The Hindu

Date:15/05/2008
URL: http://www.thehindu.com/2008/05/15/stories/2008051554991400.htm

NEW DELHI: The Lancet has warned that children would suffer irreversible damage in adult life unless proper nutritional interventions are delivered before the age of two.

Launching a five-part series of research papers on maternal and child undernutrition, the international medical journal said the prevalence of child undernutrition and micronutrient deficiencies in India was among the highest in the world.

But the challenge is not India´s alone. Worldwide, more than 3.5 million mothers and children under five die avoidable deaths each year due to the underlying cause of undernutrition. And millions are permanently disabled by the physical and mental effects of poor dietary intake in the earliest months of life, according to Robert Black, Johns Hopkins Bloomberg School of Public Health, who has authored the series.

According to data analysed in the series, over 51 per cent of children in India under five are stunted. This is a third (34 per cent) of the global total of stunted children. Anaemia affects 79 per cent of children in the lowest economic strata and 64 per cent in the better-off families. The research mirrors trends found in the National Family Health Survey-3. That benchmark survey indicated some improvements in the nutritional status of young children in several States, though overall there were widespread nutritional deficiencies and little change in the percentage of children who were underweight.

The Lancet papers quantify the prevalence of maternal and child undernutrition and consider the short-term consequences in terms of deaths and disease burden, as measured by Disability-Adjusted Life Years (DALYs) and long-term educational and economic effects and association with adult chronic diseases.

The research shows that 178 million children under five — the vast majority of whom live in Sub-Saharan Africa and South-Central Asia — have been left stunted. An estimated 55 million suffer from wasting, 19 million of whom are affected by acute malnutrition.

Stunting, severe wasting and low birth-weight contribute to an estimated 2.2 million deaths annually, representing 21 per cent of all causes of death for children under five.

Among micronutrient deficiencies, Vitamin A and zinc are the greatest contributors to the disease burden because of their direct effects on child health.

The paper estimates the potential benefits of implementing effective and applicable health and nutrition interventions. Of the 45 reviewed interventions, breastfeeding promotion, appropriate complementary feeding, supplementation with Vitamin A and zinc and appropriate management of severe acute malnutrition showed the most promise of reducing child deaths and future disease burden.