As per the latest World Hunger Index, while the prevalence of obesity amongst children under five years of age has increased drastically, India also has the highest number of school-age children who suffer from extreme thinness.

Even as overall undernourishment affects 14.5% of Indians, prevalence of mortality, low weight for height (wasting) and low height for age (stunting) amongst children under five is nearly 5%, 21% and 38.4%, respectively.

Child malnutrition:-

• The number of those suffering hunger has grown from 804 million in 2016 to 821 million in 2017 a setback to the progress the world was making towards eradicating hunger, one of the Sustainable Development Goals adopted by the UN.
• Climate change effects severely impacting food security in many nations, war-torn countries like Yemen and Syria, too, are seeing widespread starvation.
• China has an overall undernourishment prevalence of 9.6%, and under-five mortality, wasting and stunting prevalence of 1.1%, 1.8% and 6.3%.
• In Indian context, apart from access to adequate food, lack of proper sanitation affects absorption levels amongst Indian kids in economically weaker sections, aggravates undernourishment.
• Contrastingly, unwholesome diets and unhealthy dietary preferences amongst the better-off sections has led to the spike in obesity amongst young children.
• Rising obesity is putting pressure on already fragile health systems in India by posing a high risk of chronic diseases such as cardiovascular diseases, diabetes and some cancers (clubbed together as non-communicable diseases, or NCDs).Research shows that Indians have higher levels of body fat and lower levels of lean muscle when compared to many other populations. Therefore, the risk of cardiovascular diseases and diabetes operates even below global thresholds for defining overweight and obesity

How to tackle the problem:-

• Fighting global hunger may need a comprehensive approach, one that focuses on developing climate resilience as much as reducing conflict between nations.
• Midday meal scheme:-
  1. While the focus on sanitation development in communities as well as in schools could help fight malnutrition, mid-day meals, too, could be an important part of the solution.
  2. Even as mid-day meal schemes across states have seen some success in tackling childhood undernourishment, they perhaps hold the key to tackling childhood obesity as well.
  3. In Japan, under a government programme, school cafeterias give students elementary to senior secondary wholesome meals that are free of processed and junk food.
• Policy responses should include agricultural systems that promote crop diversity (to enable dietary diversity) as well as regulatory and fiscal measures (to decrease the availability, affordability and promotion of unhealthy foods, while making healthy foods more accessible).
  1. For example, taking the lead from a directive by the Delhi High Court, India should ban the sale of junk food in and around schools.
  2. Legislators should also put into practice the results of a recent Lancet study on India. It showed that higher taxes on junk food can actually lead those on lower incomes to live healthier lives.
• Even in clinical settings, counselling and care are needed. Instead of being downgraded as ways of managing “poor lifestyle choices”, obesity management, prevention and treatment should be provided as essential health services targeted at a condition that undermines health in many ways. This would help reverse the stigma attached to obesity even by health professionals.
• Further, India should link obesity and undernutrition and treat them as twinned challenges to be jointly addressed under the universal health coverage umbrella. Universal health coverage is encapsulated in the idea that no one should have to suffer financial hardship in order to access essential health care. By tackling obesity through prevention and early care, financially debilitating NCDs can be avoided.
• Package of basic measures including programmess to encourage mothers to exclusively breastfeed their children for up to six months, fortifying basic foods with essential minerals and vitamins, and increased cash transfers with payments targeted at the poorest families . Universal access to infant and young childcare, including ICDS and crèches, provisions to provide biannual critical nutrient supplements and programmes aimed at deworming children are needed.
• In the area of maternal care, the strategy proposes that the government provide nutritional support in particular, the adequate consumption of iodised salt to mothers during pregnancy and lactation.