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Current Nutrition & Food Science

Editor-in-Chief

ISSN (Print): 1573-4013
ISSN (Online): 2212-3881

Review Article

Malnutrition: A Longstanding Challenge in India

Author(s): Ritu Saini* and Meenakshi Bajpai

Volume 20, Issue 9, 2024

Published on: 08 December, 2023

Page: [1069 - 1085] Pages: 17

DOI: 10.2174/0115734013280207231120061242

Price: $65

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Abstract

According to the World Health Organization, “malnutrition is the “deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients”. Indian population has the highest rate of adolescent malnutrition. Deficiency, Illness, Small level of education, and a range of other factors contribute to India's malnutrition crisis. Undernutrition, micronutrient deficiency conditions, and overnutrition are all forms of malnutrition. A malnourished always lags in every aspect of life which will eventually affect the productivity of the country. In the 2023 Global Hunger Index, India is positioned at 111th among 125 countries, reflecting a serious level of hunger with a score of 28.7. India is grappling with a substantial population affected by anemia, malnutrition, and obesity. Other than this Indian population is also affected by several other micronutrient deficiencies. The present article provides an overview of the triple burden of malnutrition in India by applying the literature review method and the data were collected from online sources such as government survey reports, articles, and publications related to nutrition, healthcare status, healthcare indicators, nutritional indicators, and healthcare survey reports, etc. A brief introduction of the strategies followed by the Government as well as global health organisations to combat the issue is also discussed.

Keywords: Malnutrition, undernutrition, micronutrient, deficiency, overweight, obesity.

