Download Pulses And Legumes As Functional Foods

Pulses And Legumes As
Functional Foods
B.S. Narasinga Rao
Legumes and pulses have long
been a part of traditional
diets in
Asia, Africa and South America, which
include most of the world's developing countries. More than 1,000 species of legumes are known to be
grown1. Of these, only 20 or so have
been cultivated for use as food. They
have been consumed as a rich source
of protein supplementing
the cereal
- or tuber-based diets and have an
important role in human nutrition2•3.
Some legumes such as ground nut
and soybean are also good sources
of oil.
In India, from time immemorial,
many legumes and pulses (Table 1)
have been consumed as part of a
primarily cereal-based diet. They are
consumed as whole gram or as split
pulses (dhals). Pulses are the main
source of protein in the primarily vegetarian Indian diet. Besides proteins,
pulses are also good sources of vitamins, minerals, (),)-3 fatty acids and
dietary fibre or non-starch polysaccharides (NSP). Charaka4, the physician of ancient India, has identified a
number of pulses as important dietary components in disease management. In recent years, pulses and
legumes have also been recognised
as part of functional foods5.
Several legumes contain nonnutrient bioactive phytochemicals6,7
that have health-promoting
and disease-preventing
properties. The important health promoting 'non-nutrient' compounds
present in pulses
and legumes
include
non-starch
polysaccharides (NSP), phytosterols,
saponins,
isoflavones,
a class of
phytoestrogens, phenolic compounds
and antioxidants such as tocopherols
and flavonoids.
NSP IN PULSES AND LEGUMES
content in a given food11. Some legumes such as fenugreek, which contains 40 per cent gum, can exert the
expected beneficial effect on a daily
intake of about 50 g13.
The NSP components exert their
beneficial preventive effects through
several mechanisms. One ofthe mechanisms is through their swelling properties, consequently reducing the transit
time in the small intestine and reducing the rate of release and their absorption of glucone from dietary carbohydrates and of cholesterol and fat.
The second mechanism is through the
binding of carbohydrate carcinogens
and toxins in the intestinal tract by the
insoluble NSP. This prevents or slows
down the absorption of the carcinogens and toxins. The NSP can also
bind bile acids and thereby promote
the excretion of cholesterol from the
liver through bile. It must be remembered that through this binding property, NSP can also have some adverse
effects on the availability of dietary
calcium, magnesium, zinc and iron.
Pulses and legumes are a rich
source of NSp8.9. The NSP component of some of the commonly consumed pulses10 is as shown in Table
2. The NSP content of pulses and
legumes is 13 to 15 g of NSP per 100 g.
Thus, they contribute significantly to
the total NSP intake of habitual Indian
diets. The NSP in pulses consists of
soluble and insoluble non-cellulosic
fibres. The average content per 100 g
of water-soluble fibre is 4 to 7 g and
that of insoluble fibre is 5 to 7 g. The
NSP content of pulses is similar to
that of cereals and millets (8-20 g/
100 g). A combination of cereals and
pulses in a diet provides 50-85 g of
CONTENTS
Functional
Foods
School
AChildren
FiascoIn
In The
DelhiVitamin
NSP depending
onSharma
the quantity and Affluent
Overweight/Obesity
Anshu
-- B.S.
Rao
Dr C.Narasinga
Gopalan
Foundation
News
Nutrition
News
andmillet)
Comments:
Reviews
and
Comments:
• pulse
Pulses• And
Legumes
As
the type• ofReviews
cereal (or
and
used (Table 2).
Epidemiological observations and
a number of human and animal studies have shown that the NSP in pulses
have a role in protecting against degenerative diseases such as diabetes, cardiovascular disease and cancer. NSP protects against chronic
diseases such as diabetes by controlling blood glucose levels. Their hypocholesterolemic
property
protects
against cardiovascular disease. They
also help prevent bowel cancer by
binding carcinogens and toxins11,12.
The disease-preventing
potential of
NSP depends upon the proportion of
various fractions of NSP and their actual
815 87
gram proteins also has a cholesterolreducing property17. It is likely that
pulse proteins act in conjunction with
their isoflavone contentto reduce blood
cholesterol. The oestrogenic activity
of isoflavones are in the following
<
order: biochinin
A < daidzein
formononetin, and the isoflavone content varies with the variety of legume.
Lima
bean
TABLE 1
Groundnuta
Adzuki
Lablab
Sword
bean
Rice
bean
Jack
bean
bean
bean
Kesari
dhal
(Rigna
Winged
Tepery
(Phaseo/us
(Canava/ia
Fenugreekb
(Phasedus
Bambera
(Haseo/us
(Lab
(Phaseo/us
(G/ucine
(Lathyrus
umbel/ata
(Phosphocarpus
bean
(Cajanus
lab
(Pisum
(Cierarietinum)
eusiforonis)
aconitifo/ius
purpureus)
(Voandzeia
ground
angu/arus)
acutifo/is)
max
/unatus)
sativus)
sativus)
thunb)
cajan)
merr)
nut
(Arachis
hypogaea)
(Trigonel/a
foemin
(Phase
(Phase
(Canava/ia
(Phaseo/us
(Do/idios
a/us
(Da/ichos
a/us
(Lens
(Vigna
mu/ugo
aureus
escu/anta)
g/adiata)
biflourus)
vulgaris)
lab
catana)
rorb)
lab)
tetragonobo/us)
graecum)
subtaerranea)
Food
Legumes
a. b
Source
of oil and protein.
