BENGALURU: Indian researchers and policymakers have slammed the recent paper published in ‘The Lancet’ - the international science journal - in which they have stated that as of 2021, around 60 lakh children (aged between six to 23 months) in the country faced zero-food (children who did not eat any food of calorific significance for at least one day) and called it “misleading.”
According to ‘The Lancet,’ “as of 2021, the estimated number of Zero-Food children in India was 5,998,138, with the states of Uttar Pradesh (28.4%), Bihar (14.2%), Maharashtra (7.1%), Rajasthan (6.5%),and Madhya Pradesh (6%) accounting for nearly two-thirds of the total Zero-Food children in India,” stated the journal in its March 30 publication.
The authors of the controversial paper defined food deprivation or zero-food “based on the mother's reporting of the child having not eaten any food of substantial calorific content (i.e., any solid/semi-solid/soft/mushy food types, infant formula and powdered/tinned/fresh milk) in the past 24 hours.”
Denouncing ‘The Lancet’ report as “invented” and “misleading to the readers and especially the policymakers,” Associate Professor, International Institute for Population Sciences (IIPS), Mumbai, Dr Srinivas Goli told TNIE that the contention with the report is the “methodology of defining zero-food by excluding breast milk out of the definition of food for the cohort of infants and young children,” he said.
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‘The Lancet’ quoting “data from five National Family Health Surveys (NFHS) conducted in 1993, 1999, 2006, 2016 and 2021 for the 36 states/Union Territories (UTs)” has stated that the “prevalence of zero-food in India marginally declined from 20.0% in 1993 to 17.8% in 2021” The study population consisted of the “most recent children (6–23 months) born to mothers (aged 15–49 years), who were alive and living with the mother at the time of survey.
Goli and other researchers countered ‘The Lancet’ figures (17.8 per cent) and said that, “if we consider breast milk in the definition of food the actual zero-food figure stands at 1.3 per cent. Even this figure of 1.3 percent needs to be re-examined for the medication condition of the child (at the time of the survey) and possible misreporting,” argued Goli. IIPS is the nodal agency for conducting the NFHS.
“A major share (about 65%) of children with alleged zero-food intake belongs to the 6-11 months age-group who have a greater chance of being exclusively breastfed. Thus, if mothers opt for exclusive breast- feeding over complementary feeding, especially those with younger children, that is, six to 11 months, it can’t be considered zero-food. It can be insufficient but not zero-food,” added the researcher.
He said that “nearly 93 per cent of children under six to 23 months were being breast-fed at the time of the survey and this number is even higher for younger children in the age group of six to 11 months.
Therefore, in the absence of breast-feeding from the definition of ‘food’, the newly designed concept of zero-food intake “artificially inflates the numbers and creates unwarranted alarm among readers and policy makers,” said Goli.
Prof Udaya S Mishra, Department of Epidemiology and Biostatistics, IIPS said that ‘The Lancet’ report is a “clear manifestation of hurried and hasty inferences to hit headlines. The ill-defined feature (zero food) relates to exclusion of breast-feeding though the authors acknowledge that a partial share of required calorie is derived from breast milk among children above six months of age.
The sheer size (5,998,138 children) of the resulting magnitude of such adversity should raise suspicion on its definition alongside its characteristic aspect minimally responsive to the axis of economic status and social group hierarchy,” said Mishra.