Does cereal, protein and micronutrient availability hold the key to the malnutrition conundrum? An exploratory analysis of cereal cultivation and wasting patterns of India

Abstract

Background: High prevalence of maternal malnutrition, low birth-weight and child malnutrition in India contribute substantially to the global malnutrition burden. Rural India has disproportionately higher levels of child malnutrition. Stunting and wasting are the primary determinants of child malnutrition and their district-level distribution shows clustering in different geographies and regions. Methods: The last round of National Family Health Survey (NFHS4) has disaggregated data by district, enabling a more nuanced understanding of the prevalence of markers of malnutrition. We used data from NFHS4 and agricultural statistics datasets to analyse relationship of area under cereal cultivation with the prevalence of malnutrition at the district level. We analysed malnutrition through data on under-5 stunting and wasting; maternal malnutrition was assessed through prevalence of women’s low BMI and short stature by district. Results: Stunting and wasting patterns across districts show a distinct geographical and age distribution; districts with higher wasting showed relatively high prevalence of 40% before six months of age. Wasting was associated with higher cultivation of millets, with a stronger association seen for jowar and other millets (Kodo millet, little millet, proso millet, barnyard millet and foxtail millet). Stunting was associated with cultivation of all crops except other millets. Low women’s BMI was seen associated with cultivation of rice and millets. The analysis was limited by lack of fine-scale data on prevalence of low birth-weight and type of cereal consumed. Conclusions: Multi-site observational studies of long-term effects of type of cereals consumed could help explain the ecogeographic distribution of malnutrition in India. Cereals, particularly millets constitute the bulk of protein intake among the poor, especially in rural areas in India where high prevalence of wasting persists.

An intersectional analysis of the composite index of anthropometric failures in India

“…The undernutrition hotspots identified in this study are mostly clustered in the climatic zones of hot and dry (with 40–45 °C during summer days) and composite climatic zones (with 32 – 43 °C during summer days) [ 29 ]. The hot and semi-arid climate is also associated with crops cultivation (millets) and other social factors thus requiring interdisciplinary approaches to identify drivers of such clustering [ 30 ]. Although hotspot identification is helpful for national-level priority setting, there are several districts in better-off states which continue to have vulnerable groups and undernutrition pockets within districts.…”

An Intersectional Analysis of the Composite Index of Anthropometric Failures in India

“…The undernutrition hotspots identi ed in this study are mostly clustered in the climatic zones of hot and dry (with 40-45 0 C during summer days) and composite climatic zones (with 32 -43 0 C during summer days) (28). The hot and semi-arid climate is also associated with crops cultivation (millets) and other social factors thus requiring interdisciplinary approaches to identify drivers of such clustering (29). Although hotspot identi cation is helpful for national-level priority setting, there are several districts in better-off states which continue to have vulnerable groups and undernutrition pockets within districts.…”