The third mechanism by which
NSP exert beneficial effects on chronic
diseases is through their fermentation in the large intestine (colon)14.
While soluble NSP are completely
fermented, the insoluble fibres are
partially fermented. As a result of this
fermentation, bacterial cell mass increases and reduces the transit time
due to increased bulk. Also as a result of colon fermentation
of NSP,
short chain fatty acids such as butyrates, propionates and acetates are
produced. Butyrates serve as a source
of energy and thus help in rejuvenation of colon mucosal cells. They also
promote differentiation and inhibition
of cell proliferation in human carcinoma cells and promote DNA repair.
NSP, through the release offree fatty
acid like butyrate on fermentation in
the colon, reduce the risk of colon
cancer
and inflammatory
bowel
disease.
The short chain fatty acids, particularly propionates and acetates, enter
into splanchic circulation and are transported to the liver where they exercise a direct inhibitory effect on the
release of glucose and synthesis of
cholesterol. Thus, they contribute indirectly to the hypoglycaemic
and
hypocholesterolemic
effects of NSP.
ISOFLAVONES
(PHYTOESTROGENS)
Isoflavones are phytoestrogens
that exhibit weak oestrogen activity
and are present in significant amounts
in pulses and legumes5.6. Isoflavones
can protect against hormone-dependent diseases such as breast cancer
and cardiovascular disease6. Recent
studies have detected their anticancer activity in a number of animal
carcinogenesis
model experiments.
Isoflavones also possess biological
functions other than oestrogen-related
activity, for example, antioxidant activity. The important isoflavones are
daidzein, genistein, daidzin, genistin,
biochinin A, protensin, formononetin,
etc.
There have been extensive studies on the health promoting
and
disease preventing potential of soy
isoflavones5•6.
The two primary
isoflavones, daidzein and genistein,
the latter exclusively present in soybean, are reported to be most biologically
active phyto-estrogens.
Daidzein, present in high concentration in soybeans, is known to modulate hormone-related conditions such
as heart disease, osteoporosis, breast
and prostatic
cancers and menopausal symptoms5.6. There is currently considerable
interest in soy
as a health food because of these
biological functions. Isoflavones extracted from soy are commercially
marketed. Similarly, a combination
of 6.25 g of soy protein with 12.5 mg
oftotal (extracted) isoflavones, equivalent to 25 g of soy alone, is marketed
as a health food5.
Although a lot of work has gone
on during the past decade on soy
isoflavones, hardly any work, except
for a limited study by Sharma15.16,has
been done on the isoflavone content
of Indian pulses. Several commonly
consumed pulses, particularly BenSharma15.16 has studied
the
gal gram, contain high concentration
isoflavone content of common pulses
of isoflavones (152 mg/1 00 mg) 16.Green
and legumes used as food in India;
the values are given in (Table 3). gram and black gram also contain 80There have been earlier reports on 90 mg of isoflavones, made up of
mostly protensin and daidzein. There
the blood cholesterol
lowering pois, therefore, considerable scope for
tential of chickpea (Bengal gram)'?
future
research on the isoflavones of
and other legumes including soyIndian
pulses, their content, structure
bean5.6. The hypocholesterolemic
and bioactivity to exploit isoflavonepotential of these legumes have been
attributed to their isoflavone content6.15. rich pulses as health foods, in the
The isoflavone content of pulses is same way that soy has been exploited.
These isoflavones with phenolic groups
reported to increase after germinain the molecule can also act as antition.
However,
the potency
of
isoflavones decreases after the le- oxidants along with other antioxidants
such as tocopherols and flavonoids
gumes have been cooked16.
present in these pulses.
Recent studies on soy have suggested that a combination of soy proOTHER PHYTOCHEMICALS
tein and isoflavones is necessary to
produce the greatest cholesterol-lowSeveral other phytochemicals
ering effect5.6. In addition to being a such as saponins, flavones, phenolic
high-quality protein, soybean protein
acids and precursors of mammalian
is now thought to help prevent and
lignan with anticarcinogenic
potentreat cardiovascular
disease. There
tial are reported to be present in soybean and their biological function have
were also earlier reports that Bengal
2
been extensively studied6. Saponins,
which are hypocholesterolemic agents,
are reported to be present in soy at
high concentration. The presence and
content of these phytochemicals
in
Indian pulses do not appear to have
been studied to any significant extent. These pulses, unlike soy, are
widely consumed in India. Occurrence
of these phytochemicals
in Indian
pulses, their identification,
content,
chemistry and their health benefits
require a systematic study. There is
also a need to study the bioavailability
of isoflavones and other phytochemicals
present in Indian pulses.
