Table-I

NNMB - Rural average intake of selected food items (g/CUlday)

Consumption of Edible Oils in India ­The Present Picture

c. Gopalan

Year 19761978197919801982

Cereals

507.2535.5521.6532.5497.6

Pulses

43.435.937.333.430.1

Fats/Oils

10.89.012.19.59.8

Source: NNMB - Rural data

pointed out earlier, it is not our objecthere to provide an exhaustive list.

The Future

We gather that plans for the future ofNNMB have been under considerationfor several months now at the Indian

Council of Medical Research (ICMR).We are happy to know that it has been fi­nally decided to extend continued sup­

port to NNMB and to expand its activitiesto cover the entire country. This is aneminently wise and correct decision,

long overdue. The Director-General, ICMRmust be congratulated on his decision.

The ball now squarely rests in the NIN

court. NIN must respond to this chal­lenge and opportunity adequately and ina manner befitting its rich heritage andtradition. It must provide vigorous sup­port and direction to NNMB operations,

and in this task it must be aided by ahigh-powered competent executivecommittee - which will be much more

than a mere "advisory" body.NNMB will do well to revert to its ear­

lier study design as originally formulated

by Prof. C.R. Rao. However, as hasbeen pointed out by Dr. Srikantia, strictadherence to the time-frame, and cover­

age of adequate numbers of house­holds according to the prescribed sam­

ple frame are absolutely essential. Suchadditional inputs as may be necessaryto achieve this may be provided. NNMBought to bring out once in five years aNational Diet Atlas and a National Nutri­

tion Atlas; these publications will be ofimmense value to the planners and nut­rition scientists.

It wil be prudent on the part of NNMBto heed Dr. Srikantia's wise words of

caution and avoid premature and hastyconclusions, which may have serious

policy implications. Individual scientistsare entitled to their personal views andinterpretations but pronouncements inofficial NNMB publications implicitly

carry the authority of the ICMR and theNIN and (like those of the RegistrarGeneral and NSSO), they must be care­

fully weighed, screened and vetted by acompetent expert group of NNMB be­fore they are publicised.

Functioning as an integral part of NINand thus gaining its 'second wind',NNMB, in the years ahead, can not onlyprovide the much-needed data base formeaningful nutrition plans and nationalpolicies but also help to enrich and en­hance the relevance of nutrition re­

search in the country.

The one area in the entire field of food

and nutrition that has now been singledout for topmost priority in our national

planning is the augmentation of the pro­duction of oil seeds and of edible oils in

the country. This item alone among sev­

eral other possible claimants, has beenidentified as the 'thrust area' meriting thesetting up of a special Technology Mis­

sion. Production and consequently in­take of pulses, for instance, which hassteadily deteriorated (see Table I) in the

wake of the 'green revolution' does notapparently qualify for the same prioritystatus as production of oil seeds. Butthen, it must be remembered that

priorities in national planning, even withrespect to production of different food

items, are not necessarily based on nut­ritional considerations.

There can be no doubt, however, that

the augmentation of production of oilseeds and of edible oils is a desirable

objective. According to the figures avail­

able, we now produce 3.44 million ton­nes of edible oil within the country, andimport an additional 1.1 million tonnes.

The estimated availability of vanaspati(hydrogenated fat) is 0.9 million tonnes(Economic Survey, 1987-88). The per

caput availability of edible oils, even tak­ing import into consideration, works outto no more than 16 g/day. The intake of

fats in the dietaries of large sections ofour people is very low. It can be arguedthat under the circumstances, the incor­

poration of fats in these poor dietarieswill increase their caloric density and

possibly palatability.We had discussed the current situa­

tion with respect to our edible oil needsin an earlier publication (Gopalan C:Bull. Nutr. Found. India 8.1.1987);

Achaya (Bull. Nutr. Found. India.7.2.1980) had drawn pointed attention tothe fact that cereals which are the stapleof Indian dietaries, provide significant

amounts of (invisible) fat, adequate tcmeet physiological requirements of es·sential fatty acids. While it is true thaIpoor Indian dietaries will stand to benefil

both with respect to calorie density andpalatability through higher levels of in·take of edible oils, there is no demonstr­able specific evidence - clinical, func·

tional or biochemical - of fat deficiencyas such even in the poorest segments 01our population. It has also been showrthat even with current levels of fat intake,

B carotene absorption is not seriousl~hampered'. So, purely from the point 01

view of basic physiological need, au·

gmentation of fat intake (though desira·ble in the case of the dietaries of thE

poor) cannot be considered as of thE

highest nutritional priority.The reality, however, is that with reo

spect to dietary fat - more than perhap~

with respect to any other food item ­there is vast divergence beween 'needs(as assessed on the basis of minima

physiological requirement) and 'wants'.The 'wants' of the poor cannot find prac·tical expression in the form of increasecintake, but those of the affluent not on I)can (and often do) but also sometime~get such free rein as to pose seriou~health hazard to the consumer. ThE

case for a Technology Mission on oiseeds seems to rest almost entirely or

the consideration that today we speneseveral millions in foreign exchange fOIimport of edible fats.

