9. Consumption of food & nutrition

9. Consumption of food & nutrition

Various food and nutrition related policies, initiatives and programme in India have already been discussed in preceding chapters. An attempt can now be made to see the impact of these on the consumption of various food items and consequently on national and household level food and nutrition security. It is proposed to first look at food or rather "cereals" consumption and then move on to the consumption of other food and nutrition items. Normally one should take foodgrains i.e. cereals plus pulses for such an exercise, but it is proposed to concentrate on cereals first, since cereals not only provide around 70 percent of energy and protein but averages in their case are quite representative for all, including poor households. Consumption of cereals actually goes down as incomes of households increase. Thus, if average consumption of cereals is found to be equal to recommended levels, it projects quite a satisfactory picture, with poor households also consuming at least average, if not higher quantity. Same thing cannot be said of pulses, or for that matter other food items. The consumption, and resultant cereals security, is very important for a country like India which was characterised by a history of famines, has vast and expanding population; low per capita income with around 29 percent or almost 250 million people living below poverty line; poor access to health, education, safe drinking water, sanitation and other social services etc. Top most priority for such a country is to get each and every one of its people out of the clutches of hunger and starvation and assure them security of at least cereals or what is loosely called 'staple diets'. In a way this can also be described as food security, albeit in a very narrow sense. Let me, however, hasten to add that it will not be prudent for any country to confine itself to only such food security; not certainly for India, which has been endowed with such resources that providing a complete nutritious diet to every Indian should not be beyond the capabilities of the country. The country must, therefore, work towards achieving complete food and nutrition security, even though elimination of hunger may have been the first objective. In the ultimate analysis, the task is really one of around development of the human resource and "human beings need tote] nourishment for their growth, development and productivity. They need a wide range of nutrients to perform various functions in the body. These nutrients include protein, fats, carbohydrates, vitamins and minerals" (Rag, and others, 1989). As is well known, energy is vital for activity, growth and rest while protein supplies the body building material and help in recouping loss on account of wear and tear. These two are the most important nutrient but there are many vitamins and minerals that are needed by human body not only for carrying out many vital functions of the body but also for helping in utilisation of many nutrients like proteins, fats and carbohydrates. These are required in small quantities but their importance is now being seriously recognised. "It is now being increasingly realized that in the absence of just one vitamin (Vitamin A) and two minerals (iron and iodine), individuals and families suffer serious consequences expressed as increased mortality, morbidity and disability rates; communities and nations suffer losses in human potential, the social and economic costs of which no country can afford". (Ramalingaswami, Montreal Conference, 1991). What is, therefore, important is not only to assure staple diets to all people but, in the meantime, work for dietary education and diversification in ultimately achieving such a goal. However, cereals availability and consumption to the full extent can certainly be the starting point.

It is, therefore, proposed to first examine the consumption of cereals against the norms set by the experts. While production and availability projects a macro picture as discussed in Chapter 4, it is the consumption data that indicates the household food security. It is proposed to look essentially at the data on consumption of cereals and other food items generated by the NNMB and Food and Nutrition Board (FNB). Earlier in Chapter IV, we have already looked at the per capita monthly consumer expenditure data thrown up during the household surveys conducted by the National Sample Survey Organisation (NSSO). Such data is also very useful in that it indicates the ability of the households to stave off hunger if they spend less than certain proportion of their incomes on food. "Households who spend 80 per cent of their incomes on food and cannot meet at least 80 per cent of their defined calorie needs are considered vulnerable and insecure". (Bapna, 1993).

We can now look at the NNMB data on consumption of cereals and other foodstuffs generated during their two surveys, 1975-79 and 1988-90. The Recommended Dietary Intake (RDI) has also been given. The picture that emerges is given below:

Table 30 Average Consumption of Foodstuffs (gms/cu/day)

Foodstuff	Year	Posted avg. consumption	RDI
Coarse cereals &	1975-79	·504	460
millets	1988-90	490
Pulses	1975-79	36	40
	1988-90	32
Roots & Tubers	1975-79	48	50 -
	1988-90	40
Green Leafy Vegetables	1975-79	8	40
	1988-90	11
Other Vegetables	1975-79	51	60
	1988-90	49
Milk & Milk Products	1975-79	100	150
	1988-90	96
Fats & Oils	1975-79	12	20
	1988-90	13
Sugar & Jaggery	1975-79	23	30
	1988-90	29

