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Gupta, D., Sujatha H.T, Satyapriya, Bishnoi, S.,Satya Prakash and Chaturvedi, N.(2021) Agri-Nutri Strategies to Overcome Malnutrition. Food and Scientific Reports. 2 (8) 37-38.

ABSTRACT

Malnutrition is globally the most important risk factor for illness and death, affecting millions of pregnant women and young. It has deleterious health consequences at both the individual and societal level. It negatively affects almost every system in the body. Bio-fortification, therapeutic diets, probiotic foods, deworming, kitchen garden, farming system for nutrition are the strategies discussed in this article.  

 Keywords: Bio-fortification, therapeutic diets, probiotic foods, deworming, kitchen garden, 

In 1974, the World Food Conference declared, “Every man, woman and child has the inalienable right to be free from hunger and malnutrition.” However, one out of every eight people in the world, almost one billion people is still not getting enough food for an active and healthy life due to lack of resources. Malnutrition refers to “all deviations from adequate and optimal nutritional status” resulting from specific nutrient deficiencies. Malnutrition, with its two constituents of protein-energy malnutrition (marasmus and kwashiorkor) and micronutrient deficiencies (iron, iodine, vitamin A and zinc), continues to be a major health burden in developing countries. Based on the estimation of Food and Agriculture Organization of the United Nations (FAO), approximately 800 million to one billion people in the world are suffering from some degree of malnutrition. Of these, forty thousand people die daily due to poor nutrition. According to the World Health Organization (WHO), 30 to 40 per cent of children under 5 years are malnourished, 165 million stunted, 99 million underweight and 51 million wasting children. It is globally the most important risk factor for illness and death, affecting millions of pregnant women and young.

Malnutrition has deleterious health consequences at both the individual and societal level. It negatively affects almost every system in the body and is associated with stunted growth, reduced muscle strength and endurance, diminished gut function, impaired cognition across the lifespan and compromised immune function which upturns the vulnerability to having infectious diseases such as tuberculosis, cancer, heart failure, chronic obstructive pulmonary disease (COPD) and hepatitis. At the societal level, it imposes a substantial burden in morbidity, mortality and economic costs. The effect of child malnutrition is long lasting and goes beyond childhood. Thus, the planning of an appropriate intervention requires the knowledge of the extent and the underlying causes of the problem (Sahu et al., 2015).            

Strategies to Prevent Malnutrition

 A. Bio-fortification

According to FAO, WFP and UNICEF, 815 million people were suffering from hunger in 2016. Levels of nutrient deficiencies are also alarmingly high: two billion people suffer from micronutrient deficiencies, also known as “hidden hunger”. Therefore, micronutrient fortification along with supplementation programs has become a focus of national and international health agencies. Bio-fortification is a relatively new strategy that uses conventional breeding technologies, biotechnologies and agronomic practices to reduce anti-nutritional factors or to increase the micronutrients (vitamin A, zinc, and iron) in economic parts of staple food crops. This approach will not only lower the number of severely malnourished people who require treatment by complementary interventions, but will also help them to maintain improved nutritional status. Moreover, bio-fortification provides a feasible means of reaching malnourished rural populations who may have limited access to commercially marketed fortified foods and supplements. Bio-fortified staple foods cannot deliver as high level of minerals and vitamins per day as supplements or industrially fortified foods, but they can help to bring millions over the threshold from malnourishment to micronutrient sufficiency (Bouis and Saltzman, 2017).

 B. Therapeutic diet strategies F-75 and F-100 or RUTF

The major public health problem throughout the developing world, mainly in Asia is severe acute malnutrition (SAM). Approximately 20 million children million suffer from SAM. Commercially available remedial formulas to cure SAM are (F-75 and F-100) and ready-to-use therapeutic foods (RUTF) that meet specified standards with the WHO specifications are fortified with vitamin A. Patients with no adequate appetite and/or have a major medical complication are initially admitted to in-patient facilities. The formula which is used at this stage is F-75. It promotes recovery of normal metabolic function and nutrition electrolytic balance. At this stage rapid weight gain is precarious, that is why F-75 is formulated so that patients do not gain weight during this stage. Once children with severe acute malnutrition are stabilized in in-patient care, it is recommended to change the therapeutic diet to F-100 or a ready-to-use therapeutic food. This enables the recovery of weight and lean body tissue loss. Ready-to-Use Therapeutic Food (RUTF) is a broad term including different types of foods, such as compressed or spreads products, purposely designed for the treatment of SAM. Generally it consists of a mixture of milk powder, vegetable oil, sugar, peanut butter and a vitamin-mineral premix. Since bacterial growth in RUTF is limited and can be stored safely at home without refrigeration, it can be used even in areas where hygienic conditions are not optimal because it does not need water, utensils etc., before taking it. Thus, both in non-emergency situations and in disaster relief programs, RUTF has steadily turned out to be the most extensively used therapeutic resolution to fight child malnutrition (Lanyero et al., 2017).

