Which Indian State has Best Nutrition? | Dhruv Rathee

Summary

This video delves into India's nutritional landscape based on the Comprehensive National Nutrition Survey, highlighting deficiencies in vitamins and minerals across different states. It explores the prevalence of anemia, protein, zinc, Vitamin A, and Vitamin D deficiencies, offering dietary recommendations to counter these. The video also emphasizes the importance of balanced diets and the challenges faced by vegetarians in meeting protein needs. Additionally, it compares regional dietary habits, advocating for increased consumption of certain food groups where they are deficient. Viewers are encouraged to adapt their diets for better health and share this vital information.

Takeaways

• 📊 The Comprehensive National Nutrition Survey (CNNS) was conducted between 2016 and 2018 to assess nutritional deficiencies across various states in India.
• 🔍 The survey revealed significant issues such as Vitamin A, Vitamin D, Iron, and Zinc deficiencies among different age groups.
• 🍎 Anaemia is most prevalent in West Bengal and Tripura, particularly in females after puberty due to menstruation-related iron loss.
• 🥩 Iron from non-vegetarian sources is better absorbed by the body, but vegetarians can increase iron intake through seeds like flax, chia, and sunflower seeds.
• 🍊 Consuming Vitamin C-rich foods along with iron-rich foods enhances iron absorption, with citrus fruits and raw bell peppers being good sources.
• 💊 A large proportion of dietary supplements in India are fake, with 60-70% of protein supplements being unapproved or counterfeit.
• 🍗 Protein deficiency is widespread in India, especially among vegetarians, who may need to consume larger quantities of pulses, beans, and dairy to meet their protein needs.
• 🍄 Zinc deficiency is most common in Gujarat, Manipur, Punjab, and Meghalaya, and can lead to symptoms like hair loss and diarrhea.
• 🥚 Vitamin D deficiency is more prevalent in urban and wealthy populations due to reduced sun exposure, with supplementation being necessary for many.
• 📈 The video highlights regional dietary habits, encouraging viewers to consume a balanced diet that includes a variety of food groups to address potential nutritional deficiencies.

Q & A

What is the main focus of the Comprehensive National Nutrition Survey (CNNS)?

The CNNS focuses on determining various types of nutritional deficiencies across different age groups and states in the country, including deficiencies in Vitamin A, Vitamin D, Iron, and more.

What is meant by the term 'double burden' in the context of malnutrition?

The 'double burden' refers to the condition where an individual is overweight/obese while also being stunted, meaning their weight is higher than normal for their age, but their height is lower than expected.

Why is anaemia more prevalent among females after the age of 10, according to the report?

Anaemia becomes more prevalent among females after the age of 10 due to menstruation, which leads to blood loss and increased iron requirements that, if not met, can result in anaemia.

What are the dietary recommendations to prevent iron deficiency in vegetarians?

Vegetarians can prevent iron deficiency by consuming iron-rich foods such as seeds (flax seeds, sabja seeds, sunflower seeds, chia seeds), and pairing them with Vitamin C-rich foods to enhance iron absorption.

What is the significance of Vitamin C in iron absorption?

Vitamin C significantly improves the absorption of iron in the body, especially non-heme iron from plant sources. Consuming Vitamin C-rich foods, like citrus fruits or bell peppers, along with iron-rich foods enhances this absorption.

Why is protein deficiency common among vegetarians in India?

Protein deficiency is common among vegetarians because plant-based protein sources typically require larger quantities to meet protein needs compared to animal-based sources, making it more challenging to obtain adequate protein from a vegetarian diet.

What are some common signs of zinc deficiency?

Common signs of zinc deficiency include hair loss, diarrhoea, and a weakened immune system. Zinc deficiency is often seen in individuals who follow drastic or unbalanced diets.

How can a balanced diet help prevent zinc deficiency?

A balanced diet that includes a variety of nuts, pulses, grains, and other zinc-rich foods can help prevent zinc deficiency. Ensuring that the diet is diverse and well-rounded provides sufficient zinc intake.

Why is Vitamin D deficiency more prevalent among the urban population?