Source: NNMB (1991)

Before we proceed to analyse the NNMB data on food consumption, it must be mentioned that the data suffers from some limitations. It is based on a small sample of 750 households in only 10 states out of a total of 32 states and union territories. Per consumption unit consumption is assessed by one day weighment method in 80 per cent households and 24 hour recall method in the rest; but success of these methods depends on how forthcoming the lady of the house is and how accurately she can recall. Further, the two surveys, cover a time span of hardly 15 to 18 years, which is too small to assess the trends very correctly. However, notwithstanding such limitations, the NNMB surveys remain the only authentic, reliable and scientifically collected information on nutritional consumption in India and its examination and analysis, especially that of the disaggregated data, is expected to present a fairly representative picture of the both national and household food security.

It can be observed from Table No. 30 that consumption of cereals of 490 gms/cu/day in 198890 was higher than the RDI levels, which confirm adequate production and availability of cereals in the country, as brought out in Chapter 4. In fact, average consumption of cereals was 30 gms. more than RDI or, in other words, there was a cushion of 6.5 per cent in the availability and consumption of cereals as recently as in 1988-90. In view of the fact that around 70 per cent of the energy comes from cereals alone, and better-off households consume less cereals as their income rise, with their consumption of other food items like milk, milk products, fruits, vegetables, eggs, mutton etc. increasing, the cereal intake for even poor households should be quite satisfactory; richer households would not normally overconsume a commodity like cereals. The Working Group set up by Ministry of Agriculture (April 1994) has found that average availability of cereals during biennium 1991-93 has been of the order of 434 gins/capita/day, which is equivalent to energy availability of 1501 kcal/capita/day. With calories available from other foodstuffs, the total average energy availability has been worked out to be 2400 kcal against the weighted average energy requirement of only 2200 kcal. Thus, it appears that availability of cereals at the macro level and through cereals, the energy availability has been quite satisfactory during 1991-1993. However, as far as intake of energy is concerned, there is absolutely no certainty that the balance weighted average requirement of energy i.e., 2200 minus 1501 or 699 or 700 kcal, would be available to poor households from the other food items as given in the Working Group of Agriculture, (April, 1994) calculations. Some poor households may be consuming less than average quantities available for consumption as shown in Table No.9 on account of inadequate purchasing power and the better off households may be consuming more energy than average.

Against the above background, a question can legitimately be posed. If the availability of cereals and to a great extent energy, (and availability can be the proxy for consumption, on account of insignificant exports) is so comfortable, how come that 1987-88 estimate of the Planning Commission indicate that 29 per cent of people were living below the poverty line, not being able to consume 2200 kcal of energy, the weighted average requirement for the entire population or 2400 kcal in urban & 2400 kcal in rural areas ? How is that 8.7 per cent of preschool children suffered from severe and 43.8 per cent from moderate malnutrition as found by NNMB surveys during 198890 ? The explanation probably lies in the variety of factors that may contribute to malnutrition, even if a person may be consuming more than RDI levels of cereals and other foodstuffs. These factors could be unbalanced diets; poor food habits; unsafe drinking water; prevalence of diseases like diarrhoea, gastroenteritis etc.; worms infestation; other health problems and so on. One is, however, still prompted to persist with the above question because granting presence of such factors, the very fact that against the weighted average requirement of 2200 kcal energy and 50g protein, with the availability is 2400 kcal and 64.9 gms, the nutritional status of average Indian should have been better than what emerges from data on poverty and malnutrition. An examination of disaggregated data may be, therefore, important.

The mismatch can be examined by analysing the NNMB data on average consumption of foodstuffs collected during 1988-90 according to various groups in rural areas:

Table No. 31 Average Consumption of Foodstuffs by Per Capita Income (PCI)

				Consumption in gms/cu/day PCI in its/Capita/month
Per	Cereals	Pulses	Total Vegetable	Roots & Tubers	Fats & Oils	Milk & Product	Sugar & Jaggary
< 30	475	25	44	36	9	42	16
30-45	509	33	43	37	7	45	20
45-60	490	29	53	31	8	51	22
60-90	478	29	49	37	9	62	23
90-150	479	29	57	41	11	86	17
150-300	452	33	68	44	14	121	33
<300	454	43	81	56	25	230	91

Source: NNMB Report of Repeat Surveys, 1991.

