More healthy products from Nutrition companies can reduce child malnutrition

20 November 2014 | Column | By Janani Ravi

Multinational and Indian companies should come up with fortified micronutrient sachets for supporting government programmes as part of corporate social responsibility. Large corporates could be asked to adopt one State each, to look after the nutritional requirements in each State and improve their nutritional status.

Though food is considered as one of the basic necessities of life, actually nutritious food should be considered as basic necessity. Just eating food does not mean living healthy; essential nutrients are always to be taken as food at desired quantities, which leads to healthy living. Right from our childhood days till we grow old the eating patterns vary. Everybody would have experienced the compulsion of eating leafy vegetables in childhood. This is just a simple example, why our mothers compel us to eat vegetables that are bitter, half-baked and sometimes even tasteless. These have essential nutrients that the body requires during childhood. That’s why mother is a good nutritionist.

India is home to the largest number of hungry people in the world and the child nutrition segment is one of the greatest opportunities for India to target in the coming years. With growing child population with over 2.5 crore births every year, companies can focus on producing functional foods or fortified foods in order to balance the demand as well as the nutritional content. More than 5,000 Indian children below five years die every day due to malnourishment or lack of basic micronutrients like Vitamin A, iron, iodine, zinc or folic acid.

As per statistics from Health Education to Villages 2012, nearly half of India's children which is approximately 60 million, are underweight, 45% have stunted growth (too short for their age), 20% are wasted (too thin for their height, indicating acute malnutrition), 75% are anemic, and 57% are deficient in Vitamin A. If we notice, children below the age of five are major victims for malnutrition.

How the private sector players are addressing these issues is an interesting question to look at. There are many multinational and Indian companies which have established their products in child nutrition segment. Companies like Danone, Nestle, Abbott, Mead Johnson Nutrition and so on have their plants in India as the demand for child nutrition products is high.

Recently, Abbott opened its new manufacturing plant for nutrition products in Gujarat where it has invested `450 crore to strengthen its presence in nutrition segment in India. As part of corporate social responsibility, Cargill has been focusing on improving food and nutrition security in India by fortifying all packaged refined edible oils produced in India, with the essential Vitamins A, D and E; enabling food banks in India, with the help of Global Food Banking Network and Aidmatrix Foundation, which efficiently distributes food to reach those who need it the most; fighting malnutrition by initiating ‘Fast Track nutrition’ project in Madhya Pradesh which has one of India’s highest concentrations of hunger and malnutrition. The project provides health and nutrition training, promotes safe drinking water and sanitation, and helps create kitchen gardens to improve nutritional intake and provide income. Indian companies like Amul, British Biologicals, Dabur, Mother Dairy have focused on child/pediatric nutrition products.

There are various child nutrition products designed focusing on different age group of children. The categories include 4 weeks-1 year, 1-3 years, 3-6 years and 6-12 years. Many child welfare organisations have been working towards declining the rate of child malnutrition in India as malnutrition is more common in India than in Sub-Saharan Africa. One in every three malnourished children in the world lives in India. As per the latest provisional data survey ‘Rapid Survey on Children’ conducted by United Nations International Children's Emergency Fund (UNICEF) and the Union Ministry of Women and Child Development in 2013-2014, India’s proportion of underweight children fell from 45.1% in 2005-2006 to 30.1% in 2013-14. This makes the decline in one indicator of child undernourishment the sharpest in 25 years.

Overcoming malnutrition in India
It is unfortunate that despite tremendous advancement in science, technology and many government initiatives, child malnutrition is still rampant in our country. To address this, Dr Basanti Baroova, Formulator, ASSAM MIX (Baby feed) and Chief Technical Advisor (Nutrition), Aasray Concept Foods, Assam, said “both Central and local governments should change their focus to eliminate root causative factors rather than relying solely on blanket feeding programmes such as Supplementary Nutrition Programme (SNP), Midday Meal Programme (MMP) etc. These root causes of malnutrition are multifaceted from local food culture and practice; Infant and Young Child Feeding practices (IYCF), health and care practices of mother and child, hygiene and sanitary practices which varies from community to community, state to state and region to region. A plan that may be effective for one community may not be the same for others, especially in our diverse country. Community participation is absolutely necessary to eradicate this malady. The task is Herculean but perhaps not impossible. It is perhaps the biggest burden on a nation when its children suffer during their formative years.”

