Undernutrition and anaemia continue to persist as public health issues with an estimated 56.4% of total disease burden in India being attributed to unhealthy diets, according to the latest Dietary Guidelines for Indians (DGIs) developed by Indian Council of Medical Research (ICMR)-National Institute of Nutrition (ICMR-NIN), Hyderabad.
It said a significant proportion of children continue to suffer impaired nutritional status while concurrently battling rising prevalence of overweight, obese, pre-diabetic symptoms, heightened risk to non-communicable diseases (NCDs) in several States, creating a dual burden of malnutrition where both undernutrition and overweight/obesity coexist within the same communities and even within households.
The DGIs are evidence-based food and lifestyle related recommendations designed as easily understandable and practicable approaches for ensuring a diverse diet to meet the requirements of essential nutrients and prevent NCDs among people of all age groups across India.
ICMR-NIN recommends the dietary allowances and nutrient requirements for Indians and revises them from time-to-time based on the emerging scientific evidence and the changing food landscape.
Total energy per day count
The report, which was released on Wednesday, has noted that a balanced diet should provide not more than 45% calories (energy) from cereals and millets (nutri-cereals: diversifying from staples to millets) and up to 15% calories from pulses, beans and meat and the rest of the calories should ideally come from nuts, vegetables, fruits and milk. In other words, this will ensure 50%–55% of total calories from carbohydrates, 10%–15% from proteins and 20%–30% from dietary fats, it said.
“However, as per the data, cereals contribute to 50% to 70% of total energy per day. Pulses, meat, poultry and fish together contribute to 6% to 9% of the total energy per day as against the recommended intake level of 14% of total energy from these foods. In a large segment of the country’s population, the intake of micronutrient-dense foods (whole grains, pulses, beans, nuts, fresh vegetables, fruits, etc.) is found to be lower than the recommended levels, whereas the intake of refined cereals is found to be higher. A steady increase in the intake of unhealthy foods among people complicates matters further,’’ the report stated.
Preventing Type 2 diabetes
Stating that a significant proportion of premature deaths can be averted by following a healthy lifestyle, the report notes that healthy diets and physical activity can reduce a substantial proportion of coronary heart disease and hypertension and prevent up to 80% of Type 2 diabetes.
“The upsurge in the consumption of highly processed foods laden with sugars and fats, coupled with reduced physical activity and the limited access to diverse foods, exacerbate micronutrient deficiencies and the overweight/obesity problems,” said the report.
It adds that unhealthy, highly processed, high-fat, sugar and salt (HFSS) foods have become more affordable and accessible than the healthier alternatives. Aggressive advertising and marketing of these unhealthy foods are seen to influence dietary preferences among both children and adults, leading to detrimental long-term effects and a large chunk of family income is spent on buying such unhealthy foods.
“This faulty dietary pattern contributes to deficiencies in iron and folic acid, resulting in anaemia and in the higher prevalence of overweight and obesity among population groups,” it noted.
The report has recommended sourcing of macronutrients and micronutrients from a minimum of eight food groups, with vegetables, fruits, green leafy vegetables, roots and tubers forming essentially half the plate of the recommended foods per day. The other major portion is occupied by cereals and millets, followed by pulses, flesh foods, eggs, nuts, oil seeds and milk/curd.
These guidelines are meant for the benefit of the general population and for practising nutritionists, dietitians, health professionals and other stakeholders.