Current inequalities: Because O'

prevailing inequalities in income, inequit·able distribution of practically every fooe

item among the population is to be ex·pected. Thus we have the cruel parada>of vast buffer stocks of cereals whilE

considerable segments of the populatiorare subsisting on cereal intakes falbelow recommended levels. DistributivE

injustice is perhaps most marked wit~

such as Kerala and states with lowlevelS of female literacy such as MadhyaPradesh, Bihar or Uttar Pradesh. Pre­school children in all three states seemto be more or less at the same disadvan­

tage. This finding, which is somewhatcontrary to expectations, would imply.either that no special efforts were madein Kerala to exploit its high level offemale literacy to promote and achieve apattern of intra-familial food distributionmore favourable to preschool children;or that the pattern of intra-familial foodallocation in poor homes in dictated bythe compelling consideration that inorder to ensure even the existing level offood availability for the family as awhole, the wage-earner has to get a(seemingly) disproportionately highershare of the family pot. Even with this,the calorie intake of the male wage­earner falls considerably short of the re­commended level. There are apparentlylimits to what literacy and nutrition edu­cation can achieve in the face of poverty.Here is a subject which calls for deeperanalysis and more extensive research.

Policy leads: NNMB data have alsoprovided leads of great value to the plan­ner and policy-maker. We may mentionjust a few examples. What follows, how­ever, is by no means an exhaustive list.

• When NNMB data from the different

state are compared and studied in con­junction with the data on IMR and childmortality, as provided by the Registrar­General, the point clearly emerges thatbetter "child survival" does not neces­sarily imply better child health and nutri­tion. "Death control strategies" canachieve better child-survival even in thecontext of poverty and undernutrition,but promotion of health and achieve­ment of optimal nutritional status will callfor much more. This point had beenbrought out in an earlier publication (CGopalan: Bull. Nutr. Found. Ind. Jan.1984).

• NNMB data studied in conjunctionwith such data as are available from ear­

lier studies do not provide evidence ofany substantial improvement in the nutri­tional status of our poor income groupsover the last several years (C. Gopalan:Bull. Nutr. Found. Ind. Jan. 1986). Therehas perhaps been some improvementwith respect to prevalence of "severeundernutrition". This will indicate that

our 'anti-poverty' and 'rural develop­ment' programmes carried out thus far,have not as yet made a significant denton the problem of undernutrition amongour poor.

• The study on urban populationgroups (NNMB, 1975-79, 1984) carriedout by NNMB has provided some usefulpointers NNMB's data had shown thaturban slum-dwellers were no better offthan the rural landless labour and the

Harijans, as far as energy intakes wereconcerned. As Kamala Jaya Rao (Bull.Nutr. Found. Ind. Oct. 1985 and Jan.

1986) points out after an analysis ofNNMB data, "urban migration has appa­rently nof helped (the rural poor) toachieve a better food intake". Dr Srikan­

tia's paper draws attention to this impor­tant finding. Considering the distressinggrowth of urban slums, these observa­tions will call for greater attention tourban poverty and urban undernutrition.

• The NNMB urban study, despite itssmall sample size, has provided an indi­cation of the order of disparities in bodysize as between different socio­

economic groups. These data are astriking demonstration of the magnitudeof prevailing inequalities in the country.Thus, for example, while the averagebody weight of the 25-30 year old (thepeak productivity period) male adults ofthe high income group (HIG) is 55.5 kg,that of the low income group (L1G)maleadults of the same age group is 51.8 kgand of the industrial labourer (IL) 50.6kg. The HIG subjects are on the average3.5 cms taller than L1Gand 3.9 cms tai­

ler than the IL. The corresponding fi­gures for body weights of females of thesame age group in the three socio­economic categories are 50.9 kg (HIG),43.7 kg (L1G),and 44.4 kg (IL).