Sharing his thoughts on how to overcome malnutrition in infant and child, Ganesh Choudhury, President, Indian Dietetic Association, Odisha chapter said, “To combat malnutrition of infants and child, adequate and appropriate diet should be taken by children in healthy and diseased state. Childhood is a period of continuous growth and development. An infant grows rapidly. Calcium-rich foods are needed more like milk, curds, nuts, ragi and green leafy vegetables. During illness the child should never starve. Feeding of energy rich cereals-pulse diet with milk and massed vegetable in small quantities at frequent intervals is essential. Improvement in quality and quantity of the Midday Meal Programme should be assessed by the government.”

Dr Surendra Kumar Mishra, Senior Advisor at MAMTA – Health Institute for Mother & Child, Bhubaneshwar, expressed his views on Essential Nutrition Interventions (ENIs) which are necessary for a vast country like India where malnutrition is an inter-generational problem that requires urgent action by policy makers, administrators and programme managers. This will comprise the following actions for promotion of appropriate IYCF practices, delivery of maternal-child health services including micro-nutrient supplements, care of adolescent girls and women as well as improvement in water-sanitation-hygiene practices. The specific actions include:

• Developing institutional leadership for nutrition within Central and state governments
• According high priority for universal coverage of selected evidence-based ENIs, with special focus on children under 2 years of age, pregnant women and adolescent girls
• Financing and delivering at-scale ENIs with active attention to operationalising the quality interventions
• Ensuring equitable access to food security, including dietary diversity, primary health care, safe drinking water, environmental and household sanitation
• Positioning nutrition as an indicator of development and establishing a reliable Monitoring Information System (MIS) for periodic update of database

Talking about issues that have to be addressed with respect to infant and child malnutrition, Dr Jagmeet Madan, Principal, SVT College of Home Science, Mumbai, said, “The need of the hour is to innovate and explore region centric resources of nutrient dense foods in India and convert them into child friendly options with maximum reach.

“All efforts must be supported with nutrition education sensitising all stakeholders including children, parents and school management to understand the significance of introducing nutrient dense options at an early age to reap the benefits in later life. Food industry can target plan, develop and provide child friendly options or choices, specially targeted towards snacks and drinks with ethical marketing and consumer education.”

Stressing the importance on breastfeeding for infants, Dr Saradha Ramadas, Professor, Department Food Service Management and Dietetics, Avinashilingam University, Coimbatore, said, “Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers. For a healthy future, infants should be exclusively breastfed for the first six months and need to breast feed within one hour of birth. In order to meet their evolving nutritional requirements; infants should receive nutritionally adequate and safe complementary food while breastfeeding continues for up to two years of age or beyond. Exclusive breastfeeding from birth is possible except for a few medical conditions, and unrestricted exclusive breastfeeding results in ample milk production.”

Sharing her views on improvements in infant and child feeding, Dr Basanti Baroova said, “Every woman must know that brain development starts from 14th day of conception and folic acid is the only nutrient that helps its growth, and made aware of proper modes of breast feeding, weaning at right time with right food, proper methods of sourcing and preparing food etc. Improvement is needed not only in infant and child feeding but also in maternal (pregnancy & lactation) feeding. All macro (carbohydrate, protein, fat) and micro (vitamins and minerals) nutrients in varying amounts are essential for proper growth and development of the foetus and beyond.”