Vitamin D deficiency is more prevalent among the urban population because they tend to spend less time outdoors in sunlight, which is a primary source of Vitamin D. This is more common among wealthier individuals who might have indoor jobs or lifestyles.

How can one ensure they are consuming authentic protein supplements?

To ensure protein supplements are authentic, consumers should purchase from reputable brands and official websites, carefully examine the packaging for errors in text or logos, and avoid buying from unreliable sources like some online marketplaces.

Outlines

00:00

🌟 Importance of National Nutrition and Addressing Deficiencies

The video introduces the topic of national nutrition and its significance for the country's development and people's health. It highlights the Comprehensive National Nutrition Survey (CNNS), the largest micronutrient survey conducted in India, which studied over 1 lakh children and adolescents across 30 states. The video explains various types of malnutrition, such as being overweight, underweight, stunting, and wasting. The concept of 'double burden' is discussed, where individuals can be both overweight and stunted simultaneously due to poor diet. The survey's findings reveal alarming statistics, such as 26.4% of children aged 10-19 being stunted and 4.1% being overweight. The video also delves into anemia, particularly in West Bengal and Tripura, with a focus on how dietary changes, especially for vegetarians, can help prevent this condition.

05:05

🍊 Tackling Iron and Protein Deficiencies

The video continues by discussing iron deficiency, prevalent in Punjab, Rajasthan, and Gujarat, and how combining iron with Vitamin C-rich foods enhances its absorption. It also addresses protein deficiency, noting that 73% of Indians lack sufficient protein in their diets, as per a 2017 survey. The video emphasizes the challenges vegetarians face in meeting their protein needs compared to non-vegetarians and the rise of protein supplement consumption, cautioning viewers about the prevalence of fake dietary supplements. Additionally, zinc deficiency is highlighted, with Gujarat, Manipur, Punjab, and Meghalaya showing the highest percentages. The video provides dietary recommendations for addressing these deficiencies, emphasizing the importance of a balanced diet.

10:11

🌞 Vitamin Deficiencies and State-wise Dietary Patterns

The final section of the video explores Vitamin A and D deficiencies, noting that Vitamin A is better absorbed from non-vegetarian sources and that Vitamin D deficiency is more common in urban populations due to limited sun exposure. The speaker shares their own experience with Vitamin D deficiency and discusses state-wise dietary patterns, highlighting which states excel or fall behind in consuming various food groups like milk, curd, pulses, green leafy vegetables, fruits, and more. The video concludes by encouraging viewers to adjust their diets based on these insights to meet their nutritional needs and maintain overall health.

Keywords

💡Comprehensive National Nutrition Survey (CNNS)

The CNNS is the largest micronutrient survey ever conducted in the country, covering over 1 lakh children and adolescents across 30 states. It provides critical data on nutritional deficiencies like Vitamin A, Iron, and others, which are key to understanding and addressing malnutrition. The video's narrative revolves around the findings of this survey, highlighting its importance in shaping public health initiatives.

💡Malnutrition

Malnutrition refers to the condition where a person's diet lacks essential nutrients or contains them in the wrong proportions. The video discusses different types of malnutrition, such as stunting, wasting, and obesity, and explains how these conditions can coexist. Malnutrition is central to the video's message as it explores the various deficiencies affecting different states and their implications on public health.

💡Anaemia

Anaemia is a condition characterized by a deficiency in the number or quality of red blood cells, often due to low haemoglobin levels. It leads to fatigue, weakness, and a weakened immune system. The video highlights the prevalence of anaemia in certain states and discusses its causes, such as Iron, B12, and folate deficiencies, particularly emphasizing its higher incidence among females post-puberty.

💡Iron Deficiency

Iron deficiency is a common nutritional deficiency that impairs cognitive development in children. The video discusses its prevalence in states like Punjab and its lower rates in states like Jharkhand. It also covers dietary sources of Iron, the importance of combining Iron with Vitamin C for better absorption, and how vegetarians can address this deficiency through specific foods.