It may be observed from the data given above that the well accepted thesis of decline in cereal consumption with rising incomes is reflected in the general trend evident from the data. While cereal consumption was 475 gm/cu/da for the lowest PCI group, it was only 454 am. for the highest income group. It is also observed that except for the two highest PCI groups, the rest of the five groups have cereal consumption higher than the RDI and even in case of two lowest PCI groups, it is more than the ICMR norm of 460 gms. Intake of other foodstuffs was below RDI for all groups except highest.

The NNMB had also carried out surveys on intake of food stuffs in urban areas during 197579. The population was divided on occupational lines-(i) High Income Group (HIG) consisting of highly educated households occupying high positions in government (ii) Middle Income Group (MIG) composed mainly of administrative staff at middle rungs, (iii) Low Income Group (LIG) consisting of those occupying lowest position in the government, (iv) Industrial Labour (IL) and Slum Dwellers (SD). (NNMB Report on urban population, 1984). The result of the survey were as given in Table No. 32.

Table No. 32 Average intake of Foodstuff in Urban Areas (gm/cu/day)

Income Group	Cereals	Pulses	Total vegetable	Milk	Fats & Oils
HIG	316	57	134	424	46
MIG	361	49	110	250	35
LIG	428	42	71	95	22
IL	420	41	69	98	23
SD	416	33	51	42	13

Source: NNMB (1984)

The picture relating to cereals consumption is more or less similar in urban areas also. It is lowest at 316 gm/cu/day for HIG and highest at 428 gm/cu/day for LIG. In fact, the cereals consumption in urban areas for all income groups is lower than in rural areas-the lowest income group in rural areas with PCI less than Rs. 30 per month consuming 427 gms/cu/day as against only 420 gms/cu/day for LIG in urban areas. Consumption of pulses was however higher than RDI except for SD and consumption of other stuffs was much better than rural areas, except for SD groups.

We also find that the lowest cereal consumption in urban areas was amongst SD group (416 gms/cm/day) but this is substantially, lower than the lowest PCI group in rural areas (475. gm/cm/day). In fact, the cereal consumption of slum dwellers is even lower than the highest PCI group in rural areas. The diversification of diets away from cereals in urban areas is partially explained by better income opportunities in urban areas. This also possibly explains, in a large measure, migration to urban areas. In case of slum dwellers, however, the lower intake of cereals is not accompanied by higher intake of other cereals, suggesting special policy measures of this group of people.

I have not come across any empirical studies that have attempted to explain this mismatching between consumption of cereals (providing about 70 per cent of calorie requirements as also 75 per cent of protein) and poverty (based on ability to have intake of certain quantity of energy). There can, however, be a number of factors working singly or in tandem, that may be able to explain this situation. At this stage, these probable factors can be only posed as questions beseeching some competent people to tackle them exclusively. Is it that NNMB surveys based on a small sample and sampling methodology have not been able to capture a truly representative picture ? Is it that in the absence of superior or high energy foods, the people with low incomes consume more than the RDI quantity of cereals to make up for any shortages in the balanced diets ? Are the RDI norms laid down for average Indian by the ICMR Expert Group lower than what they should be, especially when one notices that the DES of a Chinese in 1986-88 was 2637 kcal against only 2104 kcal for an Indian ? Is it that with the recent disappearance of the old situation of hunger for many people, they tend to eat more than RDI levels in the short run simply to achieve a certain psychological satisfaction ? Is any change in food habits or taste, influencing cereal consumption, responsible for this ? Is this due to health related factors essentially ? Do low per capita income have a relationship with this and if so, how NSSO data on consumption expenditure can establish such relationship ? These and such others are the highly complicated questions that may have to be examined and the entire matter covering them should become a subject for a separate in depth study.

Consumption of Foodstuffs other than Cereals

As far as consumption of other foodstuffs is concerned, the picture as thrown up by NNMB surveys is not as promising as in case of cereals. Tables 31 and 32 will establish this. In case of all these foodstuffs, there is a negative gap between the average consumption and RDI. The brief analysis for each of the foodstuff is attempted hereunder:

