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Undernourishment and obesity seen as India’s economy grows

The papers on maternal and child nutrition, published in the medical journal Lancet, indicate that a 10% increase in gross domestic product (GDP) leads to a 6% reduction in stunted growth of children but a 10% increase leads to a 7% increase in overweight people. Photo: Reuters (Reuters)Premium
The papers on maternal and child nutrition, published in the medical journal Lancet, indicate that a 10% increase in gross domestic product (GDP) leads to a 6% reduction in stunted growth of children but a 10% increase leads to a 7% increase in overweight people. Photo: Reuters
(Reuters)

Indian child and maternal health indicators have a lower response to the growth in national income

New Delhi: Far from reaping the benefits of a rapidly growing economy, India’s women and children are at the receiving end of a dual epidemic of undernourishment and obesity, a study revealed. Indian child and maternal health indicators have a lower response to the growth in national income when compared with the global average.

Papers on maternal and child nutrition show that as the economy prospers, the prevalence of obesity among women increases faster than the decrease in the prevalence of underweight women. India’s economy has been growing at an average 7.3% in the past four years.

The papers on maternal and child nutrition, published in the medical journal Lancet, indicate that a 10% increase in gross domestic product (GDP) leads to a 6% reduction in stunted growth of children but a 10% increase leads to a 7% increase in overweight people.

The papers, which will be launched in India on 28 June, establish that low- and middle-income countries such as India now face high rates of stunting and malnutrition as well as an increasingly worrisome incidence of obesity among mothers and children. Further, the obesity epidemic equally affects rich and poor, the researchers found.

The papers are the medical journal’s attempt to evaluate the 2008 series on the same subject that presented compelling evidence that under-nutrition reduces a nation’s economic advancement by at least 8% and affects productivity, leading politicians globally to commit to addressing maternal and child undernourishment.

The authors now estimate that under-nutrition causes 3.1 million child deaths annually —45% in 2011. Meanwhile, globally, an estimated 43 million children younger than five years are overweight, out of which 17 million live in Asia and 12 million in Africa.

The authors reviewed nutritional effects of programmes in four sectors—agriculture, social safety nets, early child development and schooling. As economies grow, stunting rates typically decrease, but the predicted decrease was far from desired.

In the Indian context, economist and author of one of the papers Harold Alderman stated that the government had made “fair progress on mortality so it is not all gloom but the needs of the surviving children for physical, cognitive and emotional growth go beyond the issue of simply surviving. Diet diversity for young children is a key issue that many programmes fail to address. That is stressed in the paper on agriculture."

According to the paper on “nutrition-sensitive intervention", there was an “unexplained variability in the effect of national income on stunting" with countries such as Guatemala, South Africa, and India having higher rates than expected for their income levels. The paper further stated that, “the association between prevalence of child underweight and GDP growth is stronger than for stunting, with the rate of decrease with 10% GDP growth being 7%"

Indian health experts, however, maintain that GDP growth is never the best indicator of development in health sector. “It would be simplifying the problem if we look at economic causality for such complicated issues," said Amit Sengupta, public health activist with Jan Swasthya Abhiyan. “In India, child nutrition has stubbornly been between 40-45% for the past three decades regardless of the economic condition. Similarly, one cannot equate economic prosperity to obesity. Poorer populations have higher levels of obesity because of change in traditional diets, professions, level of physical activity and cheaper availability of processed junk food."

The association between national income growth and women being overweight or obese is much stronger than for underweight women: a 10% increase in GDP per person is estimated to increase prevalence of overweight and obesity in women by 7%. These findings show that when GDP per person increases, the prevalence of overweight or obese women increases faster than the prevalence of underweight women decreases.

The authors found that India had a particularly high prevalence of low birthweight with respect to national levels of income. The paper stated that a 10% increase in GDP per person typically reduces low birthweight prevalence by only 2.3%. For underweight mothers, a 10% growth in national income results in a 4% decrease in underweight prevalence, a rate substantially lower than the reduction in child underweight.

Endorsing 10 low-cost interventions, the Lancet puts a price tag of $9.6 billion annually on scale up nutrition-sensitive programmes in 34 countries—with the majority share being invested in India’s health system. The authors argue that the figure may be significant, but investing in the recommended nutrition relevant schemes would save a nearly a million lives.

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