Graphical Abstract
[1]
levels and trends s a d tr in child malnutrition 2017. https://www.who.int/nutgrowthdb/jme_brochoure2017.pdf?ua=1 (Accessed 17thApril, 2020).
[2]
Saunders J, Smith T. Malnutrition: Causes and consequences. Clin Med 2010; 10(6): 624-7.
[http://dx.doi.org/10.7861/clinmedicine.10-6-624] [PMID: 21413492]
[3]
Kamalapur SM, Reddy S. Women health in India: An analysis Res J Social Sci 2013; 2(10): 2319-3565.
[4]
National Family Health Survey (NFHS-4) 2015-16: India Available from: https://ruralindiaonline.org/en/library/resource/national-family-health-survey-nfhs-4-2015-16-india/ (accessed Jan. 21, 2022).
[5]
Chakravorty S, Manisha . Data analysis of malnutrition in India: A review of numerous factors. Int J Community Med Public Health 2023; 10(7): 2629-36.
[http://dx.doi.org/10.18203/2394-6040.ijcmph20232064]
[6]
Howard D, Wiesmann D, Sost AK, Schoeninger I. The challenge of hunger 2007: Global Hunger Index: Facts, determinants, and trends 2007; 1-59.
[7]
India. Ministry of human resource development. New Delhi, National nutrition policy 1993. Available from: https://wcd.nic.in/sites/default/files/nnp_0.pdf (accessed Jan. 21, 2022).
[8]
Jiang S, Sung J, Sawhney R, et al. The determinants of growth failure in children under five in 25 low- and middle-income countries. J Glob Health 2023; 13(04077): 04077.
[http://dx.doi.org/10.7189/jogh.13.04077] [PMID: 37539855]
[9]
Hemalatha R, Pandey A, Kinyoki D, et al. Mapping of variations in child stunting, wasting and underweight within the states of India: The Global Burden of Disease Study 2000–2017. EClinicalMedicine 2020; 22(100317): 100317.
[http://dx.doi.org/10.1016/j.eclinm.2020.100317] [PMID: 32510044]
[10]
Khan A, Ubale PV, Sajid M. A study on hunger situation in India through formulation of India state hunger using PCA. Prog Res An Intern J 2021; 16(2): 130-4.
[11]
Global nutrition 2016: from promise to impact: ending malnutrition by 2030. Washington, DC: IFPRI 2016.
[12]
Zero Hunger: Report, national geographic. Available at: https://education.nationalgeographic.org/resource/su Accessed 12 October 2023.
[13]
The CSR Journal 2020. Available at: https://thecsrjournal.in/india-global-malnutritionreport-2020/ Accessed 12 October 2023.
[14]
Kellett J, Kyle G, Itsiopoulos C, Naunton M, Luff N. Malnutrition: The importance of identification, documentation, and coding in the acute care setting. J Nutr Metab 2016; 2016: 1-6.
[http://dx.doi.org/10.1155/2016/9026098] [PMID: 27774317]
[15]
Katoch OR. Determinants of malnutrition among children: A systematic review. Nutrition 2022; 96: 111565.
[http://dx.doi.org/10.1016/j.nut.2021.111565] [PMID: 35066367]
[16]
Grantham-McGregor S. A review of studies of the effect of severe malnutrition on mental development J Nutr 1995; 125(suppl_8): 2233S-8S.
[http://dx.doi.org/10.1093/jn/125.suppl_8.2233S]
[17]
Ghosh S. Factors responsible for childhood malnutrition: A review of the literature. Curr Res Nutr Food Sci 2020; 8(2): 360-70.
[http://dx.doi.org/10.12944/CRNFSJ.8.2.01]
[18]
Mishra CP. Malnutrition-free India: Dream or reality. Indian J Public Health 2017; 61(3): 155-62.
[http://dx.doi.org/10.4103/ijph.IJPH_217_17] [PMID: 28928297]
[19]
Kumar M, Mohanty P. Does maternal overnutrition carry child undernutrition in India? PLoS One 2022; 17(6): e0265788.
[http://dx.doi.org/10.1371/journal.pone.0265788] [PMID: 35714070]
[20]
Preventing Hunger and Malnutrition in India. Observer Res Found 2017; (182): 12.
[21]
Isanaka S, Andersen CT, Cousens S, et al. Improving estimates of the burden of severe wasting: Analysis of secondary prevalence and incidence data from 352 sites. BMJ Glob Health 2021; 6(3): e004342.
[http://dx.doi.org/10.1136/bmjgh-2020-004342] [PMID: 33653730]
[22]
Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Paediatr Int Child Health 2014; 34(4): 250-65.
[http://dx.doi.org/10.1179/2046905514Y.0000000158] [PMID: 25310000]
[23]
Dasgupta R, Sinha D, Yumnam V. Rapid survey of wasting and stunting in children: What’s new, what’s old and what’s the buzz? Indian Pediatr 2016; 53(1): 47-9.
[http://dx.doi.org/10.1007/s13312-016-0790-7] [PMID: 26840673]
[24]
Gillespie S, Harris J, Nisbett N, van den Bold M. Stories of change in nutrition from Africa and Asia: An introduction to a special series in food security. Food Secur 2021; 13(4): 799-802.
