Doodh Hai Wonderful but it’s Definitely Not Enough

Fighting malnutrition in India isn’t just a matter of serving kids flavoured milk.

Updated02 Jul 2015, 05:57 AM IST
India
6 min read

Snapshot

– Contrary to the general opinion that India is predominantly vegetarian, 80% Indians consume meat.
– Animal protein comes closest to human tissue protein, with an almost 100% utilisation in the body (called biological value).
– Other vital nutrients like good quality proteins, Vitamin A, Vitamin B12, even folic acid, and good absorbable iron, are derived largely from animal protein.
– Children need to be given an additional snack, along with the milk to meet nutritional needs.
– Full-day Anganwadi centres, serving at least three meals a day to the children, are a must to eradicate malnutrition.

The Madhya Pradesh Government has started serving flavoured milk as part of the mid-day meal program in Anganwadi schools across the state. Recently, when it was proposed to Chief Minister Shivraj Chauhan that eggs, the cheapest source of animal protein, be introduced in meals for these school children, he obstinately dismissed the idea.

To handle all the media and public criticism he incurred with this decision, Chauhan announced that instead, children will be served flavoured milk to adequately meet nutrition needs. While milk is another good source of animal protein, there still remain a substantial number of unanswered questions.

We at the The Quint decided to speak with Dr Veena Shatrugna, Former Director National Institute of Nutrition (Hyderabad), a Member of the Anveshi Research Centre for Women’s Studies, and an advocate of the Right to Food campaign. Dr Shatrugna has written extensively on the Recommended Dietary Allowance (RDA) of the nation, exhibiting how a the push for a completely vegetarian and cereal-pulse heavy diet has led to severe levels of malnutrition, specifically in special groups like children and nursing mothers, belonging to the disenfranchised sections.

Food Politics and the Institutionalisation of Vegetarianism in India

Indian cuisine is not a homogenous entity, and food habits differ along regional, religious, caste, and class lines. Yet there is an assumption in dominant discourses that India is a vegetarian nation. According to Dr Shatrugna, contrary to any such assumption, about 80 per cent of Indians consume meat. Except a few upper-castes, such as Brahmins and Vaishyas, the majority of Indian society has enjoyed meat historically.

During the 1950s and early 60s when scientists and nutritionists were formulating the RDA for the nation, the impetus was on including cereals and pulses as a source of not just calories, but also proteins. One should note here that these experts were upper-caste Brahmins whose personal diet was vegetarian. In spite of scientific evidence that animal protein came closest to human tissue proteins, with an almost 100% utilisation in the body (called Biological value), it was said that if cereal and pulses are eaten in a ratio of 4:1, in every meal, it will provide sufficient proteins. In fact the doctrine of “The Myth of Protein gap” was announced with much fanfare, justifying the decision to not include milk and other sources of animal proteins.

A balanced diet includes portions of pulses, cereals, vegetables and animal protein. (Photo: iStock)
A balanced diet includes portions of pulses, cereals, vegetables and animal protein. (Photo: iStock)

Economics of a Vegetarian Diet

But disenfranchised groups can hardly afford to include cereals and pulses in the said ratio, in every meal. The poor rarely eat pulse in every meal, and moreover cereal intake during one meal does not wait in the body to metabolise whenever pulse is eaten next. Cereal was believed to provide cheap calories, e.g., 100 grams of cereals provide about 340 calories while 100 grams of meat account for about 100 calories. But it is not a question of calorie intake alone because other vital nutrients like good quality proteins, Vitamin A, Vitamin B12, even folic acid, and good absorbable iron, are derived largely from animal protein.

While deficiencies like iron deficiency anaemia, number of Vitam B complex deficiencies, Vitamin C deficiency which can lead to bleeding gums can be lived with, though making for extremely poor standards of living, Vitamin A deficiency which causes night blindness, eventually leading on to xerophthalmia and loss of sight, is an irreversible process. Hence a national Vitamin A campaign was instituted to provide drops for children. But other nutrients like Vitamin B12, iron, and other essential amino acids were conveniently kept out of the bay.

Dr Shaturgna further opines that the RDA, with cereal as the cheapest source of calories, becomes useful when the government tries to push down poverty levels, minimum wages and assess desirable per capita income. By fixing a completely cereal-pulse diet, minimum wages were brought down by one-third.

Therefore eggs, and milk, which form a relatively cheaper variety of animal protein, were not considered. Not having milk also meant that the easiest way of calcium intake for growing children was compromised. In fact the calcium recommendation during the 40s was 1 gram per day, which was later brought down to 400 milligram per day. So it might not be such a bad thing that now milk will be a part of mid-day meals in Madhya Pradesh (MP). But there remain a number of serious concerns which have not been considered.

Milk is great but the government needs to look beyond it to tackle malnutrition. (Photo: iStock)
Milk is great but the government needs to look beyond it to tackle malnutrition. (Photo: iStock)

Doodh Hai Wonderful, but When Administered Adequately, and Correctly

The MP government will provide the ‘flavoured milk’ in powder form. Dr Shatrugna says that the powder milk will have to be reconstituted with water, in order to be given to children. If that is the case, authorities have to be really careful about the water source being extremely clean, which will otherwise lead to severe diarrhoea in these kids. Also the social and economic profile of children studying in Anganwadi schools does not allow them to have proper meals at home. Ideally, if desired nutritional levels have to be acquired, the children should be provided with a snack in addition to the 300 ml of milk. Hence giving them just 300 ml of milk during lunch will not suffice.

Also a large of number of these schools in MP falls under tribal areas like Alirajpur, Mandla and Hoshangabad districts. Tribals and dalits are the worst affected groups when it comes to malnutrition, with numbers of under-nourished individuals in India being worse than sub-Sharan African countries, according to WHO standards. Dr Shatrugna further says that it is a common practice among tribals across MP, Chattisgarh, Gujarat, including Adilabad in Andhra Pradesh to not drink milk. While some groups may consume beef, but they would still not touch milk because they believe it is reserved for the calf. So this introduction of milk must be accompanied by some educational drive and literature to ensure that these kids do not face any familial opprobrium in being served and fed milk in schools.

Children line up in a school to receive their mid-day meal. (Photo: Reuters)
Children line up in a school to receive their mid-day meal. (Photo: Reuters)

Right to Food, and Day-long Anganwadis

Dr Shatrugna says that as part of the Right to Food Bill introduced during the UPA regime, the government had considered converting 20 per cent of the Anganwadis into full day centres, ideally serving at least three meals a day. What kids get from mid-day meals account for about 300-400 calories at most, in addition to the other meagre 500-600 calories that they manage to get at home, that too not on a regular daily basis. Hence the Anganwadis should preferably become day crèches where children of working class mothers are fed and looked after in a clean, healthy environment, when they are at work. But with the present government bringing down the Anganwadi budget by almost 50 per cent, this seems to be an impossible dream.

Hence while the introduction of milk in mid-day meals may not be a bad idea, it will not alleviate the country’s poor from malnutrition.

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Published: 01 Jul 2015, 01:10 PM IST

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