Consumption of Pulses

The average RDI for pulses is 40 gms/cu/day. However, average intake of pulses in rural areas is 32 gms/cu/day only. The weighted average per capita requirement for the entire population, has, however, been taken as 50 gins/capita/day (Agriculture Group, 1994). For different income groups in rural areas, the intake of pulses is highest at 43 gms for highest income group (over Rs.300 per capita per month). It is 33 arms for the next highest as also for the sixth PCI Group out of seven. For all the other income groups, it varies between 25 gm to 29 gms/cu/day. In urban areas, the NNMB surveys indicate that except for slum dwellers (consumption of pulses 33 gms/cu/day), all the other income groups have higher than RDI consumption of pulses, with HIG topping with a consumption of 57 gms/cu/day. Even LIG and IL groups have slightly higher than RDI level with 42 and 41 gms/cu/day. Protein intake of slum dwellers has to be monitored closely and it is quite possible that due to lack of nutritional awareness, these people are spending money on entertainment, drinking, clothes etc. but not sparing enough for pulses or alternate sources of protein.

It is, however, clear that majority of Indians, especially in rural areas consume less than RDI levels of pulses. For a majority of them, pulses are the most important source of protein as they happen to be vegetarians and cannot, therefore, make up for short-consumption and poor absorption of cereal based protein by consuming meat, fish, egg etc.

It is therefore, very important for India to increase production of pulses by developing high yielding varieties, suitable both for rainfed and irrigated conditions and usher in a mini-revolution in pulses production.

Consumption of Milk

The ICMR Expert Group's RDI for milk is 150 gm/cu/day. In rural areas, only the highest PCI group has average consumption of milk higher than RDI (230 gms/cu/day). Consumption of next highest PCI group is 121 gms/cu/day, whereas the lower five groups have intakes between 42 and 86 gms/cu/day. In rural areas, intake of milk is not only a function of purchasing power but also of availability. Lot of work still remains to be done in improving the breed of the non-descript cattle we have in large parts of the rural India. Nutrition education and awareness also needs to be improved.

In urban areas, HIG and MIG groups have milk consumption higher than RDI at 424 and 250 gms/cu/day. That of LIG and IL group is low at 95 and 98 gms. However, the milk intake of slum dweller is extremely low at 42 gms/cu/day. Similar efforts, as in case of pulses and protein foods including awareness drive, need to be taken up amongst slum dwellers.

Cosumptions of Fats/Oils

The RDI for fats/oils is 20 gms/cu/day. It is only the highest of the 7 PCI groups in rural areas, which consumes higher than RDI levies (25 gm/cu/day) with all the other PCI group, consuming between 9 to 14 gms/cu/day. Lowest PCI group was found to be consuming (9 gms) slightly higher than next two higher PCI groups. In urban areas, all occupational groups, except the slum dwellers (13 gms/cu/day) consume higher than RDI levels of fats/oils with HIG consuming higher than double at 46 gms/cu/day. It will be useful for this group as well as for the country, if their intake of oils/fats is reduced through proper education.

Consumption of Vegetables

As against RDI of 100 gms/cu/day of all (40 gms of green leafy vegetables plus 60 gms of other vegetables), the intake of all groups in rural areas and those other than HIG & MIG groups in urban areas is lower than RDI. It is as high as 134 gms. in case of HIG and 110 gms. in case of MIG. For LIG, IL & SD groups, it ranges between 51 and 71 gms i.e. less than RDI. Surprisingly, the intake is lower than RDI for all PCI groups in rural areas. Apart form availability, optimum use of vegetables is also very important so that washing and cooking of vegetables is done in such a way that loss of nutrients is reduced to minimum. This will go a long way in improving the general health of the people and reduce anaemia which is still a big problem especially amongst expectant and nursing mothers.

Intake of Foodstuffs by States

It will be very useful to also study the desegregated statewise data with respect to average intake of foodstuffs, as it can help policy makers in initiating special efforts in those States where situation is unsatisfactory. The Figure Nos. 5 to 8 given hereinafter show the average intake of the four important foodstuffs viz. cereals, pulses, milk and fats/oils in 10 States surveyed by NNMB and another 8 surveyed by the FNB.

AVERAGE INTAKE OF CEREALS

AVERAGE INTAKE OF PULSES

AVERAGE INTAKE OF MILK

AVERAGE INTAKE OF FATS AND OILS

An analysis of the data given in the figures 5 to 8 gives following picture:

Intake of Cereals

The cereals intake has been less than the RDI of 460 gms/cu/day per day only in case of Tamil Nadu, Goa and Meghalaya. While a relationship with poverty may not be accurately available for Goa and Meghalaya, which are very small in size but in case of Tamil Nadu, low intake of cereals is against the background of the State having 32.8 percent of its people below poetry line. Punjab which has the least number of poor as a percentage to its population (only 7.2 percent), is 7th highest cereal consuming state out of the 18 States, On the other hand, for Orissa which has the highest percentage of poor amongst all the 18 surveyed States, the average cereals intake at 628 gm/cu/day is not only very much higher than RDI of 460 gms but the highest in the country.

