BENGALURU: Childhood undernutrition contributes to childhood diseases and is a major cause of child mortality in India. As per the National Family Health Survey-5 (NFHS-5), children’s nutritional status in Karnataka has improved slightly since NFHS-4 by all measures. However, the continuing high levels of undernutrition and stunting (35.4 per cent of preschool children) are major concerns the State needs to address. In an exclusive interview with The New Sunday Express, Commissioner, Public Instruction, Government of Karnataka, Dr Vishal R shares details of government initiatives to cater to child nutrition. Excerpts:
We have seen the importance of midday meals for schoolchildren in terms of nutrition and continuing with school education. What is your understanding regarding the components of a meal for children?
The Midday Meal (MDM) guidelines envisage a hot cooked midday meal per child per day with 450 calories and 12gm of protein for primary level, and 700 calories and 20gm of protein for upper primary level. These are a supplement for the diet of a child. For the secondary level, just like primary level, supplementation is provided. A balanced meal with carbohydrates, proteins and fats along with minerals and vitamins is a must for every child to undertake various physical and mental activities, and to have healthy body development and growth.
The government decision to include eggs in midday meals has led to resistance from vegetarian families who question egg in their child’s meal. What is the right balance? If not eggs, what can be a good substitute?
Under PM-POSHAN flexi fund component, a supplementary nutrition programme has been rolled out in backward districts of Karnataka -- Kalaburagi, Yadgir, Raichur, Bidar, Koppal, Ballari and Vijayapura -- which have high prevalence of malnutrition and anaemia among children. Egg and banana are distributed to students as additional supplementary nutrition along with midday meal to students of Class 1 to 8 in government and aided schools. Egg is distributed to only those students who consume it as per their food habits, with permission from parents. Banana is given as a rich source of carbohydrates, vitamins, minerals and protein to students who don’t eat eggs.
Various alternatives are being explored, in consultation with nutritionists and experts, to give fulsome nutrition as a substitute for eggs.
What does children’s nutrition lack in India? What is the most sustainable nutritious diet for children from economically weak families?
Normally, multi-nutritional deficiency, lack of iron and folic acid, Vitamin A, Vitamin B12, fibre, fat and protein are deficient among growing children in the country. Fortification of food (rice, wheat, edible oil, salt etc) with a balanced diet is the suitable dietary intervention for children from economically weak families.Children lack both quantitative and qualitative aspects in their food, which need to redressed by encouraging and provisioning of sufficient quantity and acceptable quality of micronutrients and macronutrients. There is a need to supplement it with bio-activated ingredients like sprouted legumes, green leafy vegetables, curd and fruits, which increases bio-availability. This is in addition to main staple grains.
What is the importance of bio-availability in our meal?
Bio-available amount of a trace element in a meal, not the total amount, is the critical factor for human health. Most staple plant foods (cereal grains and legume seeds) alone contain very low levels of bio-available Fe (about 5%) because of the anti-nutrients they contain (phytate, polyphenols, etc.) Increasing bio-availability of Fe from 5% to 30% would have the same effect as increasing the total amount of Fe in staples six-fold.
How many children are covered under midday meals in Karnataka?
There are 59,83,247 student beneficiaries as per enrolment in Class 1 to 10 in government and government-aided schools under PM-POSHAN MDMS. There are 42,56,354 children in unaided schools, who are not covered.
How can we bring those not covered under midday meal scheme?
This is to be decided by the parents and school management, based on mutual agreement.
What is the percentage of children with malnutrition in Karnataka?
At the national level, 11 per cent of children are malnourished and 5 per cent are acutely malnourished. According to a recent survey among preschool children, 35.4 per cent are stunted in Karnataka, which is being revalidated. The State reported 6,899 Severe Acute Malnutritioned (SAM) children, who are being followed up on. The numbers are gradually decreasing due to medical and nutritional interventions.
What is the long-term impact of malnutrition on maternal and infant health?
It traverses a whole spectrum of disability and contributes to sub-optimal development indicators, and has an adverse effect on sustainable growth and development of the State.