Market scenario
“The current market size for child nutrition segment in India is in the range of `4,200 crore ($700 million) in 2014 and is growing at about 10-12% every year. There is a huge opportunity for child nutrition in India considering our growing young population. Multinational companies should also come out with fortified micronutrient sachets for supporting government programmes as part of corporate social responsibility. Large corporates could be asked to adopt one state each to look after the nutritional improvements in each state, there are so many large corporate both Indian and Multinational who could adopt these states and improve their nutritional status by sponsorship. This will also invite competition amongst the companies to excel in this field and win awards for states,” said Kishore Shintre, Founder & Principle Consultant, NutreShin Solutions.

Globally there are over 25 companies in child nutrition space with over 100 brands catering to the needs of children of different age groups ranging from 4 weeks to 12 years. However, in India we have very less local players with multinationals holding a majority share in this space. There are about 20 companies with about 50 brands featuring child nutrition products in India. Some of the leading local players are Amul, British Biologicals, Mother Dairy, Raptakos Brett, Dabur, etc.

Nutrition companies can look at child nutrition segment as a growth opportunity. Sharing her views Rohini Saran, Nutrition Consultant, Ministry of Women & Child development, New Delhi, pointed out that every child’s need is different. Key players who are already in the market mostly rely on research. She suggested some innovations that nutrition companies can come up with in child nutrition space:

• Providing low sugar and low sodium products for children. Ex: ketchups with less preservatives.
• Products which use ingredients which kids don’t normally like eating and include them in products. Ex: spinach and carrot candies, plum jam.
• Using packing techniques and material which are not harmful to the children.
• Also targeting low income groups and provision of affordable nutrition supplements.
• Nutraceuticals are still not very popular in India and that market can be tapped.

Commenting on the issue, Dr Basanti Baroova said, “Innovations in product range for the mother-child duo could take into consideration the condition and stage specific nutrient requirement (folic acid/iron/ protein supplement for pre and pregnant stage; weaning formulae to cater to developmental needs of infant/child etc) which should come from research institutes too beyond just nutrition companies. Assam Agricultural University, Jorhat, recently transferred a baby food technology ASSAM MIX to a state-level food production company Aasray Foods Concept, Guwahati. The product has BIS certificate and is becoming successful in fulfilling nutrition security of needy children of Jorhat District through a pilot project. It has also been deployed in calamity stricken areas of Uttarakhand, Assam, Jharkhand, Mizoram and Nagaland by organizations such as Save the Children, Oxfam and World Vision. It is affordable and indigenous baby feed, in comparison to the high priced big label products.”

The current scenario of world hunger is still heart breaking. As far as India is concerned, we have taken a substantial leap on the Global Hunger Index. According to a recent report, India has gone up to 55th position as compared to last year's 63rd. This means that there has been significantly lesser number of hungry and malnourished people across the country. The credit goes to the several government programmes that were rolled out to tackle malnutrition.

Mahatma Gandhi had said, "There are people in the world so hungry, that God cannot appear to them except in the form of bread.” Todd Post, Senior Editor at the Bread for the World Institute, in his blog on up-coming “2015 Hunger Report: When Women Flourish… We Will End Hunger” says ‘‘Hunger persists mainly because poverty persists’’.

To really eradicate hunger, one has to address the root causes of poverty, and discrimination is the most fundamental of all root causes. Ending hunger ultimately depends on working with and through women: in the developing world, women work predominantly as subsistence farmers, and subsistence farming is the backbone of community food security. In addition, at the household level, women are responsible for preparing food that nourishes children and other family members. (This holds true for most part in developed countries, too).

In the existing scenario on the child nutrition front, CSR can play an important role. As part of corporate social responsibilities, nutrition companies should also focus on child nutrition segment as there is tremendous opportunity in this field and innovative products can help in ruling out malnutrition in infants and child. World Food Day is celebrated on October 16, every year. On this day, people around the world fight against global hunger. Combined efforts by the government, researchers, and corporate may eliminate the problem rapidly and lead to a good nation.  


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