Malnutrition ails urban India too

When Alankriti and Ashwini Jain welcomed their baby girl in 2015, they vowed to give her the best. “We had been married for four years and longed for a child. We now wanted to ensure Tridha would receive all she needs for a healthy life,” says Answini, an engineer from IIT-Kharagpur, who runs a ceramics company.

“We would feed her what our elders advised and what we thought was ideal for her,” Ashwini says.

However, Jains were soon to learn that malnutrition is not simply about lack of access to food but lack of right feeding, too.

Tridha’s weight was low for her age. She’d fall ill frequently and catch infections. While no doctor flagged off nutrition as an issue, when Tridha was 16 months old, a family friend suggested they see a malnutrition expert.
Though initially reluctant to consider it, when the couple eventually went over their daughter’s diet with the doctor, it was an eye-opener, they say.

Dr Rupal Dalal of the Foundation of Mother and Child Health (FMCH) who saw Tridha, says, “The child was stuck in a malnutrition cycle due to constant infections. Being severely underweight is not the only indication of malnutrition but catching infections, being very irritable and cranky also suggest that the child is missing micro-nutrients.”

Tridha was eating mashed food well after her first birthday, and Dr Dalal diagnosed her with Type-2 nutrition deficiency. “It could be protein, amino acids, essential fatty acids or zinc. There is no way to tell for sure unless you do a muscle biopsy but based on her diet pattern, I figured she was deficient in zinc. When I first met her she would not even make eye contact. She was very irritable,” Dr Dalal says.

According to Dr Dalal, such cases of malnutrition in urban India are increasingly coming to notice. Junk food, sweet drinks and biscuits are a strict no-no for children. In case of most well-to-do families, the organic food fad is often an undoing, she says.

“I once saw a five-year-old from Bangalore who weighed only 12 kg, an ideal weight of a two-year-old. He was given organic food but his diet was missing in grains and proteins,” she says.

Children must be given protein in the form of nuts and germinated pulses, she stresses. “We have also forgotten the nutrient-value of seeds such as pumpkin, and how simple germination raises micro-nutrients in food,” she says.

Tridha went from 8 kg to 12 kg in a month-and-half with changes to her diet. She was not given any medicines. Once her meals were supplemented with zinc in the form of cashew paste, her appetite soared. 

The doctor also recommended that Tridha take five meals (solid foods) a day, along with germinated beans power and curry leaves powder mixed in her food.

“We are vegetarians but the doctor convinced us to introduce her to eggs to make up for the deficiency. We also started giving her dry fruit paste during meals, which she relishes,” says Alankriti.

In other news

93 lakh kids suffer from SAM
According to the Central Government’s data released in March 2017, over 93.4 lakh children in India suffer from have severe acute malnutrition (SAM).
India has 966 Nutritional Rehabilitation Centres (NRCs) in 25 states and union territories that need to be mobilised to tackle the issue. As per the latest survey, 10 per cent of SAM children might need admission to the NRCs. In 2015-16, 1.7 lakh children enrolled at NRCs of which close to 92 thousand recovered.

Understanding malnutrition 

Malnutrition type 1: Vitamin and mineral deficiencies like Vitamin A and D or calcium and iron. It’s symptomatic and can be measured in the blood
Type 2: Deficiency of micro-nutrients required for every metabolic process. If the body is short of them, it converts muscle to nutrients, making the child listless and irritable