Nutrition is a very confusing topic for most people these days. If you pick up a woman’s magazine or watch any morning television programme you are likely to find that an article or presentation about nutrition is trying to convince you that a particular fad diet, or a particular group of nutrients, will be the one secret that positively changes your life forever. Yet, the more you read magazine articles or watch television shows, the more you are likely to be in the dark as to which advice to follow, because many of them are contradictory.

1. OUR NUTRITION Dr.Sujnanendra Mishra

2. IT IS REAL EVEN TODAY

3. The main meal of the day

4. Women Power

5. Collection of firewood Women Power

6. Burden of large family

7. She also pulls the burden of family Perhaps the only woman in the male bastion, Sabitri Das (45) of Sasang village in Orissa's Balasore district has been pulling trolley for the last five years.

9. MOTHER AND CHILD SURVIVAL MMR 407/100,000 live births IMR* 58/1000 live births Child Mortality 19.5/1000 Children Rate(1-4 years)

11. NUTRITION PROBLEMS IN INDIA WHO IS AT RISK?? PREGNANT WOMEN LACTATING WOMEN INFANTS PRESCHOOL CHILDREN ADOLESCENT GIRLS ELDERLY SOCIALLY DEPRIVED (SC & ST Communities) .

14. PREVALENCE OF LBW IN S.E ASIAN COUNTRIES

19. SUB-CLINICAL FORMS OF PEM UNDERNUTRITION  WEIGHT FOR AGE WASTING  WEIGHT FOR HEIGHT STUNTING HEIGHT FOR AGE

20. UNDERNUTRITION IN INDIA PRESCHOOL CHILDREN ADULTS (Females) Based on BMI Based on NCHS weight for age

22. DISTRIBUTION WEIGHT FOR AGE – IAP Gujarat Normal Gr. I Gr. II Gr. III Gr. IV

23. WEIGHT FOR AGE– SD CLASSIFICATION - GUJARAT

24. VITAMIN A DEFICIENCY

25. BITOT SPOT KERATOMALACIA BILATERAL BLINDNESS V A D

27. VITAMIN A DEFICIENCY (%) IN INDIA * 24-71 MONTHS AGE GROUP SOURCE X1B XN* PRESCHOOL CHILDREN ICMR, 2001 0.7 1.03 NNMB 0.7 - NIN- SURVEYS 2.1 - PREGNANT WOMEN ICMR, 2001 - 2.8

28. VITAMIN A DEFICIENCY Districts(%) with X1B >0.5% Average prevalence (%) 2.1 Based on surveys in 126 Dts. by NIN and NNMB No VAD VAD

29. NUTRITIONAL DEFICIENCY SIGNS IN PRESCHOOL CHILDREN

31. ANAEMIA

33. PREVALENCE OF ANAEMIA -ADOLESCENT GIRLS

35. IODINE DEFICIENCY DISORDERS

36. 239 OF 282 DTs. SURVEYED – ENDEMIC 167 millions AT RISK ? IODINE DEFICIENCY DISORDERS GOITRE+

37. PREVALENCE OF GOITRE IN 6-12 Yr CHILDREN - Gujarat

38. DIETARY INTAKES

39. HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS

40. HOUSEHOLD NUTRIENT INTAKES IN DIFFERENT AREAS

41. NUTRIENT INTAKES AMONG INDIAN WOMEN Source: NNMB, 2000 NUTRIENTS NPNL PREGNANT WOMEN LACTATING WOMEN Protein (g) 49.9 47.2 56.5 Energy (kcal) 1983 1994 224.3 Total Fat (g) 24.5 21.5 373 Calcium (mg) 382 339 12.4 Iron (mg) 11.3 11.0 162 Vitamin A (  g) 148 142 1.1 Thiamin (mg) 0.9 0.9 1.1 Riboflavin (mg) 0.8 0.8 0.9 Vitamin C (mg) 32.0 28.4 29.4 Folic Acid (  g) 86 84 106