Intake of Pulses

The RDI of pulses is 40 gm/cu/day. Only Karnataka (50 gms), M.P. (56 gms) Rajasthan (50 am) and UP (45 am) exceed it. All these states have quite high proportion of population below poverty line. Interestingly, Orissa, the State with maximum poor, has an average pulses intake of 40 gms/cu/day, exactly the same as RDI. The averages based on the sample surveys conducted by both NNMB and FNB seem to throw up a confusing picture since Orissa has the highest percentage of poor (44.7 percent) in the country yet its average cereals intake is a record 628 gms against RDI of 460 gms and that of pulses is exactly equal to RDI of 40 gms/cu/day. Its fats & oil consumption as we will see later, is also third highest in the country. Orissa not only has highest proportions of poor but also has recently acquired some notoriety due to distress conditions in Kalahandi district of the State.

Consumption of Milk

The RDI for milk/milk products is 150 gms/cu/day. We find that only Punjab (very high at 396 gm/cu/day) and Karnataka (282 am) exceed it. Milk consumption is not only a function of purchasing power but also of local availability (because it cannot be easily transported to all places and over long distances) and consumption behaviour. In tune with its poverty, the milk intake in Orissa is one of the lowest, only West Bengal and Meghalaya (more consumption of tea than milk?) being lower than Orissa.

Consumption of Fats/Oils

The RDI for fats and oils is 20 gms/cu/day. Gujarat, which is the biggest producer of oil seeds and manufacturer of oils naturally tops the list with consumption of 21 gms/cu/day Next in consumption are Punjab (also consumes lot of fresh butter, cheese) with 17 gms/cu/day. Orissa, inspite its higher proportion of poor is third with an intakes of 16 gms/cu/day. On the other side of the spectrum, Utter Pradesh a food- surplus, state and a state which also grows quite a bit of oilseeds, ranks lowest with fats/oils intake of only 4 gms/cu/day. Bihar, Goa, Meghalaya, Rajasthan & Tripura also have very low consumption of fats/oils at 7 gms/cu/day.

Changes in food consumption

Before we move on to examine the status of intake of nutrients, we may have a look at the changes in foodstuff consumption at the national level between 1975-79 when NNMB carried out first surveys and 1988-90 when it undertook repeat surveys. The position is shown in Figure No. 9.

Figure 9 CHANGES IN FOOD CONSUMPTION

(During 1975-79 & 1988-90)

It is seen that per consumption unit intake of cereals, pulses, roots/tubers, other vegetables and milk/milk products has declined during this period while that of green leafy vegetables, sugar/jaggery and fats/oils has increased. However, the position must have undergone a change recently for the better in case of almost all the foodstuffs, because production of almost all food items has shown an increasing trend since 1988-89, the year following the severe drought of 1987.

INTAKE OF NUTRIENTS

Energy intake

Figure No. 10 shows the statewise average intake of energy in rural areas as against the RDI (2400 k cal.cu/day). Incidentally, the RDI of energy of 2400 kcal also defines poverty in rural areas. The average dietary intake per consumption unit per day is 2280 kcal which is quite close of RDI. however, there are sharp inter-state variations as shown in Table 10.

AVERAGE INTAKE OF ENERGY

Punjab having the least percentage of poor and surplus food production, logically enjoys the highest average energy intake of 2760 kcal. However, as was observed in respect of cereals, pulses and fats/oils intake for Orissa, it has a high average intake of 2700 kcal of energy, much higher than the RDI, which also happens to be next only to Punjab. Madhya Pradesh, which also ranks very high in the poverty scale enjoys third highest energy intake, again substantially higher than RDI. West Bengal and Karnataka also have energy intake higher than RDI. State of Andhra Pradesh and Gujarat fall behind RDI only marginally. In the remaining States, it is less than the RDI. It, therefore, appears that although the energy intake of 2400 kcal/cu/day defines the poverty, the direct relationship between energy intake and poverty does not hold good universally and may be influenced by more consumption of carbohydrates and that too in larger quantities as can be experienced during visits to rural areas of Orissa or Madhya Pradesh.