💡Double Burden

The double burden refers to the simultaneous occurrence of overweight/obesity and stunting within the same individual. This condition can arise from poor diet quality. The video explains this concept using survey data showing that a significant percentage of children experience this dual form of malnutrition, underscoring the complexity of nutritional challenges in the country.

💡Vitamin A Deficiency

Vitamin A deficiency is a lack of sufficient Vitamin A in the diet, leading to issues such as vision problems and immune deficiencies. The video explains that this deficiency is most prevalent in states like Mizoram and Jharkhand, while being least common in Rajasthan, Sikkim, and Goa. It also discusses food sources of Vitamin A, especially the higher bioavailability from animal products.

💡Zinc Deficiency

Zinc deficiency affects immune function and can lead to symptoms like hair loss and diarrhea. The video highlights the states with the highest and lowest prevalence of Zinc deficiency and discusses how a balanced diet, including nuts, pulses, and grains, can help prevent it. The concept is presented as part of the broader discussion on nutritional imbalances and their regional variations.

💡Vitamin D Deficiency

Vitamin D deficiency is more common in urban and wealthy populations due to reduced sun exposure. The video mentions that Vitamin D is crucial for bone health and is primarily obtained through sunlight, with additional sources like mushrooms and fortified foods. This deficiency is highlighted as unique because it is more prevalent in wealthier states, contrasting with other deficiencies linked to poverty.

💡Protein Deficiency

Protein deficiency, while not covered in the CNNS, is noted as a significant issue, with a 2017 survey revealing that 73% of Indians lack adequate protein in their diets. The video discusses the challenges vegetarians face in meeting their protein needs compared to non-vegetarians and the widespread use of protein supplements, some of which may be fake or unapproved, emphasizing the importance of careful product selection.

💡Balanced Diet

A balanced diet includes the right proportions of various food groups to meet the body's nutritional needs. The video stresses the importance of a balanced diet in preventing deficiencies like Zinc, Iron, and others. It provides examples of states where certain food groups are under-consumed, encouraging viewers to adjust their diets to achieve nutritional balance and prevent malnutrition.

Highlights

The Comprehensive National Nutrition Survey (CNNS) is the country’s largest micronutrient survey, conducted on over 100,000 children and adolescents across 30 states.

Malnutrition can manifest as being overweight, underweight, stunted, or wasted, and one can be both overweight and stunted, known as a 'double burden.'

According to the survey, 26.4% of children aged 10-19 in India are stunted, 4.1% are overweight, and 0.8% experience the double burden.

States like Tamil Nadu, Goa, and Delhi have the highest percentage of overweight children, while Bihar, Uttar Pradesh, and Jharkhand have higher rates of underweight children.

Anaemia, characterized by low haemoglobin levels, is most prevalent among children aged 10-19 in West Bengal and Tripura, with a higher incidence in females post-puberty due to menstruation.

Iron deficiency is highest in Punjab, Rajasthan, and Gujarat, with Punjab having 45% of children aged 10-19 suffering from this deficiency.

The report suggests that consuming Iron-rich foods along with Vitamin C can improve Iron absorption.

Protein deficiency is widespread in India, with a 2017 survey indicating that 73% of Indians are protein deficient.

Vegetarians are more prone to protein deficiency due to limited sources and often rely on protein supplements, but a significant portion of these supplements in India are fake.

Zinc deficiency is most common in Gujarat, Manipur, Punjab, and Meghalaya, affecting nearly 50% of children aged 10-19 in these states.

Vitamin A deficiency is highest in Mizoram and Jharkhand, while it is lowest in Rajasthan, Sikkim, and Goa.

Vitamin D deficiency is more common in urban and affluent populations, particularly in states like Punjab, Uttarakhand, and Manipur.

The report also highlights dietary patterns across states, with Haryana leading in milk and curd consumption, while states like Chhattisgarh and Mizoram consume the least.

Green leafy vegetables are consumed the least in Kerala, Himachal Pradesh, and Tripura, indicating potential dietary imbalances.

The speaker emphasizes the importance of a balanced diet and encourages viewers to adjust their dietary habits based on the findings of the survey to ensure better nutrition.