It would thus appear that in the pre­sent order it is precisely that section ofthe population which has to depend forits livelihood on manual labour andwhich, therefore, has to have a sturdybody build (productivity often being afunction of the body size), that ends upas the one with the poorest body size.Perhaps it will be more appropriate tosay that it is generally only those whoare born to poverty and attendant depri­vations that end up with poor body size,poor attainments and low productivityand are able to secure only jobs with lowincome (manual or unskilled labour)which keep them poor. We have herethe vicious cycle, the "Poverty Trap":Poverty-undernutrition-stunting, poor at­tainments, poor productivity-low incomeoccupation-poverty. Kamala Jaya Rao(IDe. eit) also refers to the fact thatNNMB urban data reveal little evidenceof lateral (upward) mobility among diffe­rent social classes. The cruel irony of the"Small is Healthy (for the poor?)"slogan

thus stands exposed. Though we do nothave precise data, it seems most un­likely that the Norwegian fishermen orthe Canadian lumbermen are puny andof poorer body size in comparison toprofessional classes and commercialexecutives of their respective countries.

• As Dr. Srikantia has mentioned,NNMB surveys provide data on bodyweights and heights of adults (in fact ofall age groups in the regions surveyed. Itis amazing that currently data from othersources covering adult (both male andfemale) population groups across thecountry are hard to come by. In courseof time, NNMB data could provide infor­mation on secular trends with respect tobody size including the effect of ageing.

It can be estimated on the basis of the

currently available data on body weightsand heights of rural women in the repro­ductive age period in different states sur­veyed that the percentage of womenlikely to fall in the 'at risk during preg­nancy' category on the basis of interna­tionally accepted WHO criteria (lessthan 145 cm height .and 38 kg bodyweight) would roughly work out to about20 percent to 25 percent (C. Gopalan:Bull. Nutr. Found. Ind. Jan. 1985). It isnot surprising that nearly a third of allbabies born in the country are of lowbirth weight, and that quite a good chunkof IMR is accounted for by neonatal mor­tality.

• NNMB data do not support the'popular' view that girls in poor house­holds are subjected to greater degreesof nutritional deprivation than boys. It isnot denied, however, that they are at adistinct disadvantage with respect to op­portunities for education and vocationaltraining especially in rural homes. Aproper reading of NNMB's observationwill lead to the conclusion that in the

matter of promoting the cause of the "girlchild", priority must lie in providing bettereducational opportunities and better op­portunities for vocational training so thatthe current appalling female illiteracy isreduced and women gain economicstrength; and not in trying to teach thepoor mother as to how she should goabout dividing her meagre family rationbetween her boy and girl! Our attemptmust be to ensure that there is enoughfood in the family to feed bothadequately. Evidences of growth retar­dation (in case of children), and evi­dences of substandard body weights (incase of adults) exist in both sexes to anearly similar extent.

We can add more examples of policyleads provided by NNMB data, but as

Visible fat consumption % of households(g/CU/day)

Source: NNMB Reports (1975-1981)

Based on surveys conducted in rural areas in 10states. Average intake per CU is 8.6 g.

Table-II

Percentage frequency distribution ofhouseholds according to consumption

level of visible fat (g ICU/day)(All states pooled)

respect to edible oils - with this impor­tant difference that the real victims of (orsufferers from) such distributive injusticein the case of fat intake are the affluentand not the poor - a case of poetic jus­tice born out of blatant distributive injus­tice!

463522

23

13

Fats andoil

214.0165.093.0

108.056.0

PCI'Rs. per month

Health hazards: There has been an

alarming increase in the incidence ofcoronary heart disease among oururban populations in recent years. Itmay be an over-simplification to suggest

population (20 percent of the urbanpopulation) who constitute the "urban-rich"

This roughly works out to the figure ofper caput availability of edible fat of theorder of 125-130 g daily for the "over­affluent". However, this calculation doesnot allow for possible wastages - in­

cluding considerable table wastes thatare known to occur especially amongthe affluent and are part of their culture

of conspicuous consumption (as wed­ding feasts and parties at five-star hotelswill bear ample testimony)

Unfortunately, the latest figures foredible fat consumption by different ex­penditure categories of the NationalSample Survey Operation (NSSO) arenot available. However, the 1972-73NSSO round had estimated that the per

caput fat consumption in the top expen­diture bracket (above Rs. 200 per caputper mensem) was 139 9 daily.

The above estimates of fat intake bythe affluent must be checked and vali­dated by direct diet measurements.Some ongoing studies may provide thisevidence. It seems quite possible that fatintakes, allowing for wastages, exceed100 g daily in about five percent of ourtotal population - the rich and nouveaurich who live mostly in urban areas. Inthese dietaries, fat thus could easily ac­count for more than 30 percent of totaldietary calories. The high fat intake inthese rich groups may be expected to bemade up of edible oil and ghee (clarifiedbutter). These very subjects are alsothose who are generally engaged insedentary occupations. From all that wenow know, these are the candidateseminently likely to qualify in increasingmeasure to coronary heart disease.