ANTIOXIDANT
CONTENT
Pulses contain tocopherols, flavonoids and isoflavonoids, all of which
can act as antioxidants. Although dry
pulses do not contain any ascorbic
acid, the germinated pulses and immature green pulses do contain ascorbic
acid which also has antioxidant activity. The isoflavone content of pulses
has been shown to increase two to
three times after germination16. Thus,
both dry legumes and green and germinated pulses are good sources of
antioxidants. Pulses contain about 3.5
mg of vitamin E per 100 g as compared to 1.2 mg in cereals. On the
basis of total daily intake of 400 g of
cereals with 50 or 75 g of pulses, the
--
total antioxidant tocopherol intake works
out to 7.1-7.7 g. The flavonoids are
reported to have four to five-fold antioxidant activity as compared to ascorbic
acid. However, the exact levels of flavonoids and their antioxidant patency
have not been studied in Indian pulses.
Although pulses may not be a major
source of antioxidants in a cerealpulse-based diet, they can contribute
significantly to the total daily intake of
antioxidants on a diet based on cereals, pulses, fruits and vegetables.
CURRENT PRODUCTION OF
PULSES AND LEGUMES IN INDIA
Considering the nutritional importance of legumes and pulses in
Indian diets, their production and per
capita availability is rather depressing20. While cereal production
has
dramatically
increased to self-sufficiency since Independence, pulse production and per capita availability has
actually gone down since 1950. Per
capita availability of pulses has decreased from 60 g in 1950 to 38 g in
1990, a reduction of nearly 40 per
cent. On the other hand, the per capita
availability of cereal and millets has
increased from 330 g to 470 g in spite
of a four-fold increase in population.
The cereal-to-pulse ratio, which should
be ideally 8:1, has risen from 6:1 to
12:1. There is an urgent need to im-
-3.4
2.1
5.5
3.7
2.7
23.5
13.0
.9
-26.4
-Lignin
2.7
3.8
2.5
4.9
6.4
1.0
1.6
4.1
insoluble
Water
23.5
0.9
1.2
7.1
8.6
3.1
10.3
2.6
9.9
9.1
8.2
7.1
7.3
10.1
13.3
13.4
9.7
3.7
10.6
Water
Total
Cellulose
43.4
5.3
49.2
9.5
6,5
18.6
13.4
17.0
26.0
17.2
8.3
75.6
13.6
13.2
20.8
35.2
Non-cellulose polysaccharides
ulses and Legume Foods (g/100 g)
Red gram
Total
TABLE 2
3
prove pulse production in the country
to yield at least 60 g of pulses per
capita per day. In order to provide
adequate protein in the cereal-based
Indian diets, the intake of pulses has
to be 50-75 g per day and it should be
higher (75 g) in diets based on rice
and millets (ragi), with protein content of 6-7 per cent, than in diets
based on wheat and other millets with
10-12 per cent proteins (50 g). On this
basis, the production of all pulses
and legumes should increase from
the current 14 million tonnes to at
least 27 million tonnes. This can perhaps be achieved by growing pulses
in irrigated areas, after the rice or
wheat crop, using better variety of
seeds and exploiting less commonly
used and unfamiliar legumes. The production of groundnuts and soy, which
are also important sources of edible
oil, should be taken into account while
considering per capita availability of
proteins from legumes. In the present
agricultural policy on food production, the emphasis should shift from
cereals to pulses.
There is also a need to cultivate
minor legume seeds such as rice bean,
moth bean, goa bean and tropical
lima bean after establishing their nutritional quality and safety. Several of
these unfamiliar legume pulses have
in fact been investigated at NIN for
97
152.6
88.8
80.7
40.6
2.4
95.4
85"
5.1
67.8
-bean
388.6
Red
88.0
Bengal
Black
Greengram
80.7
gram
2.7
(98.0)
gram
(81)
gram
(49)'
Soya
Content of Pulses
(mg/100
and Legumes
g fresh weight)
their chemical and nutritional quality
and safety. More studies on their use
in Indian cooking and their functional
components require to be initiated.
The possible use of lathyrus seeds as
a pulse with daily intake not exceeding 25 g with low toxin content obtained by growing low-toxin varieties21 or by the removal of toxin9 can be
explored.
SOY AS A LEGUME FOOD IN INDIA
The production of soy bean has
increased significantly in recent decades in India. Currently, it occupies
a prominent place among pulses and
legumes grown in India, current production being 6.52 million tonnes.
The soy bean grown in India is
exclusively used as a source of oil
and the meal as a protein source in
animal feeds. There is an urgent need
to promote soy bean as a legume
grain for human use in India, not only
to meet our shortage in pulses but
also to use it as a functional food.
However, several problems need to
be overcome before soy bean can be
used as a legume food in India, where
it is completely unfamiliar, unlike in
countries of East and South East Asia.