Transcripts

Greetings, friends!

I have wanted to make a video on this topic for many months.

Today, finally I have got the opportunity to do so.

It is a very important and interesting topic for the development of the country, its people and for all of your health.

I think it is one of the best ways I can make use of this platform.

You will watch this video in millions and it will be beneficial for your personal health.

The Ministry of Health and Family welfare published a great report last year about the country’s nutrition named Comprehensive National Nutrition Survey.

This survey was conducted from 2016 to 2018 in order to determine the different types of deficiencies in people of different age groups belonging to different states.

Who has a deficiency of Vitamin A? Who has a deficiency of Vitamin D? Who has Iron deficiency?

By answering these question we can come to the conclusion that in which state, which element is deficient in people’s diet

and how is it that we can make our diet more balanced and complete by learning from each other.

Some states have Iron deficiency while others have Vitamin A deficiency.

So where is the shortfall in our diet?

It will not only be interesting to know this but also useful for us to apply in our daily life.

I have made this video in collaboration with a nutritionist in order to lay out the findings of this report.

Comprehensive National Nutrition Survey (CNNS) is the country’s biggest ever micronutrient survey to have been conducted.

It has been conducted on more than 1 lakh children and adolescents.

More than 2500 people conducted this survey across 30 different states covering almost all the districts in the country.

Let me explain some basics first.

We all know obesity is a kind of problem. When someone’s weight is more, it is being overweight.

But malnutrition can be of many types

One is being overweight and the other is being underweight i.e your weight is less in accordance to your age.

Another one is stunting i.e your height is less in accordance to your age.

Yet another is wasting i.e your weight is less in accordance to your height.

What is interesting is that you can be overweight/obese as well as stunted at the same time.

This means that your weight is more according to your age but your height is less.

This is called double burden. This can happen if you have a terrible diet.

According to the survey, 26.4% children in the 10-19 age group in the country are stunted, 4.1% are overweight while 0.8% are going through double burden.

If we look state-wise then Tamil Nadu, Goa and Delhi account for the highest percentage of overweight children which is 12-14%.

The states where the percentage is lowest such as Bihar, Uttar Pradesh, Jharkhand, the percentage of underweight children is higher here.

This data is not telling us much. This is just telling us a general relation between malnutrition and poverty.

It will be more interesting to know which state has what kind of deficiency in their diet.

Firstly, we will talk about anaemia which means having low haemoglobin concentration in your body.

Due to this, you can experience fatigue, weakness, tiredness as well as weakening of your immune system.

It can happen due to many reasons. It can be due to deficiency of Iron, B12 and folate in your diet. Genetics could also be a reason.

The report states that anaemia is seen most in West Bengal and Tripura in children of age group 10-19 years old.

I talked to nutritionist Amrita in order to know more about this and what can people take in order to avoid anaemia.

-Anaemia which is caused by nutritional imbalance is mainly seen in vegetarians. -Okay.

-This is because Iron present in food is better absorbed by the body when it comes from a non-vegetarian food source.

If anaemia happens due to the deficiency of Iron and if we have to focus on food then non-vegetarians can focus on organ meats like liver.

And if you are a vegetarian then your best sources of Iron are from seeds.

So, any seeds that are available, you can take them.

-For example... What kind of seeds?

-You can take flax seeds which are called ‘alsi’. You can take ‘sabja’ seeds, sunflower seeds, chia seeds.

-In which type of food preparation, can we mix these seeds?

-You can even eat it raw, soaked in water, make it a powder and knead it with your dough for the ‘roti’.

Here, another interesting conclusion comes to the fore.

If you look at this chart, it shows the prevalence of anaemia by sex among children age group wise.

Till age 10, the male and female graph is almost similar.

However, after that, the percentage of anaemia in females rises quite a lot as compared to males.

This happens due to menstruation. Post puberty, females undergo blood loss which results in increased loss of Iron.

So, to compensate for the same, they need to consume Iron rich foods.

It is important to realise this because this is the reason that for age 19, 50% females have anaemia while only 10% males have it.