 C. Probiotic foods

In severe acute malnourished children, the incidents of diarrhoea are high, which is a main cause of child mortality of less than five years old. Probiotics have immune stimulatory activity and restoration of gut functionality by stimulating the diversity of bacteria (bifidobacteria). Therefore, delivering of probiotic products may improve the lives of hundreds and millions of people by improving micronutrient malnutrition. The consumption of fermented foods containing probiotics is one of the opportunity by which health of children may be improved. Fermentation is a preservation technique which acts as vehicles for probiotics, hence can prevent post-harvest losses and affect the gut microbiota, detoxify the raw materials as well as increase the intake of nutrients and alleviating diseases like anaemia and malnutrition. Thus, it may be concluded that, the diet higher in fibres and carbohydrates appears to select the useful gut microorganisms which in turn help to protect against infection, inflammation as well as extracts the maximum energy from the low calorie food.

 D. Deworming

                Intestinal nematodes are amongst the most common agents of chronic infection in low income countries. In India, it has been reported that about half of the population is infected with round worm (Ascaris lumbricoides), whipworm (Trichuris trichiura) and hookworm (Necator americanus, Ancylostoma duodenale). These infections could have significant effects on the development of children. Any effects on physical development would typically be subtle and chronic, manifesting as longstanding anaemia, reduced physical fitness, constrained growth and poor cognition and educational achievement. Recognition of these potential consequences of infection has led to increasing emphasis on community-based anthelmintic treatment to reduce worm burdens in children irrespective of direct evidence of infection, particularly children of school age. Hence, deworming children with albendazole allows them to better absorb nutrients, combating malnutrition, improved growth and stunted development and survival in urban north India.

E. Kitchen Gardening

The main purpose of a kitchen gardening is to provide the family daily with fresh vegetables rich in nutrients and energy. They have the potential to impact on Vitamin A, provide support for malnourished and sick children and potentially provide nutritional diversity to support complementary feeding. The World Health Organisation advocates that, five portions of fruit and vegetables (400 g collectively) need to be consumed daily to maintain a healthy diet with enough essential micronutrients. In 1996 the UNDP proposed that, urban agriculture could contribute significantly to combat urban hunger and malnutrition by providing increased and consistent access to fresh, nutritional food at lower than market cost. To achieve Sustainable Development Goals, Nutri-gardens can have a big role to play (Shubha et al., 2020).   Evidence shows that, food gardens have some success in acting as a buffer against malnutrition. Beyond the arguments around food security, they are supported for their proposed ability to provide nutritious food (improved nutrition status) to those who grow them and to provide access to nutritional diversity where this is difficult to achieve. In order to have an impact on micronutrient nutritional status, sufficient Vitamin A rich foods need to be grown (butternut, orange flesh, sweet potato, carrots, dark green leafy vegetables and pumpkin). Vegetables are rich sources of nutritional bioactive compounds. They are important sources of protective nutrients like vitamins, minerals, antioxidants, folic acid and dietary fibres. Therefore, it is cautiously proposed that, the existence of a food garden has a potential to provide nutritional benefits in terms of increased micronutrient intake and potentially beneficial income replacement options. The diversified and highly nutritive vegetables are affordable and cost effective solution to overcome hidden hunger and malnutrition. 

 F. Farming System for Nutrition

Farming System for Nutrition (FSN) is an interventional approach that includes a combination of sustainable agricultural remedies involving advanced crop production practices, biofortification, promotion of backyard/community nutrition gardens of fruits and vegetables, livestock and poultry development, setting up of small-scale fisheries and regularising veterinary services as stimulant for rendering higher income and better nutrition output. Food and diets lacking diversity and without nutrition focused, farming systems either boosting income (solely indirect effects) or monotonous diet (solely direct effects) may not be appropriate to improve household nutrition and health status. A combination of innovative FSN strategies that can diversify diet (directly) and make better use of income for nutritional adequacy (indirectly); concurrently with other interventions to improve education, health, sanitation and household infrastructure stand a better chance of combating undernutrition and micronutrient deficiency problems.

 Conclusion

                Thus, it may be concluded that, these above mentioned strategies may help in combating malnutrition. Bio-fortification has been introduced to overcome the nutritional problem and to make the important micronutrient bio-availability in staple food crops and vegetables.

The use of therapeutic diets like F100 and RUTF rectifies several health problems like anaemia and vitamin deficiency diseases. Whereas, kitchen gardening ensure the availability of nutrition rich vegetables. Further, probiotics and deworming allow better absorption of nutrients in children, while FSN strategies diversify the diet and make better use of income for nutritional adequacy.

References

 

Bouis H.E. and Saltzman A., (2017). Improving nutrition through biofortification: a review of evidence from Harvest Plus, 2003 through 2016. Global food security. 12:49-58.

Lanyero B., Namusoke H., Nabukeera-Barungi N., Grenov B., Mupere E., Michaelsen K.F. and Briend A., (2017). Transition from F-75 to ready-to-use therapeutic food in children with severe acute malnutrition, an observational study in Uganda. Nutrition journal. 16(1):1-10.

Sahu S.K., Kumar S.G., Bhat B.V., Premarajan K.C., Sarkar S., Roy G. and Joseph N., (2015). Malnutrition among under-five children in India and strategies for control. Journal of natural science, biology, and medicine. 6(1):18.

Shubha. K., Mukherjee. A., Anand. S., Koley. T.K., Kumar, U.(2020) Nutri-garden for achieving Sustainable Development Goals (SDGs). Food and Scientific Reports. 1(1): 25-27.

 

 

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Agri-nutri Strategies to overcome Malnutrition_ Food and Scientific Reports.pdf