India has the highest number — approximately 48 million — of stunted children in the world. This means, two out of every five children aged under five are stunted, and implicityly, malnourished. The Organisation of Economic Cooperation and Development ranked India below South Africa, Brazil and Indonesia in its per capita nutrition index. Curiously, at the other end of the spectrum, India ranks third in obesity, behind only the US and neighbour China.

This paradox is linked to poor nutrition and rapid urbanisation, income gap and lack of awareness, says the latest India Spotlight Index, a survey by Dutch not-for-profit Access to Nutrition, supported by the Bill and Melinda Gates Foundation.

It surveyed 10 leading food and beverage companies — including Britannia Industries, Mondelez India, Mother Dairy, Nestlé India, PepsiCo India, Parle Products, Coca-Cola India and Hindustan Unilever — on their commitment to food nutrition in India.

Tackling under-nutrition

Disturbingly, the survey also revealed only 12 per cent of the beverages and 16 per cent of the foods in the Indian market to be of high nutritional standard. The twin-pronged problem of obesity and malnutrition leaves the next generation of Indians more susceptible to lifestyle diseases such as diabetes.

The study found there was no definite correlation between economic growth and nutrition. India has reported fast-paced economic growth for the last several years. According to the World Bank, the country witnessed significant poverty reduction between 2008 and 2011. The gross domestic product (GDP) growth was about 7.9 per cent during 2015-16; household income improved significantly (rising at an average annual rate of 4.78 per cent between 1990 and 2014), leading to a reduction of 23.4 per cent in the poverty rate since 1996. But higher incomes are not sole determinants of improved nutrition. For instance, both Maharashtra and Gujarat have relatively high levels of income, but the incidence of stunted growth is lower in Maharashtra.

Currently, over 70 per cent of Indian children are anaemic, a condition that’s directly linked to nutrition deficiency. Average consumption of fruits and vegetables, a major source of micro-nutrients, remains low in the country.

According to a study published by the Indian Journal of Community Medicine, 74 per cent of households report low consumption of fruits and vegetables, despite the country being the second largest producer, accounting for 10 per cent of fruits and 15 per cent of vegetable production globally. The report blames logistical challenges and colossal mismanagement, including lack of effective supply chain and cold-storage facilities, for the loss of 35 per cent of perishable produce. Only two per cent is processed into value-added products such as juices and concentrates, in contrast to the 99 per cent preserved in the US and Thailand.

Fortifying our food

Newer dietary habits brought on by rapid urbanisation are threatening to increase the incidence of malnutrition due to poor choices. With cheaper, nutrient-poor food available that are high on fat, a large section of the population is wont to adopt them. The survey found no gender discrimination in food distribution in families, but poor child-feeding practices were widespread and overall nutrition was poor across families.

This is where processed food companies can make a difference, but their record remains sub-par. According to the report, “Most companies do not seem to have considered the importance of ensuring that healthy products are affordable and accessible, particularly to low-income consumers.” Five of the companies have declared their intention to fortify their products, and only two, Nestlé India and Britannia, have undertaken market research to do so. Britannia, Nestlé, Pepsico India and Hindustan Unilever launched healthy products in the past three years. Mother Dairy, Hindustan Unilever and Amul sell the largest proportion of healthy products among the companies assessed.

Tackling malnutrition in India to meet the UN’s Sustainable Development Goals will cost ₹20 lakh crore. Food fortification is considered one of the most effective strategies to combat micro-nutrient deficiencies. It requires the addition of nutrients to essential staples such as salt, flour and cooking oil.

The Spotlight Index, however, shows that even the corporate social responsibility efforts are disjointed and only limited to providing funding for food fortification programmes. A worthy exception is Britannia Nutrition Foundation, which was reported to be working to significantly address nutrition through outreach programmes and public-private partnerships.

Further, companies can address under-nutrition by complying with the WHO and FAO’s global Codex standards (for addition of essential nutrients to food products), and setting strict limits for salt, trans-fatty acids and saturated fats.

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