HALF OF the children in Punjab (50.9 per cent) suffer from iron deficiency, making it the state with the most number of iron-deficient children in the country, according to data published in the Comprehensive National Nutrition Survey (CNNS) of 2016-2018.
Compiled by the Ministry of Health and Family Welfare with the help of UNICEF and medical experts from the country, the CNNS report is the first of its kind to represent the nutritional habits and micronutrient levels in children and adolescents across the nation. Apart from malnutrition indicators, the report has collected data on the dietary habits of children and adolescents, along with levels of necessary micronutrients in their body.
According to the report, in Punjab, 67 per cent of children aged between 1-4 years, 51 per cent between 5-9 years and 45 per cent between 10-19 years suffer from iron deficiency.
Not too far behind Punjab, is Haryana with 35.6 per cent children having iron deficiency. Punjab also has the highest number of children with Vitamin D deficiency while Haryana ranks fifth in this category.
Deficiency in essential micronutrients
Poonam Khanna, a nutrition expert from the School of Public Health at Post Graduate Institute of Medical Education and Research, and one of the doctors involved in the collection of the data for CNNS, said it could be due to deficiency of micronutrients. “A study of micronutrients is essential. For example, Vitamin C helps absorb iron, so even if your intake of iron rich food is high, but your intake of Vitamin C is low, you can become iron-deficient.” According to Khanna, in parts of rural Punjab and Haryana, people have very low intake of Vitamin C enriched food. “In some areas, we have gone and asked farmers to locally grow amla and learn ways to preserve and consume it. Amla is such a rich source of Vitamin C and so essential for absorbing iron. This will help in increasing iron levels in children,” she added.
As for Vitamin D deficiency, the team of PGIMER doctors who contributed to the CNNS report, concur that the micronutrient is best absorbed through direct exposure to the sun. “Though fish oils, eggs and some other foods are a good source of Vitamin D, the best way to increase the level of this nutrient in your body is to spend more time in the sun and bring about some lifestyle changes that push you to leave the house,” said Khanna.
Dr Rakesh Sehgal, who was one of the doctors from PGIMER responsible for ensuring that appropriate medical practices were followed to ensure accuracy of data in the CNNS report, said that since Punjab is a relatively wealthier state, its population is increasingly becoming inactive. “I believe that there could be a co-relation between the fact that in wealthy states people have to work less, at least in terms of manual labour and hence they lack adequate exposure to the sun,” stated Sehgal.
Low consumption of meat
CNNS data also reveals that Punjabi children between the ages of 2 and 19 years have low intake of chicken and meat, beating only the states of Haryana, Himachal Pradesh and Madhya Pradesh.
Only about 5.6 per cent of children between the ages of 10 and 19 years consume chicken or any other kind of meat in Punjab. The intake is even lower in children between the ages of 6 and 9 – a mere 5.1 per cent. In Haryana, meat intake is the lowest across almost all age groups, with only 2.9 per cent children between the ages of 2 and 4 years consuming meat. Among children aged between 10 and 19 years, this rate is only slightly higher at 5.4 per cent, beating only Himachal Pradesh.
“It is quite surprising that this is the trend, because Punjabis are big chicken eaters, and even Himachalis, though they don’t eat that much chicken, they do consume other meat. So it is surprising that these states have low rates of consumption,” said Sehgal.
The CNNS report revealed that children in Haryana and Punjab have a very low intake of eggs and fish. “All dietary habits are interdependent, if one does not eat a particular kind of food, they will lack the micronutrients needed to support other crucial life functions.
If you don’t consume enough meat and green vegetables for example, you could have iron deficiency,” said Khanna.
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