There are several limitations
for the use of soy bean as a food
legume in Indian diets. These are the
anti nutritional factors (trypsin inhibitors) which are not destroyed on ordinary cooking used for pulses, the
unfamiliar organoleptic factors such
as flavour and odour, and the presence of flatulence factors. Special
processes are available to eliminate
or at least reduce these factors to a
more acceptable level20. These prob-
TABLE 312
44.1
4.8
98.6
lems with soya have been overcome
in other Asian countries through fermentation to convert it to temphe or
soya sauce which is widely used in
Japanese and Chinese cuisine.
Simple processing such as germination or the use of green immature pods can also help in utilising
soy as a food legume or as a vegetable. In India, soya can, however,
be introduced as processed flour, which,
through appropriate nutrition education, can be successfully incorporated
into various familiar dishes that use
dhal flours.
Dr B.S. Narasinga
Nutrition
NIN.
Society
Rao is the President
of India
and Former
of the
Director
of
References
1.
Tropical
Legumes
National Academy
- Resources
for the Future;
of Sciences
2. Rockland, L.B., Nishik, K.: Tropical grain legumes in tropical foods. Chemistry and Nutrition;
(Eds) G.E. Inglett and G. Charlambous, Vo12: 547572, Academic Press, New York, 1979.
3. Patwardhan, V.N.: Pulses and beans in human
nutrition. Amer J Clin Nutr; 11: 12-29, 1962.
4. Charaka:
Regime of diet and dietetics.
(English translation); (Ed) Gulab
Kunverba, Vol 1: 179-211, Ayurvedic Society,
Jamnagar, 1949.
Charaka
7. Rao, B.S. Narasinga: Bioactive phytochemicals
in Indian foods. NFl Bull; 16(1), 1995.
8. Taranath, R.N., Muralikrishna, G., Salimath, P.V.,
Rao, M.R. Raghavendra: Plant carbohydrates: An
overview. Proc Indian Acad Sci (Plant Sci); 97: 81155,1987.
9. Fehily, A.: Legume types and nutritional
of Human Nutrition;
(Ed) M.J.
value. Encyclopaedia
Sadler, Vol 2: 1161-1188, Academic Press, New
York, 1999.
10. Sharma, R.D.: Dietary fibre profile of selected
pulses. Ind J Nutr Dietet; 23: 330-332, 1986.
11. Eastwood, M.A.: The physiological effect of
dietary fibre: An update. Ann Rev Biochem; 12: 1935, 1992.
12. Rao, B.S. Narasinga: Dietary fibre in Indian
diets and its nutritional significance. NFl Bull; 9(4):
1-5, 1988.
13. Sharma, R.D., Raghuram, T.C.: Hypoglycaemic
effect of fenugreek seeds in non-insulin dependent
diabetic subjects. Nutr Res; 10(7): 31-739,1990.
14. O'Dea, K.: Factors influencing carbohydrate
digestion: Acute and long-term consequences. Dib
Nutr Metab; 3: 251-258, 1990.
15. Sharma,
R.D.: Isoflavones
and hypocholesterolemia in rats. Lipids; 14: 535-540, 1979.
16. Sharma, R.D.: Isoflavone content of Bengal
gram at various stages of germination. J Plant
Foods; 3: 259-264, 1981.
17. Mathur, K.S.: Hypocholesterolemic property of
Bengal gram. Proceedings of Symposium on Nutrition and Heart Disease; 17-23, ICMR, 1971.
Samhita
5. Oomah, B.D., Mazza, G.: Functional foods.
of Food
Science;
(Ed) F.J.
Francis, Vol 2: 1176-1182, John Wiley, New York,
2000.
18. Sharma, R.D.. Isoflavone content of Bengal
gram at various stages of germination. J Plant
Foods; 3: 259-264, 1981.
Encyclopaedia
19. Mathur, K.S.: Hypocholesterolemic property of
Bengal gram. Proceedings of Symposium on Nutrition and Heart Disease; ICMR, 17-23, 1971.
6. a) Rhodes, M., Price, K.R.: Phytochemicals:
classification and occurrence. 1539- 1548; and
20. Asthana, A.N., Chaturvedi, S.K.: Pulses: A Little
Impetus Needed. Hindu survey of Indian agriculture; 61-65, 1999.
b) Wiseman, H.: Phytochemicals: epidemiological factors. Encyclopaedia
of Human Nutrition;
(Ed) M.S. Sadler, Vol 3: 1549-1561, Academic
Press, New York, 1999.
4
21. Santha, I.M., Arti, P., Mehta, S.L.: Biotechnology approaches to remove toxin from Lathyrus
sativus. Proc Nutr Soc India; 39: 41-45, 1992.
programmes of these countries, while
paying deceptive lip service to "Home
Gardens".
Reviews and Comments
The Vitamin A Fiasco
c. Gopalan
The reported deaths of several
children in Assam following on the
administration
of massive doses of
vitamin A must have saddened all rightthinking people. A similar episode
following on the administration
of
massive doses of vitamin A to neonates in Tamil Nadu had been reported a few months ago.
