1. 1 Diet and Nutrition Situation and Time Trends in India Dr. B. Sesikeran, MD, FAMS Director National Institute of Nutrition, I.C.M.R. Hyderabad – 500 604 E-mail: sesikeran@gmail.com

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3. 3 Infant Mortality Rate (Per 1000 Live Births) in India and South-east Asian Countries Source : WHO/SEARO 2000 58 * * SRS, Registrar General of India, 2004 *

4. 4 Prevalence of Low Birth Weight in India and South-east Asian Countries Source : WHO/SEARO 2000 23 (NFHS 2) * * Increase in Institutional Deliveries

5. 5 Andhra Pradesh Madhya Pradesh Maharashtra Karnataka KeralaTamilnadu Orissa West Bengal Uttar Pradesh Gujarat NATIONAL NUTRITION MONITORING BUREAU (Estd: 1972) Objectives of NNMB 1.Assessment of Nutritional status of various communities by adopting standardized procedures and techniques 2.Periodical evaluation of National Nutrition programs operation in India

6. 6 Average Daily Food Intake (% RDA) among 1-3 Year Children : By Gender Percent RDA

7. 7 Median Intake of Nutrients (as % RDA) Among 1-3 year children : By gender Percent of RDA

8. 8 Average Daily Food Intake (% RDA) among 4-6 Year Children : By Gender Percent RDA

9. 9 Median Intake of Nutrients (as % RDA) Among 4-6 year children : By gender Percent of RDA

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11. 11 Prevalence (%) of Undernutrition Among 1-5 yr children According to SD Classification (<Median - 2SD): By Gender Percent

12. 12 Prevalence of Undernutrition among <5 years children according to Weight for Age (IAP classification) Faulty BFFaulty Complemen tary feeding

13. 13 INFANT AND YOUNG CHILD FEEDING PRACTICES (NFHS 3)

14. 14 MICRO-NUTRIENT DEFICIENCIES

15. 15 Pooled: 0.7% < 0.5 %  0.5 % Kerala 0 Tamil Nadu 0.5 Karnataka 0.7 Andhra Pradesh 1.2 Maharashtra 1.3 Madhya Pradesh 1.4 Orissa 0.3 West Bengal 0.6 Prevalence (%) of Bitot spots among 1 - <5 year children Boys: 0.9% Girls 0.6%

16. 16 Prevalence (%) of Bitot Spots among 1 - <5 yrs. Children * WHO cut-off level (0.5%) of Public Health significance

17. 17 AGE / PHYSIOLOGICAL GROUP Gender Hb (g/dl) 6 months – 6 Years Boys & Girls<11 6 – 14 Years Boys & Girls<12  14 Years Men<13 Women<12 Pregnant Women <11 WHO, Nutritional Anemia - TRS No. 405, Geneva 1968. Definition of Anemia

18. 18 10.2 0.03 11.2 0.03 11.0 0.03 9.9 0.03 10.6 0.03 Mean ±SE Prevalence (%) of Anaemia by Age, Gender & Physiological Groups > 6 months < 6 months 10.7 1.99 12.6 2.09

19. 19 Pooled: 3.9 < 5 % > 5 % Kerala 0.6 Tamil Nadu 0 Karnataka 1.9 Andhra Pradesh 3.8 Maharashtra 12.2 Madhya Pradesh 4.3 Orissa 0.1 West Bengal 9.0 Prevalence (%) of IDD among 6 – 11 Year Children Source: MND-NNMB, Tech Rep 22, 2003

20. 20 PREVALENCE (%) OF IDD AMONG CHILDREN (≤12 years old)

21. 21 Percent of Households consuming salt having adequate Amount (≥15 ppm) of Iodine * By spot test

22. 22 Time Trends

23. 23 Average Intake of Foodstuffs (per CU/day) as % of RDI by Period of Survey Percent

24. 24 Average Intake of Foodstuffs (per CU/day) as % of RDI by Period of Survey (contd.) Percent

25. 25 Average Intake of Nutrients (per CU/day) as % of RDI by Period of Survey Percent

26. 26 Percent Average Intake of Nutrients (per CU/day) as % of RDI by Period of Survey (Contd.)

27. 27 Distribution (%) of Children by Undernutrition and Period of Survey Percent UNDERNUTRITION (< Median - 2SD)

28. 28 Trends in poverty line estimates and Prevalence of Undernutrition among 1-5 yr. Children (According to SD Classification Using NCHS Standards) Source :- BPL : Economic survey and NNMB Surveys

29. 29 0 5 10 15 20 25 30 35 Worldwide Americas Europe Near/middle East Asia-Pacific Sub-Sahara Africa Prevalence (%) overweight obese Prevalence of overweight and obesity among school-age boys aged 5-17 years by global region

30. 30 AuthorYearAge groups (yr) Number of subjects Prevalence (%) OverweightObesity Mohan B 200411- 17246711.62.6 Khadilkar Y 200410 – 15122819.95.7 Chatwal J 20049 – 15200814.211.1 Subramaniam V 200310 – 1570710.06.0 Laxmaiah A et al 200412 - 17120804.61.6 Chatterji P 20024 – 18500029.06.0 Kapil U 200210 – 1687024.77.4 Ramchandran A 200213 – 18470016.83.1 Pandey S & Vaidya R 20013 - 17243915.115.3 PREVALENCE (%) OVERWEIGHT AND OBESITY AMONG CHILDREN: VARIOUS STUDIES

31. 31 CategoryN Overweight/ Obese P value TV viewing (hrs/day) None1435.6 a b P < 0.05 < 3 hrs/day7304.9 a b  3hrs/day 3359.3 b Participation in outdoor games (hrs/week) None5268.4 a P < 0.004 < 6 hrs2286.6 a  6hrs 4165.1 b Participation in HH activities (hours/day) None22118.6 a P < 0.001 < 3 hrs2334.7 b  3hrs 7163.9 b Prevalence of Overweight/Obesity and Physical Activity (NIN Study)

32. 32 Variable Overweight/ Obese Adolescents Normal Adolescents P value Consumption of Soft drinks 21.016.0 p < 0.05 Consumption of soft drinks  300 ml/day 16.79.0 p < 0.05 Prevalence of Hypertension (JNC VII) 8.33.7P < 0.05 Overweight/Obesity Vs Lifestyle practices (n:941) Laxmaiah et al 2007

33. 33 Prevalence of Overweight in relation to activity score. l Prevalence of Overweight was higher in lower tertile of physical activity. Trend  2 = 45.6, P <0.001. Tertiles of activity score % Overweight Ramachandran et al 2002

34. 34 Conclusion  Despite rapid progress in the area of food production, the intake of food and nutrients continues to be deficient, both in terms of quantity and quality  Prevalence of LBW is about 30%, and about 55% of preschool children are underweight and 50% are stunted.  Even though, the prevalence of undernutrition is significantly declining over a period of 3 decades, still the current prevalence is exceptionally high.  MNDs such as IDA VAD and IDD continues to be of public health problem.

35. 35  The prevalence of overweight and obesity is significantly increasing over a period of 3 decades even among rural population, which is the major independent risk factor for metabolic syndrome.  Prevalence of overweight and obesity is considerably high, especially when Asian cut of levels were used (≥23 BMI).  India is passing through a critical phase i.e. ‘double burden of disease’.  One fourth of our rural adults are suffering from hypertension About 5-6% of the adults have IGT/DM. Conclusion (Contd..)

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