by Marion Nestle

Currently browsing posts about: Malnutrition

Jan 12 2012

Some thoughts on high rates of child malnutrition in India

The New York Times reported a shocking statistic yesterday: about 42% of children under age 5 living in India suffer from malnutrition and are “wasted” (low weight for height). 

The figure comes from the Hungama survey of 73,000 Indian households conducted by the Naandi Foundation.  It reports an even more troubling statistic: nearly 59% of Indian children under age 5 are “stunted” (low height for age).

The Hangama report holds one hopeful note.  Rates of childhood malnutrition in India fell by 20% during the past 7 years.

But have they? 

According to a more detailed analysis in today’s New York Times

Despite the recent boom years of the 1990s and 2000s, there has been little improvement in overall nutrition in India, according to United Nations data. About 20 percent of India’s over 1 billion population remained “undernourished” during that time, meaning their “food intake regularly provides less than their minimum energy requirements.” The most recent”Global Hunger Index” shows that two-thirds of the 122 developing countries studied had reduced hunger levels in recent years, but that hunger levels in India have increased.

Ending malnutrition is a matter of political will.  If India wanted to address childhood malnutrition in any serious way, it could. 

How?  Feeding programs are emergency measures.  Long-term solutions require institution of social programs:

  • Promote breastfeeding,
  • Educate and empower women
  • Build toilets
  • Clean up water supplies
  • Eradicate worms
  • Reduce income inequality    

Two recent books summarize the research behind these ideas and explain what causes widespread hunger and what to do about it.  They make it clear that eradicating childhood malnutrition should be a first priority for any government:

  • Olivier De Schutter and Kaitlin Cordes, editors: Accounting for Hunger: The Right to Food in the Era of Globalisation (Studies in International Law), Hart, 2011.
  • Per Pinstrup-Anderson P and Derrill D. Watson II: Food Policy for Development Countries: The Role of Government in Global, National, and Local Food Systems, Cornell University Press, 2011.  
Sep 3 2010

The Plumpy’nut furor: International food politics in action

The New York Times Magazine has a long article this week about Plumpy’nut,  the peanut butter-based product designed to feed malnourished kids in emergency situations.  The product is made and patented by Nutriset, a French company.

You might think that a food product aimed at saving the lives of starving kids would be uncontroversial, but not when patents are involved.  Nutriset holds intellectual property rights to this product and defends them to the hilt.   The company extends its patent to line extensions of the product, as well.

Patents mean that people in developing countries who want to produce their own product based on local ingredients can’t do it.  It also means that anyone making the product has to follow the formula, even if ingredients are expensive and not locally available.

In September 2007, I wrote about Plumpy’nut, describing how peanut butter had become the basis of a “ready-to-use therapeutic food” (RUTF) for aiding recovery of severely malnourished children in Africa.

The study itself is published in Maternal and Child Nutrition and the authors make the point that people administering this RUTF do not need to be medically trained so this therapy can be used at home. I’m always amazed when researchers discover that feeding malnourished children helps them to recover. Peanut butter is highly concentrated in calories and the investigators mixed in some vitamins along with it, so I guess it can be considered a superfood.

Since then, much has been written about the controversy over this product, particularly about its formula, cost, and sustainability.

Its formula includes:

  • Peanut Butter
  • Dry Skim Milk
  • Vegetable oil
  • Powdered sugar
  • Minerals & vitamins

It contains about 500 calories in a 92-gram foil package.

Of these calories, one-quarter to one-third are from the added sugar.  No wonder kids like it!

What about its cost? A recent article about local production of Plumpy’ nut in Niger illustrates this particular problem.

UNICEF pays US$60 to purchase and ship a box of 150 packets from the main producer and patent holder of Plumpy’nut, Nutriset, in France. It costs $65 in Niger. The difference adds up to an extra $15,000 for the 3,000 boxes purchased in Niamey every week.

“The luxury of having no production delays and not fully depending on an external provider is a price we are willing to pay,” UNICEF’s nutrition manager, Eric-Alain Ategbo, told IRIN. Ategbo said it took at least eight weeks for the nutritious peanut butter-like paste to arrive from France.

Here are some other cost concerns:

Electricity is expensive, taxes are high and money is expensive as interest rates are high. It would be cheaper if the products we use were bought locally, but they are not available.  Peanuts are the only ingredient from Niger. Others, such as milk, sugar and oil, are purchased internationally. We also have the obligation to buy specific products [such as micronutrients and packaging] from Nutriset in order to respect the formula.

As for its sustainability:

  • Who is going to pay for these products?  And for how long?
  • Does it make sense to promote a peanut-based product in countries that do not grow peanuts?
  • Is it a good idea to give packaged, sweetened products to kids whose families cannot continue to provide such things once the crisis is over?
  • Is it a good idea to give kids the idea that sweet things in packages are what they supposed to eat?
  • Will products like this pave the way for other sweetened products in packages—soft drinks, for example?

These are all complicated issues.  Read the article and ponder.

Sep 13 2007

How’s This for a Use for Peanut Butter?

Peanut butter, it seems, is the basis of a “ready-to-use therapeutic food” (RUTF) for aiding recovery of severely malnourished children in Africa. The announcement of these results doesn’t say what kind. The study itself is published in Maternal and Child Nutrition and the authors make the point that people administering this RUTF do not need to be medically trained so this therapy can be used at home. I’m always amazed when researchers discover that feeding malnourished children helps them to recover. Peanut butter is highly concentrated in calories and the investigators mixed in some vitamins along with it, so I guess it can be considered a superfood.