Protein Undernutrition and Anemia: A Silent Public Health Crisis

Protein Undernutrition and Anemia: A Silent Public Health Crisis

Protein and iron are two essential nutrients that our body needs to function properly. However, many people in India and other developing countries do not get enough of these nutrients, leading to protein undernutrition and anemia. These conditions can have serious consequences for the health and well-being of millions of people, especially women and children. In this  post, we will explore what protein undernutrition and anemia are, how they are linked, and what we can do to prevent and treat them.

What is protein undernutrition and why does it matter?

Protein is a macronutrient that provides the building blocks for various biological functions, such as growth, repair, immunity, and metabolism. However, many people in developing countries, including India, do not consume enough protein to meet their daily requirements. This can lead to protein undernutrition, which is associated with impaired growth, increased susceptibility to infections, and reduced quality of life.

According to the National Institute of Nutrition (NIN), the average Indian consumes around 0.6 grams of protein per kilogram of body weight, falling short of the recommended 0.8-1gram/kg/day. The National Sample Survey Office (NSSO) shows that the average protein consumption in India has gone down over the years. Between 1993-94 and 2011-12, the protein intake in rural areas decreased from 60.2g to 56.5g, and in urban areas from 57.2g to 55.7g. These levels are lower than the recommended daily intake and the global average, posing a substantial risk to public health.

Protein deficiency is especially common among women and children, who may suffer from poor growth, weak immunity, slow healing, and more infections. Protein deficiency can also affect the body’s ability to produce essential molecules like enzymes and hormones.

In a survey conducted by the Right to Protein, an initiative to spread awareness survey found that 81 per cent of women believed that consuming dal, roti and rice is enough for daily protein intake

What is anemia and how is it linked to protein undernutrition?

Anemia is a condition in which the blood has a low level of red blood cells or hemoglobin, the protein that carries oxygen throughout the body. Anemia can cause symptoms such as fatigue, weakness, dizziness, and shortness of breath.

One of the main causes of anemia is iron deficiency, which occurs when the body does not have enough iron to produce hemoglobin. However, iron deficiency is not the only factor that affects hemoglobin production. Protein also plays a crucial role in the synthesis of hemoglobin and other amino acids, the building blocks of proteins. When protein intake is inadequate, the body cannot produce enough hemoglobin or amino acids, resulting in anemia.

Protein undernutrition and anemia are two interrelated conditions that often coexist and exacerbate each other. According to the World Health Organization (WHO), anemia affects around 1.62 billion people globally, with the highest prevalence in South Asia and Africa. In India, anemia affects around 53% of women and 50% of children, according to the National Family Health Survey (NFHS)

Bihar Faces Alarming Anemia Rates in Women and Children as per NFHS 5 reveals a troubling picture of anemia in Bihar:

• 61.7% of women aged 15-49 suffer from anemia, raising concerns about maternal health and pregnancy outcomes.
• 69.9% of children aged 6-59 are anemic, with potential consequences for physical and cognitive development. These high rates highlight the need for urgent action to address iron deficiency in both women and children through improved diet, iron supplementation, and tackling underlying factors.

The Hidden Costs: Economic Consequences of Protein Undernourishment and Anemia in India is a research paper by Rajesh Kumar Rai and Rajesh Shukla, published in the Journal of Nutrition in 2019.The estimated $12.5 billion annual loss paints a stark picture of how these seemingly hidden deficiencies drain the nations productivity and development. Understanding this economic burden makes the case for addressing nutrition more compelling, not just for individual health but for the nations future prosperity.

What are the consequences of protein undernutrition and anemia?

Protein undernutrition and anemia can have serious and long-lasting effects on the health and well-being of individuals and communities. Some of the consequences include:

• Reduced cognitive development and learning ability: Protein and iron are essential for the development and functioning of the brain and nervous system. Protein undernutrition and anemia can impair the cognitive development and learning ability of children, affecting their academic performance and future prospects.
• Increased morbidity and mortality: Protein and iron are vital for the immune system and the prevention and recovery from infections. Protein undernutrition and anemia can increase the risk and severity of infections, such as malaria, tuberculosis, and HIV/AIDS. They can also increase the risk of complications during pregnancy and childbirth, such as preterm delivery, low birth weight, and maternal and infant mortality.
• Reduced productivity and economic growth: Protein and iron are important for the energy and physical activity of the body. Protein undernutrition and anemia can reduce the productivity and work capacity of adults, affecting their income and livelihoods. They can also impose a significant economic burden on the health system and the society, due to the increased costs of treatment and the loss of human capital.

What are the solutions for protein undernutrition and anemia?

Protein undernutrition and anemia are preventable and treatable conditions that require a comprehensive and multisectoral approach. Some of the solutions include:

• Improving dietary diversity and quality: The best way to prevent and treat protein undernutrition and anemia is to ensure a balanced and nutritious diet that includes adequate amounts of protein and iron from various sources. This can be achieved by increasing the consumption of protein-rich foods, such as pulses, legumes, nuts, seeds, eggs, dairy, meat, and fish, and iron-rich foods, such as green leafy vegetables, fruits, and fortified cereals. It is also important to avoid foods that inhibit iron absorption, such as tea, coffee, and phytates, and to enhance iron absorption by consuming foods that contain vitamin C, such as citrus fruits, tomatoes, and peppers.
• Supplementing with micronutrients: In some cases, dietary interventions may not be sufficient to meet the protein and iron requirements of the population, especially for vulnerable groups such as pregnant and lactating women, infants, and young children.

 In such cases, supplementing with micronutrients, such as iron-folic acid tablets, multiple micronutrient powders, or ready-to-use therapeutic foods, can help to prevent and treat protein undernutrition and anemia. However, supplementation should be done under the guidance of a health professional and with regular monitoring of the hemoglobin levels and the iron status of the individuals.

• Addressing the underlying causes and determinants: Protein undernutrition and anemia are not only caused by inadequate dietary intake, but also by various social, economic, and environmental factors that affect the availability, accessibility, and utilization of food and health services. These factors include poverty, inequality, gender discrimination, poor sanitation, lack of education, and climate change.

Therefore, addressing these underlying causes and determinants is essential to ensure a sustainable and holistic solution for protein undernutrition and anemia. This requires a coordinated and collaborative effort from different sectors and stakeholders, such as the government, the private sector, the civil society, and the communities.

Conclusion

Protein undernutrition and anemia are two silent but serious public health crises that affect millions of people in India and other developing countries. They can have devastating consequences for the health and well-being of individuals and communities and hamper the social and economic development of the nations. However, protein undernutrition and anemia are preventable and treatable conditions that can be tackled with effective and evidence-based interventions. By improving the dietary diversity and quality, supplementing with micronutrients, and addressing the underlying causes and determinants, we can ensure a healthy and prosperous future for ourselves and our children.