42. NUTRIENT INTAKES IN PREGNANT WOMEN % RDI Source: NNMB,2000 % RDI Energy Protein Vitamin A Iron Riboflavin Total Fat <30 0 0 52.4 53.7 1.2 22 30-40 1.2 0 8.5 22 20.7 6.1 40-50 3.7 2.4 11 9.8 13.4 6.1 50-60 9.8 11 9.8 7.3 12.2 7.3 60-70 8.5 17.1 0 0 18.3 8.5 70-80 23.2 11 3.7 1.2 4.9 7.3 80-90 9.8 9.8 2.4 1.2 4.9 4.9 90-100 7.3 8.5 2.4 2.4 7.3 4.9  100 36.5 40.2 9.8 2.4 17.1 32.9

44. DETERMINANTS OF MALNUTRITION MATERNAL MALNUTRITION START WITH A HANDICAP( LBW ) FAULTY CHILDFEEDING PRACTICES DIETARY INADEQUACY FREQUENT INFECTIONS LOW PURCHASING POWER LARGE FAMILIES HIGH FEMALE ILLITERACY TABOOS AND SUPERSTITIONS

45. Factors Affecting Nutritional Status High illiteracy Unemployment/ Underemployment Large families Low purchasing power Ignorance High dependence rate False food beliefs Inadequate intakes Low Procurement of foods Poor PDS High cost Low availability of foods Low production Reduced work Malnutrition of foodgrains output Poor environment Morbidity Absorption of nutrients Low Appetite Poor utilization of services poor coverage of immunization Improper health services poor infrastructure Lack of resources

47. 2005-06 National Family Health Survey (NFHS-3) Adult Nutrition

49. Prevalence of Undernutrition and Overweight/Obesity among Adults by Residence NFHS-3, 2005-06 Undernutrition ( % abnormally thin) % Overweight/ obese Undernutrition is more prevalent in rural areas. Overweight and obesity are more than three times higher in urban than in rural areas. Undernutrition and overweight/ obesity are both higher for women than men

50. Undernutrtion and Overweight/Obese Women by Age Age in years Malnutrition levels are higher among young girls. Almost half of the girls in age 15-19 are undernourished. Undernutrition declines and overnutrition increases with age of women

51. Underweight and Overweight/Obese Women by Education The prevalence of undernutrition is nearly two times higher among women with no education than among those with 12 or more years of schooling. The prevalence of overweight and obesity is three times higher among women with 12 or more years of schooling than those with no education.

52. Underweight and Overweight/ Obesity among Women by Wealth More than half of women in the highest income quintile are underweight. In contrast, almost one-third of women in the highest income quintile are overweight or obese .

53. The percentage of women who are too thin is particularly high in Bihar (45%), Chhattisgarh, and Jharkhand (43% each). Malnutrition levels are lowest in Delhi, Punjab, and several of the small northeastern states. The percentage of women who are overweight or obese is highest in Punjab (30%), followed by Kerala (28%) and Delhi (26%) State Variations in Malnutrition

54. Underweight and Overweight/Obese Men Similar variations are seen by state in the percentage of men who are thin and the percentage of men who are overweight and obese. The prevalence of underweight and overweight among men shows similar variations by age, education and wealth index.

56. Trends in Anaemia Prevalence among Women The anaemia situation has worsened over time for women 10.0-10.9g/dl 7.0-9.9g/dl <7.0g/dl

57. Anaemia Prevalence among Women and Men by Residence NFHS-3, 2005-06 The anaemia prevalence levels are more than two times higher among women than men with almost half of them with moderate to severe anaemia. The prevalence of anaemia is marginally higher in rural than urban areas but anaemia is a common problem in both urban and rural areas. More than 50 percent of women in urban areas are anaemic, with almost a third of them with moderate to severe anemia. Women Men

61. Percentage of Household Using Iodized Salt By Residence Only about half of the households in India use cooking salt which is adequately iodized More than two-thirds of urban households used adequately idolized cooking salt compared with just 41 percent in rural areas.