Eleventh Five Year Plan

Nutrition and Social Safety Net 129in infancy and early childhood, resulting in malnutrition,contribute to impaired cognitive and socialdevelopment, poor school performance, and reducedproductivity in later life. Malnutrition therefore is amajor threat to social and economic development as itis among the most serious obstacles to attaining andmaintaining health of this important age group.4.1.5 When poor nutrition starts in utero, it extendsthroughout the life cycle, particularly in girls and women.This not only amplifies the risks to the individual’shealth but also increases the likelihood of damage tofuture generations, through further foetal retardation.Low birth weight increases the risk of infant and childmortality and those who survive are usually undernourished,fall ill frequently, and fail to develop optimally,both physically and mentally. Further, undernourishedadults are functionally impaired and unable to sustainproductive physical activity throughout the day. Nutrition-relateddisabilities, such as memory disturbances,osteoporosis, etc., are found among elderly.4.1.6 When nutritional needs are not met, recoveryfrom an illness also takes longer. Malnutrition is alsolinked to the growing HIV/AIDS pandemic. Malnutritionmakes adults more susceptible to the virus.Inadequate infant feeding aggravates its transmissionfrom mother to child; and evidence suggests thatmalnutrition makes ARV drugs less effective. In addition,good nutrition can help to extend the periodwhen the person with HIV/AIDS is well and working.There are also new dimensions to the malnutritionproblem. The epidemic of obesity and diet-relatedNCDs is spreading in India slowly but steadily.India is beginning to suffer from a double burdenof undernutrition and obesity. This phenomenon,called ‘nutrition transition’, means that the nationalhealth systems now have to cope with the high costof treating diet-related NCDs and at the same time,fight under nutrition and the traditional communicablediseases.4.1.7 Therefore the challenges that still remainsinclude:• High levels of adult malnutrition affecting a thirdof the country’s adults,• Inappropriate infant feeding and caring practices,• High levels of undernutrition, particularly inwomen and children,• Micronutrient undernutrition,• Emerging diet-related diseases,• Inadequate access to health care.Empirical Evidence4.1.8 The absolute weights and heights of Indians onaverage have not shown significant improvement overthe last 25 years. A staggering percentage of babies inIndia are born with LBW, a problem that began inutero. A mean deficit of 1.4 to 1.6 kg in weight at oneyear worsens to a deficit of about 9 kg at 10 years and13–18 kg when adults. A similar trend is seen in thecase of heights (where a deficit of 1cm at 1 year reaches12–13 cm when adult). It is therefore, not surprisingthat about half of children are under weight (moderateto severe under nutrition) or are stunted. Thereare no differences in the nutritional status between girlsand boys; however, the mean heights and weights ofchildren from SC/ST and other marginalized sectionsare below the national mean values. In addition, about30% of all adults have BMI