[http://dx.doi.org/10.1007/s12571-021-01166-8] [PMID: 33976750]
[25]
Webb P, Stordalen GA, Singh S, Wijesinha-Bettoni R, Shetty P, Lartey A. Hunger and malnutrition in the 21st century. BMJ. 2018; 361.
[26]
Mark HE, Dias da Costa G, Pagliari C, Unger SA. Malnutrition: The silent pandemic. BMJ 2020; 371: m4593.
[http://dx.doi.org/10.1136/bmj.m4593] [PMID: 33262147]
[27]
de Onís M, Monteiro C, Akré J, Glugston G. The worldwide magnitude of protein-energy malnutrition: An overview from the WHO Global Database on Child Growth. Bull World Health Organ 1993; 71(6): 703-12.
[PMID: 8313488]
[28]
Global Nutrition Report, Introduction - Global Nutrition Report. Available from: https://globalnutritionreport.org/reports/global-nutrition-report-2018/introduction/ (accessed Jan. 21, 2022).
[29]
Viswaroopan D, GR A R, U S, Mallannavar V, S L P. Undernutrition in children: an updated review. Int J Res Ayurveda Pharm 2017; 8(2): 13-8.
[http://dx.doi.org/10.7897/2277-4343.08275]
[30]
Maleta K. Nutrition and metabolism. In: Lanham-New SA, Macdonald IA, Roche HM, Eds. Malawi Med J 2010; 18(4): 378-86.
[http://dx.doi.org/10.1002/9781444327779.ch17] [PMID: 27529011]
[31]
Mathad V, Shivprasad S. Malnutrition: A Daunting Problem for India’s Spectacular Growth. 2013.
[32]
Malnutrition in children - Unicef data. Available from: https://data.unicef.org/topic/nutrition/malnutrition/ (accessed Jan. 21, 2022).
[33]
Narayan J, John D, Ramadas N. Malnutrition in India: Status and government initiatives. J Public Health Policy 2018; 1-17.
[http://dx.doi.org/10.1057/s41271-018-0149-5] [PMID: 30353132]
[34]
Puri P, Khan J, Shil A, Ali M. A cross-sectional study on selected child health outcomes in India: Quantifying the spatial variations and identifcation of the parental risk factors. Scientific Reports Nature research. 2020; 10: pp. 6645-16.1-16.
[http://dx.doi.org/10.1038/s41598-020-63210-5]
[35]
Singh SK, Chauhan A, Sharma SK, et al. Cultural and contextual drivers of triple burden of malnutrition among children in India. Nutrients 2023; 15(15): 3478.
[http://dx.doi.org/10.3390/nu15153478] [PMID: 37571415]
[36]
Singh A. Childhood malnutrition in India. Perspective of Recent Advances in Acute Diarrhea 2020.
[http://dx.doi.org/10.5772/intechopen.89701]
[37]
Ewune HA, Abebe RK, Sisay D, Tesfa GA. Prevalence of wasting and associated factors among children aged 2–5 years, southern Ethiopia: a community-based cross-sectional study. BMC Nutr 2022; 8(1): 160.
[http://dx.doi.org/10.1186/s40795-022-00657-x] [PMID: 36585708]
[38]
Malnutrition. Fact sheets - Malnutrition 2021. Available from: who.int (Accessed Oct. 15, 2023).
[39]
Global Hunger Index 2023: India Available from: India - Global Hunger Index (GHI) - peer-reviewed annual publication designed to comprehensively measure and track hunger at the global, regional, and country levels (Accessed Oct. 15, 2023)
[40]
Levels and trends in child malnutrition 2023. Available from:. UNICEF-WHO-The World Bank: Joint Child Malnutrition Estimates (JME) — Levels and Trends – 2023 edition - UNICEF DATA (Accessed Oct. 15, 2023).
[41]
National Family Health Survey (NFHS-5) 2019-21: India Available from:.” National Family Health Survey (NFHS-5) (rchiips.org) (Accessed Oct. 15, 2023).
[42]
Indicators Available from: https://www.who.int/data/gho/data/indicators(accessed Jan. 21, 2022).
[43]
Nuttall FQ. Body mass index. Nutr Today 2015; 50(3): 117-28.
[http://dx.doi.org/10.1097/NT.0000000000000092] [PMID: 27340299]
[44]
Zierie-Ghosh A, Jan A. Physiology, Body Mass Index 2023. Treasure Island [FL]: StarPearls https://www.ncbi.nlm.nih.gov/books/NBK535456/ (accessed Sep. 11, 2023).
[45]
Global Nutrition Report, The burden of malnutrition - Global Nutrition Report. Available from: https://globalnutritionreport.org/reports/global-nutrition-report-2018/burden-malnutrition/ (accessed Jan. 21, 2022).
[46]
Dietary Guidelines for Indians - A Manual National Institute of Nutrition. Hyderabad 1998; 500.(7)
[47]
Sight and life magazine, sight and life magazine: Double burden of malnutrition by sight and life - issuu. Available from: https://issuu.com/sight_and_life/docs/sightandlifemagazine_doubleburden_2 (accessed Jan. 21, 2022).
[48]