Table-IIIAverage intake of fat (g /CU/day)

in different socio-economic groups (urban)

Socio-economic

groups

High income groupMiddle income groupLow income groupIndustrial labourSlum dwellers

, per capita incomeSource: NNMB - Urban (1975-1981)

Urban areas: In Table III, NNMB datawith respect to consumption of fat in dif­ferent socio-economic groups of theurban population are presented. It mustbe noted that the top-most income brac­ket captured in the NNMB urban opera­tion - the so-called "high income

groups" - have average income levelsof no more than Rs. 1,000 per mensemper family - a level which even at 1975­79 prices, cannot be considered as re­flecting "real" high income. It will bereasonable to assume that even at the1975-79 prices, the average per men­sem family income level of around 20percent of the urban population wouldhave exceeded RS.1,000. We do nothave any hard evidence for this (and inany case real incomes, specially of thevery rich are difficult to compute); buteven so, this appears to be a reasonableestimate, not likely to be very much wideoff the mark.

We do not also have precise figuresfor the distribution of urban populationsin the different income occupation

categories mentioned in the NNMBurban survey. If we assume that allcategories surveyed by NNMB in itsurban study represent 80 percent of theurban population and that their averagedaily intake of edible fat per CU is of theorder of 28 g (ranging from 13 g in theslum dweller to 46 g in the "high incomegroup") we can conclude that around 35percent of the available edible fat in thecountry is being consumed by these dif­ferent income/occupation categoriesrepresenting 80 percent of the urbanpopulation in the NNMB urban survey.

If, going by the above estimates, 25percent of all available edible fat in thecountry is consumed by the rural popula­tion and an additional 35 percent of av­ailable fat by the "not-so-rich" urbanpopulation, we are led to the conclusionthat 40 percent of all edible fat currentlyavailable in the country is being con­sumed by just five percent of our total

17.121.521.313.27.34.53.72.62.11.51.04.2

100.0

Nil<44+8+

12+16+20+24+28+32+36+40+

Total

finitive conclusions regarding precise in­take levels but indicators of trends ofconsumption in poor rural householdswhich could account for more thanthree-fourths of our population. It will benoticed from these data that in over 17percent of poor rural households, dietsdo not include any edible oils at all. It canbe calculated that at the reported levelsof intake, consumption in rural house­holds can account for just about one­fourth of the total available edible fat in

the country. This would imply that nearly75 percent of edible fat available in thecountry is being consumed by the 25percent of the population living mostly inurban areas.

Rural areas: In Table II we presentdata, as provided by the NNMB with re­spect to intake of edible oils in the ruralpopulations covered in the NNMB sur­veys. NNMB surveys admittedly coversmall numbers of rural households in 10states of the country and the data pre­sented pertain to a five-year period.Conclusions based on the extrapolationof data derived from such a small sam­

ple size may not be justified; but thenwhat we are attempting here are not de-

that such increase is directly (or perhapseven predominantly) related to exces­sive fat consumption; but excessive fatconsumption is certainly an important at­titude of the lifestyle of that affluent sec~tion of our urban population, whichseems to be specially intolerable. Whilein the U.S.A. and Europe, vigorous ef­forts at reducing intake of dietary fat arebeginning to yield results in the form ofreduction in the incidence of heart dis­ease, in India our major national effortseems to be confined - at least for the

present - to augmenting our availabilityof dietary fat. A recent study byGopinath and colleagues (N. Gopinath:R.J. Vakil Memorial Award Oration­1987) showed that on the basis of clini­cal examination and ECG, the approxi­mate prevalence rate of coronary heartdisease in urban Delhi was 7.3 percentmeaning that there were at least2,19,000 subjects currently sufferingfrom the disease among the 30 lakh ofurban population in the age group 25-64years. It was also estimated that annu­ally at least 8,100 new cases were beingadded to this number. It was also ob­served that most subjects with estab­lished evidence of coronary heart dis­ease belonged to the higher incomebrackets of the urban population. Datafrom the rural environs of Delhi are still

being analysed but the preliminary indi­cations are that the problem in ruralareas is of relatively insignificant propor­tion the prevalence rate being just aboveone-sixth of the urban.