Secondly, let’s directly talk about Iron deficiency. It is highest in Punjab, Rajasthan and Gujarat.

Specifically in Punjab, 45% children in the age group of 10-19 have Iron deficiency.

The best states in regards to Iron deficiency is Jharkhand, Mizoram and Assam where this percentage is around 10%

-The only problem is when you combine Iron with Vitamin C rich food then the absorption of Iron is much better.

-Oh...okay.

-When we think of Vitamin C, we think of citrus fruits or fruits that are tangy in taste have Vitamin C.

Red or orange bell peppers have high Vitamin C content when consumed raw.

Generally, whenever you are consuming any seed preparation then consume it with combination of any Vitamin C preparation.

-It is to be consumed with orange, lemon and the like?

-For example, seeds. You can mix it with milk and consume it or if you are eating it raw then you can consume fruits along with it for breakfast.

Iron deficiency is one of the most common nutritional deficiencies in the entire world.

If any child suffers from Iron deficiency then it affects his cognitive development.

So, make note of the food items that you can consume in order to avoid this deficiency.

Next is protein deficiency.

This has not been mentioned in this report. But a 2017 survey revealed that 73% Indians have protein deficiency.

This is quite a big and shocking number.

-Again, if you are a non-vegetarian then protein is pretty easy to get. Any animal product that you consume has protein in it.

Vegetarians commune only milk in animal products i.e they only consume dairy products.

All types of meats, chicken and fish have protein in it. Consuming even small quantities of these will get you a decent amount of protein.

Vegetarians on the other hand can have dairy such as milk, buttermilk, cottage cheese as well as pulses and beans.

But they need to be consumed in larger quantities in order to get the same amount of protein as non-vegetarians.

The protein that you get in this much chicken, for the same amount of protein you might have to eat this much of dal which is not possible to eat.

-Hmmm...hmmm...okay.

-A lot of vegetarians take protein supplements as well because they are aware that they do not get much protein from their diet

and it’s easier to get it from protein powder because it comes in a concentrated form.

To fulfill the deficiency of protein, a lot of people take protein supplements in the country.

I would like to tell you a shocking fact regarding this as well.

A 2015 study revealed that 60-70% dietary supplements consumed by people in the entire country are fake and unapproved.

Whenever you are buying a protein supplement then be aware as to how you can recognize whether the product is authentic or not.

Be mindful of the packaging. Look at texts on the packaging and the labels?

Is written clearly or not or are there any grammatical mistakes?

Is the logo on the package correctly placed or there are any mistakes with the logo.

Quite often, fake products and logos have a lot of mistakes. You can easily make it out.

Additionally, you should always buy from a reputable brand and from their website.

Not like you are buying from Amazon because anyone can sell a fake product there.

After protein, next is Zinc deficiency.

Gujarat, Manipur, Punjab and Meghalaya have the highest percentage of Zinc deficiency. Almost 50% of children in age group 10-19 have Zinc deficiency.

The best states in this regard are Nagaland, Mizoram and Haryana.

Zinc deficiency can result in hair loss and diarrhoea.

-So, Zinc is also...it is very interesting that you asked this question and that it showed up in the test results.

Zinc is most commonly found in our food such as nuts (almonds, walnuts), pulses (dal, beans, rajma, chole) and grains (wheat, rice).

Zinc deficiency is mostly found in people who have switched to a drastic diet and eliminates many things from their diet.

-Oh...okay. -Zinc deficiency is more likely to be seen in such people.

So, if you are eating a balanced diet then we will get the Zinc from food itself.

-So you are recommending that one should eat a balanced diet if there is Zinc deficiency? -For Zinc, yes!

Next is Vitamin A deficiency. It’s lowest percentage is in Rajasthan, Sikkim and Goa. It is highest in Mizoram and Jharkhand.

-So, Vitamin A too is like Iron. The body absorbs it much more when it comes from non-vegetarian food.

It is found mostly in animal food such as eggs, milk as well as in all animal meats.

As for vegetarian options, it is found in colourful vegetables such as red capsicum, carrots, yellow capsicum. All the colours- red, yellow, orange...

