Protein intakes of pregnant women and children in India-protein quality implications

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Sulagna Bandyopadhyay¹, Nirupama Shivakumar¹, Anura V Kurpad^1,2

¹Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Sarjapur Road, Bangalore, 560034, India.

Maternal & Child Nutrition

|December 21, 2020

Insights

This study assessed protein quality in Indian diets for pregnant women and young children, identifying risks of inadequacy linked to low birthweight and stunting. Findings inform nutrition programs to improve child health outcomes.

Area of Science:

Nutritional Science
Public Health
Maternal and Child Health

Background:

National Family Health Survey (NFHS-4, 2016) indicates high rates of low birthweight (LBW) and stunting in Indian children under 5.
Nutrition and environmental factors, including poor water, sanitation, and hygiene (WASH), critically impact population health, especially for vulnerable groups.
Suboptimal nutrition and living conditions during pregnancy and early childhood have long-lasting, intergenerational consequences.

Purpose of the Study:

To analyze indispensable amino acid (IAA) requirements for pregnant women in India during the second and third trimesters.
To assess the protein quality of Indian diets consumed by pregnant women and young children (1-6 years) in rural areas.
To evaluate the risk of dietary protein inadequacy in relation to LBW, stunting, and underweight, and inform nutrition intervention planning.

Main Methods:

Estimated IAA requirements for pregnant women using protein accretion data from an Indian study.
Assessed dietary protein quality using IAA requirements for pregnancy and current requirements for young children.
Analyzed data from the National Nutrition Monitoring Bureau (NNMB) rural survey for dietary intake and anthropometric measurements.
Determined the proportion of the population at risk of dietary protein inadequacy and provided state-wise estimates.

Main Results:

The study provides novel estimates of IAA requirements for pregnant women in India.
Dietary protein quality was assessed in the context of adverse environmental exposures.
Identified populations at risk of dietary quality protein inadequacy, with state-wise estimates provided.
Evaluated the potential impact of dietary supplementation on improving health outcomes.

Conclusions:

Dietary protein quality is a critical factor influencing LBW, stunting, and underweight in Indian children.
Understanding IAA requirements is essential for assessing protein quality in diverse populations.
State-specific data on protein inadequacy risk can guide targeted nutrition interventions.
Findings support the need for evidence-based supplementary nutrition programs to improve maternal and child health.

Read full analysis

Abstract:

The recent National Family Health Survey (NFHS-4, 2016) reports a national average of 18% for low birthweight (LBW) and 38% for stunting in children <5 years. Nutrition and environmental influences (chronic enteric pathogenic exposure through poor water, sanitation, and hygiene) are two critical factors that impact the health outcomes of the populxation. This is particularly relevant for vulnerable age groups such as pregnant women and children <5 years, who bear long-lasting and intergenerational consequences of impoverished nutrition and suboptimal living conditions. The present review provides, for the first time, an analysis of indispensable amino acid (IAA) requirements for pregnant women, separately for the second and third trimesters, using protein accretion data from a recent Indian study. Furthermore, using these estimates for pregnancy, and the current IAA requirements for young children, the quality of protein was assessed in Indian diets consumed by pregnant women and children (1-3 and 4-6 years) from national representative rural National Nutrition Monitoring Bureau survey. The assessment was considered in the context of an adverse environment and in relation to outcomes such as LBW, stunting, and underweight. Finally, an assessment was made of the proportion of the surveyed population at risk of dietary quality protein inadequacy and implications for planning nutrition intervention programmes. Specifically, state-wise estimates of the risk of quality protein inadequacy are provided, in addition to evaluations of additional dietary supplementation, which could inform the policy of supplementary nutrition programmes to improve health outcomes.

Keywords:

child growth infant and child nutrition low birthweight nutrition-infection interaction pregnancy and nutrition stunting undernutrition

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