It is claimed that not all reported
deaths in the recent Assam episode
were really attributable to vitamin A
administration.
This is possible. On
the other hand, it is known that massive doses of vitamin A can prove
dangerous if strict precautions are
not observed. The major precautions
are:
• Massive doses of vitamin A are to
be avoided in infants,
• The dose limit should be strictly
adhered to and never exceeded,
• Administration is to be avoided in
the case of children who are ill,
• Administration is to be carried out
under strict supervision by trained
workers.
In a mass campaign where the
object is to "capture" as many children (and to push in as much vitamin
A) as possible, these precautions cannot
be adhered to. It is for this reason that
the National Consultation on vitamin
A had clearly expressed the view that
massive doses of vitamin A should
not be administered along with the
pulse polio programme. What has happened is in blatant violation of this
national directive. Under these circumstances it cannot be denied that
quite a few of these reported deaths
were, in fact, due to wrongful administration of massive doses of vitamin
A. Massive doses of vitamin A have
been claimed in some quarters to bring
about reduction in child mortality. This
claim has been challenged and may
be in doubt. What is, however, not in
doubt from these reports, is that massive doses of vitamin A could actually
increase child mortality in some situations!
The approach involving massive
doses of vitamin A was initiated in
the National Institute of Nutrition over
30 years ago at a time when keratomalacia was a major public-health problem. Even at that time, the limitations
of this approach had been known'.
This approach was envisaged purely
as a short-term emergency measure
and as an adjunct to dietary improvement. Green leafy vegetables and
fruits in seasons, plentifully available
in the countryside and well within the
economic reach of even the poor, if
judiciously
used, could control the
problem. Today, keratomalacia is certainly no longer the public-health problem that it was several decades ago.
Mild cases of vitamin A deficiency
are sometimes seen in some pockets
of the cou ntry but they hard Iy call for
drastic and potentially dangerous preventive remedies. If, besides dietary
improvement,
supplements
are
needed, harmless natural preparations such as red palm oil produced
within the country could be used. It
will be wise to restrict synthetic vitamin A administration to children who
are actually suffering from signs of
vitamin A deficiency.
In several previous issues of this
Bulletin, I had repeatedly cautioned
against the exaggerated claims regarding the beneficial effects of massive doses of vitamin A and had warned
against their indiscriminate
use, especially
in infants and pregnant
women2,3,4,5.
I had pleaded for vigorous promotion of optimal use of horticultural products in household diets
and for the prompt treatment of infections, especially respiratory infections
in children as being the logical public
health approach to the problem of
vitamin A deficiency.
Unfortunately, the rapid decline
in the incidence of even milder forms
of vitamin A deficiency, instead of
causing satisfaction, seems to have
rung alarm bells in some commercial
circles. Frantic efforts are being mounted
to expand the market for synthetic
vitamin A in poor South Asian countries and to permanently
entrench
synthetic vitamin A and ensure for it a
permanent safe place in the health
5
It is intriguing that in certain communities, in which more than 50 per
cent of the children are stunted and
quite a large number are anaemic
because of poor diets, near-exclusive
attention is being directed by some
agencies to prevent a "problem" which,
at its worst, is of relatively minor importance, Massive doses of vitamin A
are being administered not only to
children but also to neonates. If these
agencies have their way, pregnant
and nursing women will also be targeted. The same forces are also involved in the promotion of fortification of tea and ice-cream with vitamin
A - programmes which by no stretch
of the imagination can be claimed to
be of any use to the poor! It should be
obvious that these efforts are aimed
at expanding the market for a favoured
commercial
product rather than to
combat a national health problem.
International agencies of repute, which
have had a good record and are looked
upon as custodians of the poor, should
carefully avoid getting involved in these
operations, in order to retain their
credibility. International agencies are
expected to playa legitimate role as
facilitators of nationally accepted publichealth programmes. In their own interest, they should avoid the temptation to assume supra-national roles,
which could sometimes run contrary
to national policy.
It is to be hoped that health agencies, the scientific community and the
enlightened public will muster sufficient strength and sense to firmly resist ongoing attempts at commercial
exploitation of undernutrition
by external agencies. Such concerted action had brought about the "protein
fiasco" and had saved us from "fish
protein concentrates", which were being
vigorously peddled as the answer to
our prayers by the "bureaus of commercial fisheries" of powerful countries. The present situation again calls
for such concerted action.
The country expects its national
health agencies to ensure that health/
nutrition programmes are implemented,
in accordance with national dictates,
to protect the true interests of its people
- not in accordance with the wishes
and advice of external agencies (and
their hired local cohorts), who may
have different
perceptions
and a
different agenda. Distortions in national programmes arising from overreliance on external interests could
cause several repeats of the Assam
episode in the future as well, and
therefore should be avoided. In order
to ensure harmonious relations and
to protect national interests, guidelines in this regard should be immediately laid down and strictly enforced.