-Yes...colourful fruits and vegetables.

-So, fresh fruits...yes! Vegetables when consumed in the cooked form will have more absorption of Vitamin A because Vitamin A is such a nutrient that dissolves in fat.

Next is the deficiency of Vitamin D. It is one of the only deficiencies which is found more in the rich and urban population as compared to the poor.

This is because they stay less out in the sun. Sunlight is the source of Vitamin D.

In fact it is one deficiency that I too have. I take supplements for the same.

State wise- Assam, Tamil Nadu, Meghalaya and Nagaland has lowest deficiency while Punjab, Uttarakhand and Manipur has the highest.

-So, in vegetarian food... Mushroom is one such vegetable that is quite rich in Vitamin D.

Another strategy is eggs. Eggs have Vitamin D content. Animal products have Vitamin D. Milk may have some Vitamin D but not a lot.

What happens in the West is that in countries like the US is that dairy products are fortified with Vitamin D before being sold.

-Oh...okay. So they generally add it in milk

Overall, leaving aside deficiencies, there is another great comparison that has been made in this report: which state consumes which food group and in how much quantity.

Where are people eating less of what food?

It is interesting to observe that. Haryana tops in Milk and curd. They are also given to children in good quantities in Rajasthan, Tamil Nadu and Gujarat.

Chattisgarh , Mizoram, Andhra Pradesh, Odisha and Jharkhand are placed at the bottom.

The different comparisons that I am showing you of the food groups do not mean that if you live in these states then you should consume more of it.

It is quite likely you might be consuming less of milk and curd and more of meat and therefore your dietary requirements get fulfilled anyway.

These are generally such food groups that are main components of your diet and if it is being consumed less in your state

then I would recommend you to eat more of it so that your diet is more balanced and varied.

Pulses and beans score well in Tamil Nadu, Odisha and Maharashtra while Mizoram, Meghalaya, Sikkim and Arunachal Pradesh fall quite far behind in consuming them.

Green leafy vegetables score quite low in Kerala, Himachal Pradesh and Tripura

so if you live in these states then maybe you should concentrate on consuming green leafy vegetables.

Fruits are consumed in abundance in Goa, Delhi, Kerala, Tamil Nadu while Bihar, Jharkhand, Odisha, Chattisgarh score quite low here.

Although, I would say that this chart could have a relation with poverty because poor people do not have money to buy fruits

Therefore, the states with higher rates of poverty rank here at the bottom.

Root and tubers fall behind in Punjab, Sikkim, Himachal Pradesh. These are vegetables that grow under the soil such as potato and Radish.

For the rest of the vegetables, Punjab, Mizoram and Arunachal Pradesh score quite low. So, people living in these states need to eat vegetables a lot.

Telegana, Tamil Nadu and Odisha are performing quite well.

-People consume less of vegetables and more of roti and rice. This is what you have noticed?

-Yes, yes. Compared to the amount of roti and rice people consume, the quantity of vegetables is far lesser.

Generally, what the norm should be is vegetables should be double the quantity of roti or rice that you consume. But the opposite is always true.

We consume more quantity of rice and the quantity of vegetables is less.

Chicken and meat is obviously consumed less in vegetarian states. Andhra Pradesh, Telangana and Tamil Nadu feature in the top here.

This is something I would like to say is not necessary as I am myself a vegetarian.

It is possible to meet your dietary requirements without consuming chicken and meat.

It is a little difficult but it is possible. You can do so by consuming more dairy.

If you do not want to consume dairy and become vegan then it becomes a little more difficult yet it is possible.

A similar trend is seen for fish and eggs. Kerala, Goa, Assam and west Bengal consume fish the most.

Rajasthan, Punjab and Haryana which are vegetarian states always feature at the bottom.

Hopefully friends that you found this video to be informative.

Share it with your friends and family so that everyone gets to know what could be lacking in their diet

and what you should eat in order to meet your dietary requirements and maintain your nutrition.

This is very important.

If you like my work then you can support me at patreon.com/dhruvrathee or by becoming a member on You Tube.

See you in the next video. Thank you so much.