Klassen-Wigger P, Geraets M, Messier MC, Detzel P, Lenoble HP, Barclay DV. Micronutrient fortification of bouillon cubes in central and west Africa Food Fortification in a Globalized World. 2018; pp. 363-72.
[http://dx.doi.org/10.1016/B978-0-12-802861-2.00039-0]
[49]
Schiavo L, Scalera G, Barbarisi A. Micronutrient deficiencies and sleeve gastrectomy for weight reduction, metabolism and pathophysiology of bariatric surgery: Nutrition. Procedures, Outcomes and Adverse Effects. 2017; pp. 469-77.
[http://dx.doi.org/10.1016/B978-0-12-804011-9.00035-2]
[50]
Pasquale A. The Role of Nutrition in achieving hormonal balance in women. Horizons- Intern Scient J. 2022; 31: pp. (2)365-76.
[http://dx.doi.org/10.20544/HORIZONS.A.31.2.22.P28]
[51]
Dance A, Thundathil J, Wilde R, Blondin P, Kastelic J. Enhanced early-life nutrition promotes hormone production and reproductive development in holstein bulls. J Dairy Sci 2015; 98(2): 987-98.
[http://dx.doi.org/10.3168/jds.2014-8564] [PMID: 25497791]
[52]
Bertucci JI, Blanco AM, Sundarrajan L, Rajeswari JJ, Velasco C, Unniappan S. Nutrient regulation of endocrine factors influencing feeding and growth in fish. Front Endocrinol 2019; 10(83): 83.
[http://dx.doi.org/10.3389/fendo.2019.00083] [PMID: 30873115]
[53]
Nutrition Available from: https://www.who.int/health-topics/nutrition (accessed Jan. 21, 2022).
[54]
Norman HA, Butrum RR, Feldman E, et al. The role of dietary supplements during cancer therapy. J Nutr 2003; 133(11) (Suppl. 1): 3794S-9S.
[http://dx.doi.org/10.1093/jn/133.11.3794S] [PMID: 14608116]
[55]
Masri OA, Chalhoub JM, Sharara AI. Role of vitamins in gastrointestinal diseases. World J Gastroenterol 2015; 21(17): 5191-209.
[http://dx.doi.org/10.3748/wjg.v21.i17.5191] [PMID: 25954093]
[56]
Said HM, Nexo E. Mechanisms and regulation of intestinal absorption of water-soluble vitamins. Physiology of the Gastrointestinal Tract 2012; 2: 1711-56.
[http://dx.doi.org/10.1016/B978-0-12-382026-6.00064-6]
[57]
Rastmanesh R, Kaynar P, Rastmanesh R. Biochemical functions of micronutrients. Advances in Obesity, Weight Management & Control 2017; 6(2): 43-5.
[http://dx.doi.org/10.15406/aowmc.2017.06.00147]
[58]
Oregon. Oregon State University. Corvallis, “Micronutrients for Health,” Linus Pauling Institute 2016. Available from: https://lpi.oregonstate.edu/sites/lpi.oregonstate.edu/files/pdf/mic/micronutrients_for_health.pdf
[59]
Fiorentino M, Landais E, Bastard G, Carriquiry A, Wieringa F, Berger J. Nutrient intake is insufficient among senegalese urban school children and adolescents: Results from two 24 h recalls in state primary schools in Dakar. Nutrients 2016; 8(10): 650.
[http://dx.doi.org/10.3390/nu8100650] [PMID: 27775598]
[60]
cdc, “Micronutrient Facts | Nutrition | CDC Available from: https://www.cdc.gov/nutrition/micronutrient-malnutrition/micronutrients/index.html(accessed Jan. 21, 2022).
[61]
Jimenez K, Kulnigg-Dabsch S, Gasche C. Management of iron deficiency anemia. Gastroenterol Hepatol 2015; 11(4): 241-50.
[PMID: 27099596]
[62]
Stevens GA, Finucane MM, De-Regil LM, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health 2013; 1(1): e16-25.
[http://dx.doi.org/10.1016/S2214-109X(13)70001-9] [PMID: 25103581]
[63]
Hatch-McChesney A, Lieberman HR. Iodine and iodine deficiency: A comprehensive review of a re-emerging issue. Nutrients 2022; 14(17): 3474.
[http://dx.doi.org/10.3390/nu14173474] [PMID: 36079737]
[64]
Eastman C J, Zimmermann M B. The Iodine Deficiency Disorders Endotext. South Dartmouth (MA): Feingold KR, Anawalt B, Blackman MR, et al., editors 2018.
[65]
Chaouki ML, Benmiloud M. Prevention of iodine deficiency disorders by oral administration of lipiodol during pregnancy. Eur J Endocrinol 1994; 130(6): 547-51.
[http://dx.doi.org/10.1530/eje.0.1300547] [PMID: 8205252]
[66]
Zimmermann MB. Iodine deficiency. Endocr Rev 2009; 30(4): 376-408.
[http://dx.doi.org/10.1210/er.2009-0011] [PMID: 19460960]
[67]
Zimmermann MB, Molinari L, Spehl M, et al. Toward a consensus on reference values for thyroid volume in iodine-replete schoolchildren: Results of a workshop on inter-observer and inter-equipment variation in sonographic measurement of thyroid volume. Eur J Endocrinol 2001; 144(3): 213-20.
[http://dx.doi.org/10.1530/eje.0.1440213] [PMID: 11248739]
[68]