References
1. Gopalan, C.: Prevention of micronutrient malnutrition. NFl Bull; 22(4): 1-7,2001.
2. Gopalan, C.: Vitamin A deficiency and child
mortality. NFl Bull; 7(3): 3-6,1986.
3. Gopalan, C.: Vitamin A and child mortality. NFl
Bull; 11(3): 1-3, 1990.
4, Gopalan, C,: Acute toxicity of vitamin A in infancy. NFl Bull; 15(1): 8, 1994.
5. Gopalan, C.: Combating Vitamin A deficiency
through dietary improvement. Special Publication
Series; 6: 5-13, NFl, 1992.
APPENDICES
The following earlier issues of
the NFl Bulletin may also interest the
readers.
I. Distorted Perceptions
(From Special Publication
Series; 6: 6-7, NFl, 1992.)
In retrospect, it seems that our
frequent reference, in the past, to
dietary improvement
as the "Iongterm solution", and to the provision
of massive doses of synthetic vitamin A as the "short-term solution"
may have been a major mistake. The
term "short-term solution" carries with
it a sense of immediacy and urgency
and is recognised as being very much
the agenda for the present. The "Iongterm solution", on the other hand, is
perceived as something for the distant future, and therefore ends up on
the shelf rather than on the desk. The
highly exaggerated (almost fictitious)
reports of the magnitude of the problem of "nutritional blindness" in the
country suggest that blindness due
to vitamin A deficiency is a major
public health "emergency" needing
immediate drastic solutions. These
reports, coupled with the recent claims
of the miraculous anti lethal properties of synthetic vitamin A, have conferred added "legitimacy" on "the shortterm emergency solution". The "Iongterm solution" has further receded
into the background.
If we are going to make any headway at all towards our proposed goal
of overcoming vitamin A deficiency
through dietary improvement, these
distorted perceptions, which are largely
responsible for the current inertia, wi II
need to be corrected. Dietary improvement, through increased intake of
carotene-rich foods in the dietaries of
mothers and children, must be recognised as the solution which must claim
our central attention here and now.
The steps necessary to put the solution on a firm basis must be the major
item of the present agenda. However,
promotion of the intake of green leafy
vegetables and the effective harnessing of our rich horticultural food resources are to be seen as much more
than an answer to the problem of a
single nutrient deficiency - namely,
that of vitamin A. Green leafy vegetables and fruits are good sources of
folic acid, vitamin C, iron and calcium
and can therefore contribute to the
betterment of the overall nutritional
status of our population. Therefore, in
promoting carotene-rich foods, we are
attempting much more than combating vitamin A deficiency.
There is absolutely no case at
present for the further expansion of
the periodic vitamin massive dosage
approach and for building it into EPI.
This ill-conceived step must be resisted. In order to achieve results and
to inject the necessary sense of purpose and urgency, we may set for
ourselves a time-frame for the progressive and phased withdrawal of
the approach involving periodic massive doses of synthetic vitamin A, even
in its present (unexpanded) form. This
would remove a major reason for our
inertia. It would also indicate that as
scientists and administrators we earnestly accept the challenge to overcome, within a reasonable time-frame,
the obstacles which currently stand
in the way of the effective use of wide
variety of carotene-rich foods available within the country to combat the
problem of vitamin A deficiency. The
magnitude of this undertaking and its
enormous implications with respect
to actions at various levels and in
different sectors must, however, not
be minimised.
II. An Innovative Strategy to
Promote Production and Consumption of Vegetables and Fruits
(From Scientific
Report;
12: IX-XI, NFl, 1996.)
Food-based
programmes
for
combating micronutrient deficiencies,
though widely recognised as being
6
important, are today not receiving necessary financial support from either
national agencies or international/bilateral donors. Micronutrient deficiencies
are still being largely perceived as
problems to be solved with tablets,
pills and capsules. Where food is
mentioned, it is mostly as a possible
vehicle for fortification with synthetic
nutrients. This perception has to change
if food-based programmes of the real
sense have to make headway and
find financial support.
Some of the policy initiative suggested to promote production of micronutrient foods such as promotion
of "kitchen-gardens"
and "home-gardens", while justifiable in themselves,
have not made much impact because
they are not of a scale and nature
which would attract financial support
of a substantial order.
Through supportto imaginatively
designed
large scale food-based
programmes for combating micronutrient malnutrition, international and
bilateral lending agencies can significantly contribute towards overcoming the problem of micronutrient deficiencies and also towards combating
poverty in thousands of poor households in developing countries, through
employment generation. The case for
such support rests on sound scientific and practical
considerations.
Investments
in such food-based
programmes could be expected to
yield durable, long-term
benefits,
as against short-term relief that is
now being achieved through many
ongoing
"supplementary
feeding
programmes" which are largely in the
nature of welfare operations based
on donated foods supplemented with
pills and capsules, and are therefore
not self-sustaining.
