Malnutrition is ‘a pathological state resulting from a relative or absolute deficiency/excess of one or more essential nutrients’. It is of four types: (a) under nutrition, (b) over nutrition, (c) imbalance, and (d) specific deficiency. In India under nutrition is more common than other types of malnutrition. It is mainly because an average Indian has fewer intakes of calories than his actual requirement. An average Indian needs about 2357 calories per day to keep his body in a healthy state, but he gets only 1945 calories.
About 30 percent of the people, living below the poverty line, get less than 1700 calories, about 40 per cent get between 1780 and 2300 calories, and the remaining 30 per cent get 2300 calories or more. What is most disturbing is the gradual decline in the availability of ‘pulses and oil seeds which are the major source of protein and fats in the country, especially for poor people. The inadequate consumption of protective foods like meat, milk, fruits and vegetables shows the low nutritive value of the Indian diet.
In the Indian diet about two-third of the calories come from the cereal foods, the remainder being obtained from sugars, fats, oils and meat. Bajra and gram are the popular staples in the dry regions of the country and for the poor people, while wheat and rice are common staples in the major portion of the country. Studies in Maharashtra in the 1960s showed that the poor people consumed only 1120 calories. According to P. V. Sukhatme (1965) about one-third or one-fourth of our people has too little food.
At state-level only Punjab and Haryana have satisfactory position. In general the well-fed states are those where a wheat diet predominates together with a more in South than in the North. The Tamil Nat Nutrition Study by Sidney M. Cantor Associateslil (1973) found half the families in the State below required limit of calories. On an average young pregnant or lactating woman got only 60 per cent J their calorie needs. That the small children suffer/ supported by the finding that out of 1000 live birth only 555 survive to be six (Johnson, 1980, p.28).
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Malnutrition leads to nutritional disorders in different parts of the country. This exposes the population to various deficiency diseases. Goiter, arising from the deficiency of iodine is a major health problem along the sub-Himalayan belt. Lathyrism, a disabling paralytic disorder, caused by the excessive consumption of khesari dal, is endemic in Central India, Madhya Pradesh, eastern Uttar Pradesh and adjoining parts of Bihar.
This high level of protein intake. The jowar, bajra and ragi eaters, supplementing their millet with wheat or rice as the case may be, come in the middle, with the rice eating states at the bottom of the list. The consumption of pulses, which is the major source of vegetable protein in the Indian diet, is lower in the southern states in comparison to the northern and central states. Hence, protein calorie malnutrition is pulse, being cheaper, is the main item of food of the poor people in these areas.
Similarly skeletal flourish, a crippling disorder and to excessive consumption of fluoride in water is endemic in parts of Andhra Pradesh and Punjab. Pellagra, deficiency of nicotinic acid, is peculiar to the Deccan plateau where jowar forms the staple food. Similarly there are a number of diseases and physical disorders which are caused by under-nourishment or semi-nourishment die tuberculosis is very common in economically weaker section of the society. Several diseases due to vitamin deficiency is taking heavy toll of the lives of the people, especially in the lower strata of the society. Incidence of AIDS is increasing in the families of highway truck drivers and labourers.
Since malnutrition is the outcome of several factors, the problems can be solved only by taking action simultaneously at various levels-family, community and national levels. It requires a coordinated approach of many disciplines-nutrition, food technology, health administration, health education, population control, marketing, etc. At family level nutrition education can yield maximum success. Both husband and wife need to be educated on the selection of right kinds of local foods and in the planning of nutritionally adequate diets within the best limits of their purchasing power.
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Attention should also be focused on the nutritional needs of expectant and nursing mothers and children in the family. Similarly package of mother and child health, family planning and immunization services, etc are other related activities at the family level.
The community level strategy should include the analysis of the nutrition problems in terms of: (a) the extent, distribution and types of nutritional deficiencies, (b) the population groups at risk, and (c) the dietary and non-dietary factors contributing to malnutrition. It may include such measures like midday school meals, applied nutrition programme and integrated child development services (ICDS) programme.
The national level strategy should be aimed at increasing the agricultural production, stabilization of population, control of epidemics and diseases, and improving peoples’ health.