K nowledge of nutrition is important because it helps individuals attain optimum health throughout life. WHO advises that eating a balanced diet improves a person’s health and well-being and reduces risks of major causes of health issues including death? About two billion people in the world suffering from different degrees of malnutrition and malnutrition is an important cause of death of about 2.6 million children each year. Considering this situation, our government has been working hard to advocating for nutrition of the children.
The policymakers, nutritionists, and dietitians work together to identify the food approaches that address diet-related public health glitches. By understanding, the root causes of diet-related issues, a well-founded public policy need to be established to ensure good general health. Developing practical nutrition and food approaches to mitigate the risk of health issues, government has given nutrition as a priority area in health sector. Nutrition is vital for the well-being of the community and we all know that the food is a source of energy, vitamins, minerals, protein and essential fats needed by the body to live, grow and function properly. With good nutrition, people can reduce the risk of numerous diet-related diseases, including coronary heart disease, stroke, hypertension, obesity, osteoporosis and nutritional anemia. Considering the significant connection between good nutrition and healthy life, it is thus important for people to make smart food choices.
Bangladesh has made remarkable progress in demographic, health, and nutritional status of the population in the last one decade. Based on the Bangladesh Health and Demographic Survey (BDHS) 2017-18, 31 per cent of under 5 children are stunted, 8 per cent are wasted, 22 per cent are underweight and 2 per cent are overweight. The percentage of stunting declined from 43 per cent in 2007 to 31 per cent in 2017-18. Similarly, the percentage of underweight fell from 41 per cent in 2007 to 22 per cent in 2017-18. Rate of wasting decreased from 17 per cent in 2007 to 8 per cent in 2017-18.
The Multiple Indicators Cluster Survey (MICS) 2019 shows the stunting rate of under five children is 28 per cent, as well as 7.8 per cent are wasted, while 22.6 per cent are underweight. The preliminary findings of National Micronutrient Survey in Bangladesh 2019-2020 show high prevalence of micronutrient deficiencies especially Vitamin A, Vitamin D, Vitamin B12, Folate, Iron deficiency anemia, Zinc across the population. Considering the prevalence of micronutrient deficiencies, the Government of Bangladesh has been emphasising food fortification both crop bio-fortification to industrial fortification through different policies.
Malnutrition is a global problem. Almost half of all child deaths are linked to undernutrition. Despite important progress and action over the past decade, malnutrition levels in developing countries remain dangerously high. Currently, rural children in Bangladesh mostly are suffering from wasting (dangerously low weight for height, typically due to acute malnutrition), and stunted children (dangerously low height for age, due to prolonged malnutrition).
Investing in nutrition is one of the most cost-effective drivers for cognitive development of children. Improved nutrition helps education, gender equality, reduces poverty and improves life opportunities. This is why nutrition is considered foundational to sustainable development. Another WHO study showed that 40 per cent reduction in the number of stunted children under-5 and 50 per cent reduction of anemia in women of reproductive age, 30 per cent reduction in low birth weight could be addressed just by nutritional food, food habit and good dietary knowledge. It is essential to include the healthy food lessons in early childhood education. It makes children understand that what is good for their body and what is harmful. Children in high schools and colleges mostly prefer processed and fast food. It is critical to give nutrition-related knowledge to children on healthy eating habits. Poor nutrition brings different diseases with it that can have severe effects on health. A poor diet also increases the risk of different cancers, including breast cancer for women, colorectal cancer, and endometrial (uterine) cancer.
Due to consuming an unhealthy diet, people also face stress and anxiety that affect their mental and physical health. Nutrition helps strengthen immune system by providing the necessary minerals and vitamins.
Poor nutrition in the first 1,000 days of a child’s life – from a woman’s pregnancy to that child’s second birthday – can lock them into a lifetime of health challenges that are devastating and irreversible. During this critical period, if children do not get the vital ingredients they need to grow their bodies and develop their brains, they are more likely to get sick from diseases throughout their whole life (WHO reports 2019).
There can be no greater unfairness than a child whose potential future is robbed off before their life has barely started. The first 1,000 days of a child’s life also provide us with an incredible window of opportunity to ensure their health is protected and that their potential is maximised. Small steps for both mother and child can make a big difference collectively. These include promoting early and exclusive breastfeeding; educating mothers about health and diverse diets for their babies and good hygiene practices; providing supplements for women during pregnancy and for infants after birth; encouraging agricultural sector to produce diverse and nutritious foods; and legislating the production of fortified staple foods. These interventions can reshape a child’s future, giving them the best chance to become healthy and productive members of society. A country can make a few, if any, better investments than nutrition for children. A study shows that for every dollar invested in nutrition for children, a country can expect to get $16 back in increased productivity. The immune system can work as defence force against diseases to boost resistant system and keeps fight against disease constantly. Studies have also shown that two thirds of people who eat fruit and vegetables every single day report no mental health issues (ref. Marx W. Moseley G. Berk M. Jacka F. Nutritional psychiatry: the present state of the evidence. 2017; 76: 427436). For that reason, changes in eating habits are essential.
Bangladesh has maintained an impressive record of accomplishment of 6 percent economic growth over the past decade, coupled with remarkable improvements in human development, and has reduced poverty by nearly one-third. Bangladesh has also achieved remarkable progress in the areas of primary school enrollment, gender parity in primary and secondary level education, immunisation coverage, and incidence of communicable diseases. Bangladesh is on track to achieve the SDGs in respect to maternal and child mortality. Even though in some vulnerable pockets, low dietary diversity, inadequate protein and less micronutrient intake, poor sanitation and hygiene are continuously worsening the situation. Stunting also negatively affected a number of children under five years in urban poor areas and poverty-stricken char villages. In those villages, micronutrient deficiencies are widespread, driving high rates of anemia in women and children.
The Government of Bangladesh has laid out numerous nutrition strategies, plans and policies over the past 12 years. The recently developed Health, Population and Nutrition Sector Development Programme 2011-2016, includes an operational plan for mainstreaming and scaling up nutrition services nationally through the National Nutrition Services (NNS), which intends to reduce the prevalence of undernutrition, especially among women and girls. By focusing on the first 1,000 days (the period from pregnancy to a child’s second birthday), the government aims to ensure universal access to nutrition services, strengthen human resource capacity and nutrition information systems, and increase coordination with other relevant sectors such as agriculture, economic development agenda and education. The USAID-funded National Food Policy Capacity Strengthening Programme is in place, and assisted Ministry of Food and Disaster Management in developing the Country Investment Plan and National Food Policy Plan of Action.
In 2011, Bangladesh joined Scaling up Nutrition (SUN), a global movement that unites national leaders, civil society, bilateral and multilateral organisations, donours, businesses and researchers in a collective effort to improve nutrition. The Government is strengthening evidence-based interventions, which include promotion of exclusive breastfeeding, appropriate complementary feeding practices, and iron-folic acid supplementation during pregnancy, and management of severe acute malnutrition. Nutrient-dense products to increase the availability, accessibility and consumption practices of nutritious food are need of the hour. The Global Alliance for Improved Nutrition (GAIN) is working with the stakeholders in Bangladesh to increase the fortification foods.
At the district and upazila level, more and more Nutritionists need to be posted to render these very basic and fundamental services for maintaining good health as a preventive care to clinical services is essentially important.
Bangladesh National Nutrition Council (BNNC), Institute of Public Health and Department of Agricultural Extension need to work in a collaborative approach for making nutrition base with fortified food production available at grass root.
(The writer is Adjunct Faculty, Bangladesh Institute of Governance and Management).
