Food Consumption and Nutritional Status of Urban Low Middle-income Families

Abstract

In the 1970s Green Revolution enabled India to become self-sufficient in food production, but poverty, low dietary intake and under-nutrition were high. India identified poor families on the basis of energy consumption, provided employment to these families to improve purchasing power, subsidized food grains through PDS to improve family food security and food supplementation through ICDS to children and women from poor families to bridge the gap in their dietary intake. Over years, there has been a decline in under-nutrition but rate of decline was slow. The country is currently having persistent high under-nutrition in children, rise in over-nutrition in adults and increasing intra-family differences in nutritional status. A study was taken up in 547 urban low middle-income families with dual nutrition burden, to assess the current food and macronutrient consumption and food security status of the families and the nutritional status of the individual family members. The average energy intake of these families was 1900 Kcal. This was lower than the EAR for reference population (2110 Kcal/day) but higher by 140 Kcal when compared to the EAR for average Indian population (1760 Kcal/day). In pre-school and school-age children stunting rates were high but wasting and over-nutrition rates were low. Over-nutrition rates in adults were high perhaps due to higher energy intake as compared to the requirements for the short-statured sedentary adults. In view of these findings, it may be useful to explore a dual approach: programmes aimed at improving household food security continue to focus on families; while programmes aimed at improving nutritional status focus on anthropometric screening of individual members (children and adults) for early identification of under-or over-nutrition, appropriate management and monitoring improvement.

Intrafamily differences in nutritional status of preschool children

“…These findings have been confirmed by all national 3-6 surveys and many research studies. [10][11][12] As there are substantial intra-family differences in nutritional status between adults and children, it might be appropriate to use a dual approach for nutrition interventions. Programmes aimed at improving household food security may continue to focus on families as the unit of intervention.…”

“…Even in families that were food secure and women were normally nourished or over-nourished, the prevalence of undernutrition in pre-school children was high, suggesting that household food insecurity and low energy intake were not the major factors responsible for under-nutrition in preschool children. [10][11][12] Over time there had been changes in factors associated with under-nutrition in pre-school children. Low birthweight was and continues to be a major factor associated with low trajectory of growth and under-nutrition in pre-school children.…”

“…2 NNMB surveys had shown that in about a third of the families surveyed in the 1990s adults had adequate energy intake but energy intake in under-five children was inadequate, suggesting that poor child feeding practices may be an important determinant of under-nutrition in pre-school children. 6,[9][10][11][12] Infections were an important factor responsible for undernutrition earlier, but recent studies show that with improved access to health services infections were not associated with persistent deterioration in the nutritional status of children. 13 Research studies in urban food-secure families showed that in families with two under-five children, prevalence of stunting, underweight and wasting were higher in children whose elder siblings were stunted, underweight or wasted.…”

“…13 Research studies in urban food-secure families showed that in families with two under-five children, prevalence of stunting, underweight and wasting were higher in children whose elder siblings were stunted, underweight or wasted. 12 This could be because the siblings from the same family shared the factors responsible for undernutrition. These studies also showed that, prevalence of stunting, underweight and wasting were higher in the elder sibling as compared to the younger siblings.…”

“…These studies also showed that, prevalence of stunting, underweight and wasting were higher in the elder sibling as compared to the younger siblings. 12 National surveys have shown that in under-five children there was an increase in the prevalence of stunting and underweight and decrease in the prevalence of wasting with increase in age. [3][4][5][6] These data suggest that differences in nutritional status between younger and older under-five siblings might be due to changes in nutritional status with increasing age.…”