New evidence on adolescent nutrition in India is a call to action

First thematic report based on ground-breaking Comprehensive National Nutrition Survey (CNNS), 2016-18: ‘Adolescents, Diets and Nutrition: Growing Well in a Changing World’

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Ms. Henrietta H. Fore, Executive Director, UNICEF addressing the Adolescent Nutrition Meeting at Niti Aayog.

New Delhi: Half of India’s adolescents (10 to 19 years) – almost 63 million girls and 81 million boys – are either short, thin, overweight or obese. These are the findings of a report on adolescents released in a high-level meeting at the NITI Aayog, together with UNICEF India, recently. Over 80 percent of adolescents also suffer from ‘hidden hunger’, i.e. the deficiency of one or more micronutrients such as iron, folate, zinc, vitamin A, vitamin B12 and vitamin D, according to the report.

The report, ‘Adolescents, Diets and Nutrition: Growing Well in a Changing World’, is based on the recently released Comprehensive National Nutrition Survey (CNNS).

The CNNS data set provides unparalleled new insights into all types of macronutrient and micronutrient malnutrition, dietary habits, life skill behaviours, access to services (school, health and nutrition) and physical activity throughout adolescence (10-19 years) for both girls and boys. This is the first thematic analysis of the wealth of CNNS data that provides important insights on the lives of India’s adolescents.

The new report reveals that almost all adolescents in India have unhealthy or poor diets. This is the main cause for all forms of malnutrition.

Key facts on the poor diets of adolescents include:

  • Fruits and eggs are consumed daily by less than 10 per cent of boys and girls.

  • Over 25 per cent of adolescents reported no consumption of green leafy vegetables even once a week.

  • Milk products are consumed by 50 percent of adolescents daily.

Growing incomes and increased spending on food has translated to greater consumption of fried foods, junk foods, sweets and aerated drinks. Today, 10 to 19-year-olds in every Indian state face an increased risk of diabetes and heart disease.

Adolescent girls especially suffer multiple nutritional deprivations. The report finds:

  • More girls suffer from shortness than boys.

  • Anaemia affects 40 percent of adolescent girls, compared to 18 per cent of boys, and worsens as they get older.

For the first time, the CNNS data provides the evidence base necessary to implement high impact interventions for adolescent nutrition with full coverage, continuity, intensity and quality. Some key findings for solutions include:

  • Focusing on adolescent girls, before they become mothers, is critical to break India’s intergenerational cycle of malnutrition. One of the goals of POSHAN Abhiyaan (National Nutrition Mission) is to reduce anaemia among adolescent girls by 3 per cent per year. Ensuring that school and community-based interventions reach all is essential to achieve this goal.

  • CNNS gives important programme insights on strengthening school-based services. Schools are a cross-sectoral platform to address good nutrition – diets, services and behaviours. This is especially important for the early adolescent age-range (10-14 years), as 85 per cent of this age-group is enrolled in school.

  • The findings reveal that nearly 25 percent of girls and boys do not receive any of the four school-based services (mid-day meal, biannual health check-ups, biannual deworming and weekly iron folic acid supplementation). Addressing this gap will be critical to addressing early adolescent nutrition issues.

  • The report also recognizes the how important it is that meals and snacks at home be nutritious.Campaigns on healthy food choices should be centred around the promotion of a variety of items in appropriate proportions at home.

  • Risks for non-communicable diseases are established in childhood and adolescence. For example, diabetes, cardiovascular diseases and hypertension among adolescents is increasing. The second decade of life (10 to 19 years), is therefore critical to intervene in early adolescence to prevent such diseases.

  • All girls and boys are unable to meet the 60 minutes per day recommended outdoor sports and exercise time. On an average, girls in late adolescence spend only 10 minutes per day on such activities. Boys do relatively better, with exercise time of 40 to 50 minutes per day.

  • The report recommends that adolescents themselves be supported as mobilizers and co-implementers at schools and other platforms they access, to spread the right nutrition messages to aid India’s Jan Andolan to end malnutrition.

With the POSHAN Abhiyaan now in its second year, the timing is right to strengthen nutrition interventions for “would be mothers and fathers” to prevent the intergenerational cycle of malnutrition.

This first-ever national analysis on adolescents, diets and nutrition has been made possible through the wealth of CNNS data released by the Ministry of Health and Family Welfare and generously supported by the Mittal family. It will go a long way in ensuring that millions of adolescents in India are enabled with a ‘Solid Body, Smart Mind’.

The full CNNS report can be accessed here.