Malnutrition rampant among South Asian infants

Undernourished women give birth to underweight babies and sap public health across Asia. Sudhamani Reghunathan reports for Inter Press Service.

New Delhi (IPS): Kanti's mother-in-law was watching her carefully as she munch down an apple. As soon as Kanti reached for a second, her mother-in-law said, "Don't eat too much or your child will be too big and you will have a difficult delivery."

In a local hospital four weeks later, 19-year-old Kanti, a construction worker, finally gave birth. But her baby barely weighed 2.2 kg, well below the World Health Organization (WHO) norm of 2.5 kg.

Kanti's child is also another addition to Asia's growing number of low birth weight infants, who now make up 21 percent of all newborns in the region. Comparatively, the average birth weight of babies in North America, Western Europe and Australia is up to 3.6 kg.

"Birth weights are indicative of the immediate viability as well as the state of maternal health and nutrition during pregnancy," says C. Gopalan, president of India's Nutrition Foundation.

He says the correlation between malnutrition among infants and young mothers is more prevalent in the seven South Asian nations of India, Pakistan, Bhutan, Bangladesh, Nepal, Sri Lanka and Maldives, than anywhere else in the world.

According to Gopalan, there is a link between low birth weights and malnutrition and the disturbing evidence of the greater proneness of Asians, particularly Indians, to diabetes and cardiovascular disease.

"These observations indicate that environmental factors, namely maternal undernutrition and the consequent unfavorable intra-uterine environment rather than genetic predisposition, as is generally believed, may account for the suspected proneness of Asians (to the diabetes and heart ailments)," he says.

Of more concern is the fact of the similarity between the immunological profile of people with malnutrition and those suffering from AIDS, doctors here say.

"The body tissues of the fetus seem to have an elephantine memory and intra-uterine retardation as reflected in low births weights has a lasting and deleterious impact on growth which a good diet and environment cannot reverse," Gopalan notes.

Of Asia's underweight babies, Indian infants comprise 33 percent, Pakistani babies 25 percent, Bangladeshis 50 percent, while Thailand, Indonesia and Burma average 14 percent.

Interestingly, there is a direct connection between the low birth weight babies and per capita incomes of the countries within Asia.

Sri Lanka, Thailand, and Indonesia, all of which have a lower percentages of low birth weight babies, record per capita incomes substantially higher than India, Bangladesh or Nepal. These three South Asian countries have a higher percentage of low birth weight babies.

Besides income that have a direct bearing on the food inputs of mothers, harmful beliefs like the one that stopped Kanti from getting her quota of calories abound -- especially in South Asia -- and result in underweight babies.

In Bangladesh, eating spinach and other iron-rich foods by mothers is supposed to give babies diarrhea. But nutritionists say these foods are necessary to reduce Vitamin A deficiency and anemia in mothers and thus avoid low birth weight babies.

The average age of marriage is another important factor responsible for undernourished babies. In India, the average age of marriage is a mere 14 years as compared to the higher ages in countries of the West where healthy babies are born.

Production and consumption trends are another important determining factor. In India, the Green Revolution that involved the use of chemicals and high yielding varieties of seeds to boost production of chiefly rice and wheat, saw a decline in the production of pulses.

With this, the per capita intake of proteins declined from 61 grams a day to 33 grams per day between 1965 and 1988.

And while there has been an overall increase in fish production in Thailand and Indonesia, as well as some South Asian countries, most of it has been for export. Trawlers for augmenting shrimp cultivation for export have depleted marine fish for local use.

Industrial pollution added to effluents from sewers have also reduced the number of riverine fish available to the people in Asia. This has cut off a very important source of protein from prospective mothers in the region.

Then there is the rapid rate of deforestation in Asia that has robbed rural populations of their source of forest produce not only for their livelihood, but also for their food and fodder, affecting nutritional intake.

In addition, the widespread use of faulty technology like excessive pesticide dousing and slash and burn cultivation methods has created a plant micronutrient imbalance that can result not only result in malnutrition, but also cause toxicity.

Goitre, an iodine deficiency disease endemic to the sub- Himalayan region, is now found in Southeast Asia. Nutritionist suspect excessive pesticides have disturbed the iodine thiocyanate composition of the region's food crops.

Rapid urbanization across the continent without adequate infrastructure growth has led to contaminated water supplies, poor sanitation and increased pollution from the unregulated growth of traffic.

These factors have contributed to the improper absorption of nutrients by the inhabitants of the cities and caused prospective mothers to be more malnourished.

An agenda for the protection and conservation of the environment across Asia is a must for nutritional well being, says Gopalan.

He adds, "There is an urgent need to handle land and water resources far more judiciously in the future than in the past for what is at stake is the very foundation of the food and nutrition system of the developing countries of Asia."