Lancet study has a worrying message for Indians

People across all age groups in India, both men and women, are consuming inadequate amounts of micronutrients critical for health, including iron, calcium and folate, as per estimates in a study published in The Lancet Global Health journal.

The study is the first to provide estimates of insufficient consumption of 15 micronutrients across 185 countries, taken through diets without the use of supplements, according to an international team, including researchers from Harvard University, US.

The findings suggested that around the world, almost 70 per cent, or over five billion, people do not consume enough iodine, vitamin E, and calcium.

The researchers also found that within a country and an age group, more women were consuming inadequate amounts of iodine, vitamin B12 and iron, compared to men, whereas more men were consuming inadequate amounts of magnesium, vitamin B6, zinc and vitamin C, compared to women.

In India, while more women consumed insufficient amounts of iodine, compared to men, more men consumed inadequate amounts of zinc and magnesium, compared to women, the team found.

While analyses over the past 10 years have looked at micronutrient deficiencies, the researchers said large data gaps remain for many micronutrients and population groups.

In this study, the authors used publicly available data from the Global Dietary Database to estimate the prevalence of insufficient nutrient intakes for 99.3 per cent of the global population.

Men and women aged 10-30 years were most prone to low-levels of calcium intake, especially in South Asia, Southeast Asia and sub-Saharan Africa, the team said.

The authors said that the findings could be used by public health professionals to target populations in need of dietary interventions.

They added that since they did not account for intake of fortified foods or supplements, the results could possibly be an overestimate for some key nutrients in particular locations where people consume high amounts of fortified foods and supplements.

The findings come ahead of the National Nutrition Week in India, which is observed from September 1 to September 7. Aimed at raising awareness about nutrition and promoting healthier eating habits, it has been observed annually since 1982.

Reacting to the study, geneticist Aparna Bhanushali said that it not only reflects limited dietary diversity, but also point to deeper socioeconomic barriers restricting access to nutrient-rich foods.

"Scientifically, these deficiencies are rooted in diets dominated by staple grains like rice and wheat, which lack these crucial nutrients," Bhanushali, Head of Growth and Scientific Support at HaystackAnalytics, Mumbai, a genomics-based diagnostic solution provider, told PTI.

She added that the bioavailability, or absorption, of these nutrients is often reduced by phytates and oxalates, commonly found in vegetarian diets prevalent in India.

"While Indian diets generally provide sufficient levels of essential micronutrients, factors like the type of iron, presence of absorption inhibitors, and regional dietary patterns significantly affect micronutrient bioavailability and absorption rates," Bhanushali said.

Along with dietary factors, regional practices and socioeconomic conditions have been shown to influence micronutrient absorption.

"Despite adequate dietary iron intake, with most diets containing around 26 mg of iron, the absorption rate is notably low, ranging between 1-5 per cent. This low bioavailability (or absorption) is primarily due to the presence of non-haem iron in cereal-pulse based diets, which is less efficiently absorbed compared to haem iron found in red meat," Bhanushali said.

To close the dietary gaps revealed in the study, she recommended taking supplements and called for widespread public health campaigns.

Suggesting solutions on micronutrient deficiencies, Bhanushali said, "Precision nutrition offers a transformative solution for addressing micronutrient deficiencies in India by using detailed individual and group-level data to tailor dietary recommendations." Precision nutrition is based on the principle that people respond differently to nutrition due to genetic, biochemical, and environmental factors. Therefore, it can provide a way to tailor dietary recommendations to an individual and provide a more informed advice.

"While large-scale individualisation is complex and costly, stratification -- or grouping individuals with similar profiles -- offers a practical approach," she said.