The energy intake among rural and urban proxy income groups is shown in Figures No. 11 and 12.

ENERGY INTAKE OF RURAL POPULATION

ENERGY INTAKE OF URBAN POPULATION

It is observed that in the rural areas, average energy intake is highest among cultivators (2514 kcal./cu/day) against pooled average of 2340 kcal. This is understandable as the cultivators tend to keep a portion of their produce for self consumption. The lowest (2043 kcal) is amongst the landless agriculture labourers, which, therefore, is the category that needs maximum attention as far as food & nutrition security is concerned. In urban areas, highest energy intake is by HIG (2603 kcal) and lowest (2008 kcal) by slum dwellers who consume less energy even as compared to the lowest income rural category of landless agricultural labourers and therefore, require special attention if food & nutrition security is it be assured for them.

Protein intake

The national average intake of protein as reflected in NNMB surveys comes to 62 gms/cu/day which is slightly above the RDI of 60 gms/cu/day. However, here again, pronounced Statewise variations are seen as will be observed from Figure No 13.

AVERAGE INTAKE OF PROTEIN

Punjab again leads all other States with an average protein intake of 85 gms. Madhya Pradesh, even though having large proportion of poor in its population, is second with 82.5, probably because of very high production of pulses and soybean, part of the production being kept back by even poor growers for self consumption. High average intake of protein in Uttar Pradesh and Gujarat can also be explained by same logic. Karnataka, Maharashtra, Orissa, Goa, Jammu and Kashmir, Meghalaya and Rajasthan also have protein intake higher can RDI. The States which are lagging behind are Andhra Pradesh, Kerala, Tamil Nadu, West Bengal. Sikkim and Tripura appear to be low due to poor production of pulses and high transport cost of pulses imported from other parts of the country, as also poor state of the milch animals.

Andhra Pradesh, Tamil Nadu and W.Bengal can increase their protein foods and supplement it by fish and should quickly attain at least RDI levels of protein intake. In fact, with tremendous increase in fish and eggs in A.P., the protein intake in that state will be quite different in next surveys.

Intake of Micro-nutrients

It is observed from the NNMB surveys during 1975-79 that in the urban areas, the aggregate intake levels of iron were higher in all income group than ICMR recommended level. In respect of Vitamin A, however, deficiencies existed among all groups except the High Income Group. As shown below, the slum dwellers are at the bottom for both, as they were in case of energy and protein intake:

Table 33 AVERAGE INTAKE OF IRON AND VITAMIN "A" IN URBAN AREAS

	IN TAKE OF
GROUP	IRON (in ma)	Vit "A" (in ug.)
HIG	27.3	881
MIG	26.7	555
LIG	26.5	332
UK	26.3	352
SD	24.9	248
RDA (ICMR)	24.0	750

SOURCE: NNMB Report, 1981.

The data on intake of iron and Vitamin A in respect of rural areas is given below:

Table 34 AVERAGE INTAKE OF IRON AND VITAMIN A IN RURAL AREAS

	IN TAKE OF
YEAR	IRON (in ma)	Vit "A" (in ug.)
1975	31.8	263
1977	29.3	262
1979	30.3	270
1981	31.7	373
1982	30.4	366
1983	31.1	300
1988-89	30.5	352
RDA (ICMR)	24.0	750

It will be observed from the data for rural areas that average iron consumption has remained around 30 mg/cu/day against the ICMR norm of 24 ma. Thus, iron intake for rural population as a whole appears higher than RDI. These high intakes of iron should however be taken with a pinch of salt. It is common knowledge that there are large groups at risk, especially pre-school children and pregnant/lactating mothers, who suffer from iron deficiency anaemia. It has been estimated in various studies, particularly those conducted by NIN, that "roughly 55 percent preschool children and almost 50 percent of the expectant mothers in the third trimester of pregnancy, suffer from iron deficiency, which is basically due to inadequate or poor absorption of iron form a predominantly cereal based diet". (NIN, 1993). The problem is vegetarian diets, which have iron but not much of that is absorbed by the body in view of blocking substances that such foods, especially cereals, contain. Iron deficiency anaemia is also prevalent amongst non-vegetarians also, because very few of them can afford non-vegetarian food on a regular basis. "It is therefore, necessary to educate the masses about the rich sources of iron and associated factors like positive influence of Vitamin 'C' or the citrus fruits on the absorption of iron, negative influence of tea/coffee in the diet and role of hookworm infestation, material parasites etc. in aggravating the situation" (Dr. Smt. Ramachandran, 1993). India was, however, among the very first amongst developing countries to take up a prophylaxis programme amongst pregnant women and children, essentially through iron foliate administration. Besides, fortication of common foods with iron and required medical interventions are also indicated.