Outline of large-scale foodbased programmes
for boosting
production and consumption offruits
and vegetables: In order that foodbased programmes yield such durable
long-term benefits, leading to selfreliance, they must be designed as
large-scale cooperative
community
operations. The participants, the entrepreneurs in the programmes, would
be the currently unemployed and under-employed poor rural youth (men
and women) drawn from the community. They would be mobilised and
enlisted, given initial basic training,
and provided necessary inputs and
technical support to start the programme
with supportive supervision. Since the
programme would be a joint venture
sponsored by international/bilateral
lending agencies and national governments, political support and commitment at the national levels may be
expected. Basic facilities - land, water and power - will be made available
by the local authority. Pricing policies
and subsidies favouring the programme
may be forthcoming.
The programme will be directed
not only to production but also to the
entire chain of operations leading to
increased consumption at the household and community level. Modern
intensive bio-agro-technological methods will be employed to promote largescale mass production of high nutritive value varieties of vegetables land
fruits, taking into account seasonal
and regional factors, in big cooperativefarms. Arrangements for processing,
preservation and storage will be made
available. The farmers engaged in the
operation will be assured attractive
returns. Arrangements for transport
and marketing will also be a part of
the programme. The products will
be made available for use in statesponsored
supplementary
feeding
programme; indeed the incorporation
of micronutrient-rich food ingredients
generated in the programme into the
food supplements now being offered
through the state sponsored supplementary feeding programmes could
be made mandatory. This will ensure
a steady offtake and also contribute
to the enhancement of the nutritive
value of present supplements. Women,
who are part of the proposed cooperative movement, can in fact be
engaged in operations involved in preparing and sending the food supplements. This will further enlarge the
scope for employment generation.
The setting up of agro-based smallscale and medium-scale industries in
villages and small towns for the manufacture of "ready-to-eat"
foods and
"convenience foods" will also be a
part ofthe programme. Immense scope
and need currently exist for the production of such products as "dehydrated leaf powder" (from such alpha/beta-carotene
rich sources such
as spinach and drumstick leaves). Pilot
studies have indicated that this effort
is feasible; that the processed products are of good nutritive value, and
acceptable. These processed products could be used to "fortify" food
supplements now being offered through
the ongoing National Supplementary
Feeding Programme, which caters to
millions of children. This would be a
"natural" way of achieving fortification, the fortification here being based
on indigenous
food sources and
achieved through indigenous labour.
The above operation can also
be extended to special locations (where
favourable agro-climatic
conditions
exist) for the production of other micronutrient-rich foods such as red palm
oil and spirulina, and for selective
propagation of varieties oftubers, maize,
and sorghum rich in alpha/beta-carotene.
Production of common salt of
fortified with iodine or "double-fortified" with iron and iodine on the lines
of the technology developed at NIN,
Hyderabad, could also be a part of
the same cooperative efforts, and factories could be set up for the manufacture of these products.
The model prepared above is by
no means utopian. This model is, in
fact, based on the rich experience
gained in the highly successful National Dairy Development Programme
in India - "Operation Flood". In this
latter programme, thousands of farmers had been successfully enlisted
and welded into a massive cooperative movement; provided technical and
logistic support for cattle rearing and
milk production. As a result, Operation Flood yielded substantial returns
and contributed to significant augmentation of production of milk and
milk products in the country apart
from bringing about improvement in
the living conditions and socio-economic status of thousands of rural
households. Similar gratifying results
may also be expected through a foodbased programme of the type discussed above.
The World Bank is currently reported to have over $2 billion available
for well-designed, broad based, timebound nutrition programmes which could
generate self-reliance and lead to durable results in critical areas. An approach of the type suggested above
will eminently qualify for such support.
This is because what has been proposed is not just a narrow nutrition
programme, but a major anti-poverty,
employment generation programme,
of which nutritional (micronutritional)
upliftment is only a part. The programme
could he4J to transform the rural countryside in many developing countries
and could significantly contribute to
the improvement of nutritional status
of their population.
Recent findings suggesting that
bioactive phytochemicals
present in
vegetables and fruits could be protective against epithelial cancers has
led to the increased intake of these
foo.ds in developed countries. Thus
these foods have now gained a new
"prestige"! This could help to raise
the "social prestige" of green leafy
vegetables in developing countries
as well. There is a general belief that
green leafy vegetables were being
considered as the poor man's food,
and so suffered low social prestige.
Modern biotechnology
offers
numerous possibilities for the selective breeding and propagation ofvegetables and fruits with high micronutrient contents. We can expect that
with these new developments it will
become increasingly possible for us
to combat micronutrient deficiencies
through dietary improvement.
NUTRITION
NEWS
• IX Asian Congress of Nutrition:
Arrangements for this Congress are
going ahead. Readers are requested
to visit the Congress Website, http://
www.acn2003india.net.
for the latest
information.
• XXIV Annual Conference of the
Nutrition Society of India: Dr Madhu
Mishra organised this Conference on
December 5-6, 2001, at Bhopal.