Whom does the Technology Mis­sion benefit: The question that arisesthen is: whom does the Technology Mis­sion for augmentation of production of oilseeds and of edible oil benefit? Certainlynot the poor because in any case, asmatters now stand, they cannot buy theoil; indeed 40 percent of them cannoteven buy the less expensive cereals inamounts that they need to meet theirbare energy requirement. It will help therich to satisfy their 'wants', but certainlynot to ensure their better health. It may,to a certain extent, help the urban middleclasses to obtain some edible oils to

meet their modest needs. It may help tosave foreign exchange by cutting downimports if indigenous production is in factstepped up. It may thus improve India'soverall economic position to some ex­tent. Oil-seed meals can no doubt aug­ment available protein food resourcesand can find several important uses, butwe suspect a good part of it is being ex­ported as cattle feed to Europe.

It seems, however, unlikely that aug­mentation of edible oil availability, giventhe present inequalities in distribution,will help solve any of our current majorhealth and nutritional problems.

We are not arguing against the au­gmentation of oil seed production. Weemphasise that such a programme willbe meaningful only if simultaneous vig­orous attempts are instituted (as an in­tegral part of the same Mission) to:

• Reduce current glaring inequalitieswith respect to availability and consump­tion of edible oil as between rural andurban areas. Fair price shops whichexist only on paper in rural areas mustbecome functional. The possibility ofmaking edible oil available to poor rationcard-holders must not be confined to

urban metropolitan areas only.• There must be an intensive prog­

ramme of health education beamed to

the new-rich highlighting the dangers ofexcessive consumption of fat. A level offat which provides anything more than20 percent of total calories should beconsidered as clearly unnecessary andunhealthy; in fact, it may be prudent toaim at keeping edible oil intake down toless than 40 g per CU per day, sinceapart from edible oil there are othersources of fat in the diet. This must alsobecome part of the "health education"programme in schools which cater to thechildren of the affluent, because dietaryhabits ingrained in childhood are hard tochange and in any case much of thedamage may already be done in child­hood and adolescence.

We must learn from the mistakes of

the technologipally developed countriesof the West. It will be far better to start

now on an intensive programme de­signed to educate the affluent (and theirchildren) to restrict their fat intake than towait for the problems arising from exces­sive fat intake to reach even more alarm­ing proportions than at present.

NUTRITIONNEWS

The XXI Annual Meeting of the Nutri­tion Society of India will be held onNovember 24-25, 1988 at the NationalInstitute of Nutrition, Hyderabad. On thisoccasion, symposia and special lectureswill be arranged on the following sub­jects:Symposium- I: "Lipids in Nutrition"

Symposium : "Drought ands Nutri­tion"

Special Lecture- I: "B-Carotenes"Special Lecture-II: "Riboflavin Carrier

Protein"

Awards for best papers in CommunityNutrition and Experimental Nutrition re­spectively will be presented to youngscientists below 40 years of age. Detailsregarding these awards may be ob­tained from the Secretary, Nutrition Soc­iety of India, National Institute of Nutri­tion, Hyderabad.

Joint Meeting of Indian Academy ofPaediatrics (Andhra Pradesh StateChapter) and Nutrition Society ofIndia: Under the joint auspices of thesetwo bodies, an up-date session on"Child Nutrition" will be organised at theNational Institute of Nutrition,Hyderabad, on September 23-24, 1988.Details regarding the meeting may beobtained from Dr. Vinodini Reddy, Or­ganising Secretary, National Institute ofNutrition, Hyderabad.

Awards and Prizes

Dr. K.T. Achaya, current Vice-Presi­dent of the Nutrition Society of India re­ceived the J.G. Kane Memorial Award;

Dr. B.S. Narasinga Rao, Director, Na­tional Institute of Nutrition was awardedthe P.S. Rama Rao Memorial Award bythe Society of Biological Chemists ofIndia;

Dr. M.S. Bamji, Director-Grade-Scien­tist, National Institute of Nutrition,Hyderabad, received the B.C. GuhaMemorial Lecture Award of the Indian

National Science Academy;Dr. Vinodini Reddy, Director-Grade­

Scientist, National Institute of Nutrition,Hyderabad, received the J.B. ChatterjeeOration Award of the Calcutta School ofTropical Medicine;

Dr. A.K. Susheela of the Departmentof Anatomy, All India Institute of MedicalSciences, received the Ranbaxy Awardfor her work on fluorosis; and

The Sir C.V. Raman Gold Medal for1988 has been awarded by the IndianNational Science Academy to Dr. C.Gopalan. 1988 happens to be the birthcentenary year of Sir C.V. Raman andalso marks the Diamond Jubilee of thediscovery of the Raman Effect.

Announcement

Integrated Child Development Service(ICDS) - A Study of Some Aspects ofthe System; NFl SCientific Report7has'just been pubUshed.

Edited by N. Madhuri for the Nutrition Foundation of India, B-37. Gulmohar Park. New Delhi. Designed and produced by Media Workshop. Typeset al FOlotype.