Dr Umesh Kapil is a professor of epidemiology at the Institute of Liver And Biliary Sciences, Delhi. He has been a professor of Public Health Nutrition at the All India Institute of Medical Sciences, Delhi, earlier.
Q: You have been working relentlessly in the nutrition space for long. How do you account for its sudden prominence on the global agenda? A: The global agenda has been set by several world organisations, the most important being the World Health Organisation. Around 2014, the WHO set up the World Health Assembly with a specific target, to be followed by governments worldwide. Nutrition has come up as a key agenda there, focusing on two types of interventions: nutrition-sensitive interventions and nutrition-specific recommendations. Take for instance, you have a child. We give him the best of everything. But in case the water given to him is contaminated, the child will catch diarrhoea. And everything will go down the drain. Similarly, you give children health education, as to which type of food should be eaten, how much and when, etc. This is a perfect example of nutrition-sensitive intervention. And it plays a huge role in maintaining the nutritional status of the entire population of a country. Nutrition specific recommendations mean imparting nutrients to population suffering from certain deficiencies: vitamins to iron. All the major organisations, say, the UN bodies, are working towards achieving these targets initiated by the Assembly. This is how the global agenda has been set. For execution and funding, they are helped by the European Union and the World Bank.
Dr Umesh Kapil, professor of epidemiology at the Institute of Liver And Biliary Sciences, Delhi.
Q: India suffers from a malnutrition double whammy. Obesity is nearly as big a problem as undernutrition. How difficult does that make the task of formulating the blueprint of the nation’s nourishment?
A: The main reason behind these problems is a “nutrition transition.” With rising income, people tend to consume foods that are rich in fat, or calorie-dense foods. The problem is associated with low physical activity. So people eat, but don’t exercise, and don’t burn out the excess calorie. This is leading to overweight and obesity. This is a global phenomenon.
On the other hand, our country has a lot more poor people, without proper access to food. What we have seen recently in India is that the problem of obesity is increasing, and undernutrition is decreasing. This is a part of the nutrition transition, which is being observed in all the developing countries. In India, obesity is spotted most among the newly-rich, middle-class. When a person becomes rich, he is more inclined towards food rich in oil and butter. Low-income people cannot afford rich fatty foods. Obesity is one of the main causes leading to a downfall in the nation’s overall development.
Q: What exactly is “humanitarian nutrition”? A: When an earthquake, flood or famine occurs, a large number of people get displaced, but do not have access to food and water. During an emergency, the first thing that people need is food. This is one of the aspects of humanitarian nutrition. To elaborate on the concept, we must ensure that we consume safe and potable water. So potable water is very important. Children under age five should consume milk. We must also ensure that infants should not be fed commercial brands. In short, humanitarian nutrition is supplying normal and basic foods, preferably hot-cooked food, under hygienic conditions.
Q: Nutrition is no longer just plain nutrition. There’s a whole new science to it, new technology like Artificial Intelligence, new Big Data approach and new buzz for its inclusion as a human right. What is your take on the field? A: Strategies like artificial intelligence are very important. These are really good areas, provided the government uses them for the benefit of the population. For instance, Facebook can be used at the national level, state level, or maybe district level, to list out people and survey their tastes, what they are eating, and what they want to eat. Accordingly, marketing strategies can be developed by food brands. These are very good strategies, but we need to take proper caution. India, however, is still at an infancy where these strategies are concerned.