The magnitude of child malnutrition in India requires urgent and innovative action. Although the prevalence of child stunting in India has fallen dramatically over recent decades—from 57.7 per cent in 1992-93 to 37.9 per cent in 2015-16 (Levels and trends in child malnutrition,”UNICEF, WHO, World Bank Group, 2019)— India remains the country with the highest number of stunted children in the world. Approximately 46.6 million children in India are stunted (Global Nutrition Report, 2018). This is more than three times the equivalent for Nigeria, which ranks second in the world with approximately 14 million stunted children.
Stunting is a technical term to describe children being too short for their age. It is a sign not just of poor body growth, but also of substandard development of the immune system and brain accompanied by limited cognitive development and less resilience to disease. These consequences of malnutrition in children are irreversible. Parents and societies have only one chance to ensure children are well fed and develop to their full potential.
Alarmingly, a new study calculates that the prevalence of stunting in India has risen since 2016, and is now 38.4%, with an extremely high degree of variability in the prevalence across the different districts. The study also finds that only behind women’s body mass index (BMI) and women’s education factors, the children’s diet quality is a main factor explaining the differences in stunting prevalence across the different districts.
While addressing stunting (and other under nutrition challenges, i.e. micronutrient deficiencies) must remain a priority in India, levels of overweight and obesity are growing rapidly too. India also needs to put in place strategies to halt these rises and prevent children from becoming overweight and obese. Childhood obesity typically persists into adulthood and being overweight or obese increases the risk of developing several diet-related diseases and dying early.
Rates of childhood obesity have risen globally in recent years, with the International Association for the Study of Obesity (IASO) and International Obesity Taskforce estimating that 200 million school children around the world are either overweight or obese. According to the Global Nutrition Report 2018, the prevalence of overweight children and adolescents in India is 13.6% and 4% are obese.
Overall, therefore, all these forms of malnutrition have severe implications for children’s health and development, and also affect the country’s overall economic productivity. In 2016, the Global Panel on Agriculture and Food Systems for Nutrition (GLoPAN) estimated that all forms of malnutrition combined generate a global cost of close to $3.5 trillion per year. Investing in solutions to the nutrition crisis can help to improve nutritional outcomes long term.
The food and beverage sector in India is growing strongly and sales of processed foods are rapidly increasing. As the second most populated country in the world India is one of the leaders in the global food and beverage industry. The EMIS Insights Industry Report on Food and Beverages Sector estimated that the gross value added of the food and beverage sector expanded at a CAGR of 4.8% over FY 2013-16.
Given their scale and reach, food and beverage companies can and must be part of the solution to India’s nutrition challenges. This industry has a role to play in ensuring healthy and nutritious diets are accessible and affordable to all.
New marketing channels and ever-evolving marketing techniques have caused an increase in children’s exposure to advertising and marketing, this can have a powerful effect on them. Evidence gathered over the past 20 years shows that unhealthy food marketing is one of the factors that contributes to growing rates of overweight and obesity. To curb these negative effects, governments and companies should follow the 2010 ‘WHO Recommendations on the Marketing of Foods and Non-Alcoholic Beverages to Children’.
The first Access to Nutrition India Spotlight Index, published in 2016 by the Access to Nutrition Foundation, found that the largest food and beverage manufacturers in India have been falling far short of what they need to do to help fight the enduring double burden of nutrition in India.
The Index showed that most of the companies assessed make strategic commitments to grow their businesses by focusing on health and nutrition and demonstrate some good practice. However, it was clear that companies needed to do much more to translate their words into action by introducing clear and ambitious strategies for all relevant business activities (e.g. reformulating their products, making their healthy products affordable and accessible, responsible marketing and labelling) underpinned by specific, measurable and time-bound targets. It was however encouraging to see that many companies assessed were willing to engage with ATNF after publication and were keen to boost their efforts in many of the areas mentioned.
The second iteration of the Index, due to be released at the end of this year, will show whether the companies assessed have improved their performance and have stepped up to play their full part in addressing India’s serious nutrition challenges.
Mark Wijne is Senior Program Manager, Access to Nutrition Foundation
Estefania Marti Malvido interns with the Access to Nutrition Foundation