Growth Standards used by the World Health Organisation (WHO) to measure malnutrition
Undernourishment:
- When the body lacks the vitamins, minerals, and other nutrients necessary to keep healthy tissues and organ function, malnutrition sets in.
- People who are either overfed or undernourished suffer from malnutrition.
The significance of diet throughout adolescence:
- An important time for cognitive growth is adolescence.
- It enhances the availability of nourishment throughout this “second window of opportunity for growth.”
- It makes up for any nutritional deficits the girl kid may have had throughout her early years of growth.
- Long-term participation of women in the Indian labour force is significantly correlated with the health of adolescents.
- As better nutrition enhances every young girl’s chance to participate in productive activities.
Undernutrition’s contributing factors are:
- consumption of food
- Variety in diet
- Well-being
- hygienic
- Status of women
Undernutrition in children is measured using anthropometric criteria like:
- Height relative to age (chronic undernutrition/stunting)
- Weight in relation to height (wasting/acute malnourishment)
MGRS, or Multicentre Growth Reference Study:
- It was carried out from 1997 to 2003 in six different nations.
- The goal was to ascertain the growth trend of children who did not experience any recognised environmental impairments from birth to age five.
- The MGRS adopted a prescriptive strategy with the express purpose of establishing “standards” for growth—that is, how kids should develop.
- rather than growth “references,” which are the ways in which kids in the reference group grow, as long as they are in a healthy environment.
- The MGRS sample for India was derived from a group of well-off South Delhi households.
- kids who fulfilled all the requirements to be eligible for the study, such as
- possessing a climate that is conducive to growth
- receiving breast milk
- possessing nonsmoking moms.
What sets MGRS apart from other surveys:
- Large-scale surveys in India have difficulty finding an adequate number of similar samples because of the high levels of inequality and the underrepresentation of the wealthiest in these datasets.
- For example: Among six to twenty-three-month-old children living in the highest quintile of the National Family Health Survey (NFHS)-5 (2019–21)
- just 12.7% meet the requirements of a ‘minimum acceptable diet’ as outlined by WHO.
- In the 2000–01 MGRS sample, nearly all women had completed more than 15 years of education.
- In NFHS-5, 7% of the female students had finished 12 years or more of education.
- These prevalence studies employ different research criteria than the WHO-MGRS.
- For instance, MGRS incorporated counselling to guarantee proper feeding patterns.
- The Comprehensive National Nutrition Survey (NFHS) does not include it.
- The MGRS sample was used to establish prescriptive standards, and the majority of the sampling issues have been addressed.
- Difference in genetic development capacity of Indians with respect to others and the influence of maternal heights on infant growth.
- The height of the mother has an unchangeable effect on the child’s growth.
- Low average maternal heights are an indication of women’s low status and the generational transfer of poverty.
- Consequently, a gauge of a deprived environment.
- Replace: A suitable marker of a poor environment, such stunting,
Why does WHO-MGRS appear to be a better fit?
- Using the same WHO-MGRS criteria, several nations with comparable or even worse economic circumstances—including those in South Asia—have demonstrated greater increases in the prevalence of stunting.
- Disparities by region in India in terms of adult height growth and the frequency of stunting
- It suggests that certain States—like Tamil Nadu, Kerala, Chhattisgarh, and Odisha—are reducing considerably more quickly than others.
- Population-level gene pools change as socioeconomic development increases.
- As evidenced by the rising average heights of nations like Japan
- It disputes the idea that genetic potential is unchangeable.
What problems does India have right now?
- Unreasonably high criteria that cause the problem to be misdiagnosed
- possible overfeeding of incorrectly classed children as a result of government efforts intended to combat undernutrition
- Resulting in an increase in overweight and obesity.
- Non-communicable diseases (NCDs) are becoming more prevalent in India.
- gaps in children’s diets
- Inadequate implementation of programmes like midday meals and additional nutrition in anganwadis
The Way Ahead:
- To guarantee that the meals served under the programmes are not overly cereal-based, the quality of the meals must be raised.
- Incorporate every nutrient and support a diverse diet.
- Urgent action is required to implement recommendations like adding eggs to children’s meals and putting pulses in the Public Distribution System.
- Better nutritional results necessitate a combination of dietary improvements and other initiatives, such as increased access to healthcare, childcare services, and improved sanitation.
- It’s crucial to apply the right standards when comparing countries internationally and within a single nation.
- A benefit that would be acceptable to give up for any new national standards.
- A committee has been established by the Indian Council of Medical Research to update the growth references for India.
- The committee has suggested that a thorough, nationwide investigation be carried out to look at child development to create national growth charts, if needed.
- It is a positive step to obtain more recent and accurate data on child development.
- Considering our lofty goals of achieving progress for every person by 2047.
- Adhering to the ambitious yet attainable benchmarks proposed by the WHO-MGRS makes sense.