IODINE DEFICIENCY

It is only recently that experts and policy makers have fully realised that endemic goiter and cretinism is not the only manifestation of iodine deficiency. "The term iodine deficiency disorders (IDD) now covers a wide spectrum of effects leading to human misery and degradation that are largely irreversible, once manifested. The long list of clinical disorders which are now ascribed to iodine deficiency, starting from still birth and abortion to goiter and various types of mental retardation and finally to cretinism, the most cruel form of IDD, is indeed scaring" (Kalyan Bagchi, July 1993). To make things worse, IDD can affect human beings at any stage, even during his intra-uterine existence. In meeting the challenge of IDD, the policy makers have to appreciate that iodine deficiency is not really related to dietary deficiency but originates from lack of adequate iodine in the soil itself. Thus, whoever lives off that soil, rich or poor, will have IDD because neither the water nor any other produce will supply him adequate iodine which is considered to be just 120 to 150 microgram per day. Those living in coastal areas have, of course, the advantage of intake of large quantity of sea food which contains substantial quantities of iodine. The only way to tackle the IDD is, therefore, to either add iodine to food or water consumed by people at risk or through oral/injected medication. The most popular method, which is also followed in India, is to iodise the salt at the time of manufacture and ensure that only such salt is consumed in endemic areas. Considering the problem of non-iodised salt being cheaper than iodised, Govt. of India has decided that statutory change over to iodised salt will be undertaken in phases and completed by 1995. In India, IDD is highly prevalent in a broad sub-Himalayan belt, almost 2400 km. long, stretching from Kashmir in North to Naga hills in the East. Surveys conducted by the Central Goitre Survey team during past two decades indicate that around 54 million people suffer not only from endemic goitre and cretinism but other manifestations of IDD, like deaf-mutism, mental retardation and various degrees of neuro-motor dysfunctions. It is estimated that "with every passing hour 10 children are born in this country who will not attain their optimum mental and physical potential due to neo-natal hypothyroidism caused by iodine deficiency". (IDD Project document, Min of H.& FW, 1993)

Government of India had launched a National Goitre Control Programme in 1962 with focus on consumption of iodised salt in endemic areas. This programme was converted into National Iodine Deficiency Disorder Control Programme in August 1992 to emphasise the wider spectrum of the fight against IDD. An important element of the new programme was to ultimately ban non-iodised salt. 22 of the 32 States /UTs have accordingly banned entry of noniodised salt in these States/UTs. Programme includes establishing more plants to manufacture iodised slat, privatisation of the industry, provision of subsidy to such industries, monitoring consumption of iodised salt, conducting surveys to identify extent of IDD, conducting training and improving communications.

It is, thus, brought out by NNMB data on consumption of food items and nutrients that:

a) While energy and protein intake at the national level may appear quite satisfactory, which is also indicated by the availability of foodstuffs as worked out by the Working Group of the Ministry of Agriculture (April, 1994), the situation varies greatly between states. Although there is a mix-match between consumption of energy and proportion of people below poverty line, exemplified forcefully by Orissa, the difference in consumption would really be due to prevalence of poverty, status of health and educational attainments.

b) While food security, especially limited to cereals or staple diets, appears quite satisfactory, even at the household levels, such security appears to have been achieved by poor households by paying a social cost, like making their children work, working at lower than statutory minimum wages, putting long hours of hard work, working in hazardous and unhealthy environment etc.

c) It has been brought out that notwithstanding some improvements, certain' groups of households like those having no land and agricultural labourers in rural areas and slum dwellers in urban areas are still relatively more food-insecure. The most satisfying indication is an improvement in the nutritional status of pre-school children.

d) While food security position is somewhat satisfactory, the nutritional security is still a distant reality. No doubt, production of other foodstuffs like milk, mutton, eggs, fish, fruits etc. has shown sharp increases in recent years which may give an improved picture of nutrition security during surveys conducted in future.