Dworkin HJ, Jacquez JA, Beierwaltes WH. Relationship of iodine ingestion to iodine excretion in pregnancy. J Clin Endocrinol Metab 1966; 26(12): 1329-42.
[http://dx.doi.org/10.1210/jcem-26-12-1329] [PMID: 5959526]
[69]
ELLIS S M, EKINS R P, WILLIAMS E S. Maternal thyroid function, iodine deficiency and fetal development. Clin Endocrinol 1976; 5(2): 159-66.
[http://dx.doi.org/10.1111/j.1365-2265.1976.tb02827.x] [PMID: 1269162]
[70]
Zimmermann MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: A review. Am J Clin Nutr 2009; 89(2): 668S-72S.
[http://dx.doi.org/10.3945/ajcn.2008.26811C] [PMID: 19088150]
[71]
Kapil U, Sareen N, Nambiar VS, Khenduja P, Sofi NY. Iodine nutritional status among adolescent girls in uttarakhand, India. J Trop Pediatr 2016; 62(1): 81-2.
[http://dx.doi.org/10.1093/tropej/fmv069] [PMID: 26477042]
[72]
Jain A, Tiwari A, Verma A, Jain SK. Vitamins for cancer prevention and treatment: An insight. Curr Mol Med 2018; 17(5): 321-40.
[http://dx.doi.org/10.2174/1566524018666171205113329] [PMID: 29210648]
[73]
West KP Jr. Vitamin A deficiency disorders in children and women. Food Nutr Bull 2003; 24(4_suppl_1) (Suppl.): S78-90.
[http://dx.doi.org/10.1177/15648265030244S104] [PMID: 17016949]
[74]
Global Nutrition Report 2017. Available from: https://globalnutritionreport.org/reports/2017-global-nutrition-report/(accessed Jan. 21, 2022).
[75]
National nutrition monitoring bureau in India - An overview. Available from: https://www.indmedica.com/journals/xhtml/39_National Nutrition Monitoring Bureau in India - An Overview_brahman.htm (accessed Jan. 21, 2022).
[76]
Kundu S, Rai B, Shukla A. Prevalence and determinants of Vitamin A deficiency among children in India: Findings from a national cross-sectional survey. Clin Epidemiol Glob Health 2021; 11: 100768.
[http://dx.doi.org/10.1016/j.cegh.2021.100768]
[77]
Harinarayan CK, Akhila H, Shanthisree E. Modern India and dietary calcium deficiency—half a century nutrition data—retrospect–introspect and the road ahead. Front Endocrinol 2021; 12: 583654.
[http://dx.doi.org/10.3389/fendo.2021.583654]
[78]
Rana G, Abraham RA, Sachdev HS, et al. Prevalence and correlates of vitamin d deficiency among children and adolescents from a nationally representative survey in India. Indian Pediatr 2023; 60(3): 202-6.
[http://dx.doi.org/10.1007/s13312-023-2835-1] [PMID: 36604939]
[79]
Beto JA. The role of calcium in human aging. Clin Nutr Res 2015; 4(1): 1-8.
[http://dx.doi.org/10.7762/cnr.2015.4.1.1] [PMID: 25713787]
[80]
Civitelli R, Ziambaras K. Calcium, magnesium, and vitamin D absorption, metabolism, and deficiency Encyclopedia Gastroenterol. 2004; pp. 248-54.
[http://dx.doi.org/10.1016/B0-12-386860-2/00098-8]
[81]
Lewis SM, Ullrey DE, Barnard DE, Knapka JJ. Nutrition. The Laboratory Rat 2006; pp. 219-301.
[http://dx.doi.org/10.1016/B978-012074903-4/50012-1]
[82]
Triggle D J. Calcium channel antagonists: Clinical uses-Past, present and future Biochemical Pharmacology. Elsevier Inc 2007; 74: pp. (1)1-9.
[http://dx.doi.org/10.1016/j.bcp.2007.01.016]
[83]
Shalini T, Pullakhandam R, Ghosh S, et al. Prevalence of vitamin B12 and folate deficiencies in indian children and adolescents. Nutrients 2023; 15(13): 3026.
[http://dx.doi.org/10.3390/nu15133026] [PMID: 37447351]
[84]
Huffman WE, Huffman SK, Rickertsen K, Tegene A. Over-nutrition and changing health status in high income countries. Forum Health Econ Policy 2010; 13(1.)
[http://dx.doi.org/10.2202/1558-9544.1181]
[85]
Shimpton R, Rokx C. The Double Burden of Malnutrition – A Review of Global Evidence. 2012.
[86]
de Onis M, Blössner M. Prevalence and trends of overweight among preschool children in developing countries. Am J Clin Nutr 2000; 72(4): 1032-9.
[http://dx.doi.org/10.1093/ajcn/72.4.1032] [PMID: 11010948]
[87]
Pravst I, Lavriša Ž, Hribar M, et al. Dietary intake of folate and assessment of the folate deficiency prevalence in slovenia using serum biomarkers. Nutrients 2021; 13(11): 3860.
[http://dx.doi.org/10.3390/nu13113860] [PMID: 34836112]
[88]
Dwivedi LK, Puri P, Pant A, et al. Concurrent undernutrition and overnutrition within Indian families between 2006 and 2021. Curr Dev Nutr 2023; 7(9): 101987.
[http://dx.doi.org/10.1016/j.cdnut.2023.101987] [PMID: 37720241]

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