Request HLPE to consider the following feedback:
1. Animal studies indicates that “Maternal protein restriction leads to hyperresponsiveness to stress and salt-sensitive hypertension in male offspring”1. Further research on similar studies on PEM (protein energy malnutrition) in humans is required. It is necessary to study the possibility of PEM related malnutrition from pregnant ladies to male children. In the meantime, protein requirement guidelines of pregnant ladies should be prepared.
2. A holistic ‘people centric’ approach to food, health and nutrition is required to address issues beyond food systems. Data collection and reporting tools should be supplemented with causal analysis and monitoring tools. Best practices in the world (health care) should be considered to eliminate all forms of malnutrition. For example, two ultrasound examinations during pregnancy (normal cases) in Switzerland is one such measure to monitor the health of a pregnant lady and would be born baby. “Maternity: Pregnancy: Your basic insurance covers the cost of seven routine antenatal examinations carried out by a doctor or a midwife and two ultrasound examinations (one between the 11th and 14th weeks of pregnancy and one between the 20th and 23rd weeks). In high-risk pregnancies your insurance will cover as many examinations and ultrasound examinations as necessary.”2Low cost mobile scanners are available now (suitable for LMICS). With wide spread mobile connectivity telemedicine/ virtual consultation / video consultation with specialist is a call away.
3. In the WHO recommended healthy diet there are no guidelines on quality and quantity of protein3. Many countries are yet to prepare their own guidelines. Statistics reveal that 93% of Indian population are unaware of ideal protein requirement per day with pregnant ladies on the top (97%), followed by lactating mothers (96%) and adolescents (95%) 4. Situation in other countries is not much different.
4. Food security and nutrition plays a key role in Sustainable Development Goal1(SDG1) of UN: ‘zero hunger’ and elimination of all forms of malnutrition. The difference between ‘food security’ and ‘protein adequacy’ is not clearly communicated. In many countries vulnerable groups consume more carbohydrates instead of protein to meet the dietary energy requirement. Cost of protein is much more than cost of carbohydrates. There are no protein foods being provided under most of the nutrition programmes– possibly due lack of availability, affordability and/or awareness on food groups and dietary adequacy and frequency5,6
5. Meal maker is a by-product of soya bean oil extraction and refining process. Pulp remaining after extracting the oil from soya beans is converted into small chunks looking like small meat pieces and are often referred as vegetable meat. Meal maker is rich in proteins, 100 grams of meal maker has about 52 grams proteins, four times that of a boiled egg costing much less than four eggs.
Protein cost per gram in Indian Rupee (₹) Hyderabad, India,12 April 2022: Meal maker- 0.23; Rice- 0.53; Wheat- 0.42; Milk- 1.62; Boiled egg- 0.38; Chicken meat- 1.78; Mutton- 2.5; Fish-1.3 to 3.0
6. Supplementing diet with Meal Maker Protein Powder (MMPP) is a cost- effective pathway to reduce PEM. Soya bean is one of the major crops cultivated across the world. It is grown under several weather conditions. In 2019 global production of soya bean is 334million tonnes. Approximately 85% of the world's soybean crop is processed into soya bean oil and soya bean meal. More than 95% of soya bean meal is used as animal feed. That is, about 284 million tonnes soya meal is produced in 2019, and about 270 million tonnes is used as animal feed. Increasing human consumption of meal maker is a sustainable approach to reduce protein deficiency. A small fraction of produced soya meal, that is less than10 million tonnes can provide 25 grams soya meal per day per person to reduce PEM of 1 billion undernourished people in the world for one year.
References:
1. Maternal protein restriction leads to hyperresponsiveness to stress and salt-sensitive hypertension in male offspring, Robert A. Augustyniak, Karan Singh, Daniel Zeldes, Melissa Singh, and Noreen F. Rossi, American Journal of Physiology , MAY 2010, https://doi.org/10.1152/ajpregu.00848.2009.
2. The compulsory health insurance in Switzerland Your questions, our answers, Published by the Swiss Federal Office of Public Health, Article No.: 316.950.ENG
3. Home/ Newsroom/Fact sheets/Detail/Healthy diet, World Health Organization, 29 April 2020.
4. A Look at Indian Protein Deficiency. And how to fix it. Heal with Priyanka, Aug 5, 2017
5. India’s protein deficiency and the need to address the problem, SHOBA SURI, HEALTH EXPRESS, OCT 16 2020.
6. The Effects of Protein Deficiency The Importance of Amino Acids, Darla Leal, June 04, 2021, Verywellfit.
Dr. C V Kameswara Rao, M. Tech, Ph.D
Information Practitioner (voluntary)
Health, food, nutrition and climate change
Dr. Kameswararao Chiruvolu