'Proper nutrition policy can cut diet-related deaths in India' By Rupesh Dutta

New Delhi: Following India's poor ranking in the world hunger index last year, experts have urged the government to come up with a comprehensive nutritional policy to alleviate diet-related deaths in the country. A recent study by the Institute of Health Metrics and Evaluation (IHME), University of Washington revealed that over 1.1 crore deaths occur due to poor diet alone globally. According to a study published in the Lancet journal in April, poor diet leads to hundreds of deaths in India annually.

The study tracked trends in consumption of 15 dietary factors from 1990 to 2017 in 195 countries, showing India ranked 118th with 310 deaths per 100,000 people. Experts believe the government will have to ensure access to nutritious food to the people living in both rural as well as urban areas. "We have failed in terms of a proper nutritional food policy. Poor diet creates a deficiency of essential nutrition due to low supply of vitamin, protein, fat, minerals and other micronutrients," said Rajesh Kumar, a senior expert at Paras Hospital, Gurugram.

"These elements not only give us energy to move and work, they are key in building the immunity of the body that fights the bacteria and viruses in the atmosphere from entering our body," Kumar said. "In its absence a child becomes susceptible to diseases, especially infectious disease such as tuberculosis among others," he said. Kumar urged the government to come up with a comprehensive plan to reach out to people in the remote areas suffering from nutritional food crisis that certainly is a root cause for several serious diseases. Emphasising that India's hunger and poor dietary problem is a major concern as it continued to ignore its health burden, Kumar said: "India is not immune to the problems that poor diet can cause.

A healthy diet does not mean an absence of feeling of hunger." It tracked trends for close to two decades. In 2018, India ranked 103rd among 119 countries on the Global Hunger Index. The country slipped three positions from its 100th rank in 2017. It was among the list of 45 nations that have serious levels of hunger. India is ranked way below its neighbouring countries such as China (25th), Nepal (72), Myanmar (68), Sri Lanka (67) and Bangladesh (86). Pakistan is placed at the 106th position. Tritiya Jana, a prominent Bengaluru-based dietician at Apollo Spectra, said that globally, three million deaths were attributed to too much sodium -- but another three million deaths were attributed to a lack of adequate whole grains, and another two million deaths were attributed to a lack of adequate fruits.

Indicating that population was one of the major factor, Jana urged the government to ensure that its agencies should provide the citizen with proper nutritious food at reasonable rates. Population growth has high contribution to the dietary health burden. As death rates fell, birth rates continued to be high, and some of the earlier killer diseases began to be tackled, the population grew rapidly. Fortunately, the Green Revolution staved off the threat of food grain shortages," she told PTI. "Similarly urban migration also is a reason.

As the cities developed and offered more opportunities for employment, agriculture became gradually less labour-intensive, people moved in large numbers into the cities. "This phenomenon resulted in the mushrooming of urban slums and sharp changes in the lifestyles and diets of the erstwhile rural people," she added. The experts also believe that the more cause of worry was that the poor diet also creates Disability-Adjusted Life Year (DALYs). According to World Health Organization, One DALY can be thought of as one lost year of "healthy" life.

The sum of these DALYs across the population, or the burden of disease, can be thought of as a measurement of the gap between current health status and an ideal health situation where the entire population lives to an advanced age, free of disease and disability. Agreed Amitabha Ghosh, consultant of Internal Medicine at Gurgaon-based Columbia Asia hospital, who said the current era was such that both people residing in urban and rural areas have diet-related issues. "The urban population which falls under good economic condition does not take proper healthy food despite no economic hindrances while on the other hand people in rural areas can't afford even three meals a day," he said.