• Kamala Puri Sabharwal Lecture:
By Dr Selvamurthy (Director Defence
Institute of Physiology), on "Nutritional
Requirements of Man in Extreme Environments", on December 14, 2001,
at the Lady Irwin College, New Delhi.
Dr Gopalan presided.
• The Vitamin A Tragedy in Assam:
The Government has constituted a
committee
consisting
of Drs A.K.
Ganguly, C. Gopalan, Mahalanobis,
Soman, M.K. Bhan and Shanti Ghosh,
to report on this tragedy and to recommend suitable remedial measures
for the avoidance of similar mishaps
in future.
ered the First C. Ramchandran
Memorial Lecture on "Child Health in
India." The Seminar hall was named
C. RAMCHANDRAN HALL in memory
of the late C. Ramchandran.
Reviews and Comments
Overweight/Obesity In
Affluent School Children In Delhi
Anshu Sharma
A study was recently carried out
by NFl on over 4,000 children aged
Study Circle
volved in the transition from childhood to adolescence this could partly
377
343
507
14
64
492
449
369
306
109
40
197
183
73
313
284
232
54
27
186
169
239
24
81
974
408
116
503
401
634
705
157
36
412
Number
BMI
Girls
200
Girls
15
Girls
Normal
Obese
(25.95)
(31.07)
(60.84)
(22.15)
(10.35)
(31.21)
(5.67)
(7.95)
Boys
(74.12
(17.96
(15.68)
(22.88)
(0.25)
(13.10)
(17.25)
) ) Overweight
(10.04)
(4.30)
(6.27)
(4.84)
(2.85)
(75)
(84.06)
(2.76)
(8.62)
(90.86)
Boys
Body Mass Index (BMI)* in Children
4-18 Years of Age
Lectures
• Dr Patrice L. Engle (Chief, Child
Development and Nutrition, Unicef,
New Delhi) on "Behavioural Aspects
of Complimentary Feeding" on October 23, 2001.
• Dr Adarsh Chaudhary (Professor
and Head, Department of Gastroenterology Surgery, G.B. Pant Hospital,
New Delhi) on "Nutrition Intervention
in Gastrointestinal
Fistulae" on December 12, 2001, under the auspices
of the CRNSS.
President's
Engagements
• The Golden Jubilee Oration of the
Home Science Association of India
on "Empowerment of Women - the
Key to National Development" was
held atthe Lady Irwin College of Home
Science on October 4, 2001.
Nutrition Education and Extension
Programmes of the Foundation
*Body
mass index (BMI) is the ratio of weight
in kg to the square
of the height
in metres
(kg/m2).
*Figures
within brackets
indicate
percentages.
between four and 18 years in a public
school in Delhi. This school caters to
the children of the most affluent sections of society.
be due to a greater degree of dietary
discipline
with respect to adolescents as compared to children in
affluent homes.
The cut-off points for overweight
and obesity used in the study were
those proposed by Cole et al'. The
data provide in the table will show
that:
The author is Scientific
Foundation
of India.
• In the 15-18-year age group, the
incidence of obesity in girls was negligible, although 16 per cent of the
girls were still overweight.
These data suggest that overweight and obesity in the affluent
are more in evidence in childhood
than in adolescence. Apartfrom physiological or metabolic changes in-
[email protected]
Designed
and produced
NEWS
The Annual Foundation Day was
celebrated on November 29, 2001.
On that occasion Dr M.K. Bhan (Professor of Paediatrics, AIIMS) delivof India, C-13 Qutab Institutional
India Pvt Ltd. e-mail:
• Education
and demonstration
programmes beamed to lower- income
groups in Delhi slums,
• Audio-visual aids to promote this
programme, which have been developed and are in demand by schools
and other institutions.
The First C. Ramchandran
Memorial Lecture
Workshop
• School workshops offering nutrition/health education for children and
adolescents,
• A Diet Counselling Service for affluent and poor sections, and
FOUNDATION
by Media
The major items ofthe programme
have been the following:
• Nutrition education camps and exhibitions in schools,
1. Cole. Tim J., Bellizzi, Mary C., Flegal, Katherine
M., Dietz, William H.: BMJ; 320:1240-1243,
2000.
Edited by Dr (Mrs) Hema Sarath Gopalan for the Nutrition Foundation
e-mail:
at the Nutrition
Reference
• Incidence of overweight reached
its peak in boys by 12-14 years and in
girls by 9-11 years and showed some
decline in later age groups;
• Incidence of obesity reached its
peak between 6-8 years in both boys
and girls and thereafter showed a striking
decline; and
Officer
In addition to its programmes of
scientific research, scientific lectures
and scientific publications, the Foundation is also intensifying its Nutrition
Education and Extension Programmes
beamed to critical segments of the
population.
The Nutrition Foundation
India is grateful to FAO
and WHO for matching
grants towards the cost of
this publication
Area, New Delhi 110 016. website: www.nutritionfoundationofindia.org
[email protected]