3 92
80
82
84
86
88
90
92
94
96
98
100
%
MAHA. H.P. A.P. BIHAR M.P. ASSAM J&K POOLED
Source: ICMR, 1999
PREVALENCE OF ANAEMIA -ADOLESCENT GIRLS
![Page 28: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/28.jpg)
ANAEMIA IN FEMALES
• PREVALENCE OF ANAEMIA IS VERY HIGH IN BOTH THE GROUPS
• NO CHANGE NOTICED OVER TIME IN THE PREVALENCE
84.6
92
50
55
60
65
70
75
80
85
90
95
Pe
rce
nt
Pregnant Women
Adolescent girls
Vijayaraghavan
![Page 29: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/29.jpg)
IODINE DEFICIENCY DISORDERS
![Page 30: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/30.jpg)
239 OF 282 DTs. SURVEYED –ENDEMIC167 millions AT RISK ?
IODINE DEFICIENCY DISORDERS
GOITRE+
![Page 31: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/31.jpg)
PREVALENCE OF GOITRE IN 6-12 Yr CHILDREN - Gujarat
0
2
4
6
8
10
12
14
16
Gr. I Gr. II Total
Surat
Valsad
![Page 32: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/32.jpg)
DIETARY INTAKES
![Page 33: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/33.jpg)
HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS
78
118
79
85
48
98
91
92
51
131
87
90
0 20 40 60 80 100 120 140
Iron (mg)
Calcium (mg)
Energy (Kcal)
Protein (g)
PER CENT
RuralTribalUrban Slums
VIJAY’00
![Page 34: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/34.jpg)
0
105
55
87
46
164
120
64
100
63
156
102
71
104
51
0 50 100 150 200
Folic acid (µg)
Vitamin C (mg)
Riboflavin (mg)
Thaimin (mg)
Vitamin A (µg)
PER CENT
Rural
Tribal
Urban Slums
HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS
![Page 35: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/35.jpg)
NUTRIENT INTAKES AMONG INDIAN WOMEN
NUTRIENTS NPNL PREGNANT
WOMEN
LACTATING WOMEN
Protein (g) 49.9 47.2 56.5
Energy (kcal) 1983 1994 224.3
Total Fat (g) 24.5 21.5 373
Calcium (mg) 382 339 12.4
Iron (mg) 11.3 11.0 162
Vitamin A (g) 148 142 1.1
Thiamin (mg) 0.9 0.9 1.1
Riboflavin (mg) 0.8 0.8 0.9
Vitamin C (mg) 32.0 28.4 29.4
Folic Acid (g) 86 84 106Source: NNMB, 2000
![Page 36: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/36.jpg)
NUTRIENT INTAKES IN PREGNANT WOMEN % RDI
% RDI Energy Protein Vitamin A Iron Riboflavin Total Fat
<30 0 0 52.4 53.7 1.2 22
30-40 1.2 0 8.5 22 20.7 6.1
40-50 3.7 2.4 11 9.8 13.4 6.1
50-60 9.8 11 9.8 7.3 12.2 7.3
60-70 8.5 17.1 0 0 18.3 8.5
70-80 23.2 11 3.7 1.2 4.9 7.3
80-90 9.8 9.8 2.4 1.2 4.9 4.9
90-100 7.3 8.5 2.4 2.4 7.3 4.9
100 36.5 40.2 9.8 2.4 17.1 32.9
Source: NNMB,2000
![Page 37: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/37.jpg)
NUTRIENT INTAKES (per day) IN CHILDREN
Age in Years 1-3 4-6 Nutrients
Mean Median Mean Median Protien (g) 22.4 20.4 31.4 29.40 Tot fat (g) 13.5 10.1 17.6 13.90 Energy (Kcal) 867 815 1215 1154 Calcium (mg) 250 168 300 224 Iron (mg) 5.50 4.30 8.4 6.90 Vit A (ug) 145 72 205 96 Thiamin (mg) 0.44 0.40 0.69 0.60 Ribo. (mg) 0.44 0.40 0.56 0.50 Niacin (mg) 4.97 4.5 7.37 6.60 Vit C (mg) 16.5 9.9 24.9 17.5 Folic acid (mg) 45 36.6 65 55.1
NNMB, 2000 Vijayaraghavan
![Page 38: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/38.jpg)
DETERMINANTS OF MALNUTRITION
MATERNAL MALNUTRITIONSTART WITH A HANDICAP(LBW)FAULTY CHILDFEEDING PRACTICESDIETARY INADEQUACYFREQUENT INFECTIONSLOW PURCHASING POWERLARGE FAMILIESHIGH FEMALE ILLITERACYTABOOS AND SUPERSTITIONS
![Page 39: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/39.jpg)
Factors Affecting Nutritional Status
High illiteracy Unemployment/Underemployment
Large familiesLow purchasing power
Ignorance High dependence rateFalse food beliefs Inadequate intakes
Low Procurement of foods Poor PDS High cost
Low availability of foodsLow production Reduced work Malnutritionof foodgrains output
Poor environment Morbidity Absorption of nutrients Low Appetite
Poor utilization of services poor coverage of immunizationImproper health services
poor infrastructure Lack of resources
![Page 40: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/40.jpg)
INTERVENTIONS IN OPERATION
DIRECT•CONVERGENCE OF SERVICES (RCH)•INTEGRATED CHILD DEVELOPMENT SERVICES•IRON AND FOLIC ACID DISTRIBUTION•MASSIVE DOSE VITAMIN A PROGRAMME•PRIMARY HEALTH CARE PROGRAMME•HEALTH AND NUTRITION EDUCATION
INDIRECT•POVERTY ALLEVIATION PROGRAMMES•ENVIRONMENTAL SANITATION•PROTECTED WATER SUPPLY•LITERACY PROGRAMME
![Page 41: COMMON NUTRITION PROBLEMS IN INDIA](https://reader035.fdocuments.net/reader035/viewer/2022070411/5681489a550346895db5b0b9/html5/thumbnails/41.jpg)