By M L Satyan
Coimbatore, April 13, 2024: Three times I had accompanied my daughter to a few shopping malls. Once you are inside, you get a feel that you are in a foreign land. I have found the food courts overcrowded. I have witnessed over-eating and wastage of food. It is beyond description.
Once you are out of the mall, you see the other side of India like garbage, filth and children/women/elderly people begging around the malls. In India we live amid contradictions.
Global Hunger Index (GHI) is a peer-reviewed report, published on an annual basis by Concern Worldwide and Welthungerhilfe. It is a tool designed to comprehensively measure and track hunger at global, regional, and national levels, reflecting multiple dimensions of hunger over time.
In the 2023 Global Hunger Index, India ranks 111 out of the125 countries. With a score of 28.7 in the 2023 Global Hunger Index, India has a level of hunger that is serious.
How GHI is calculated? Each country’s GHI score is calculated based on a formula that combines four indicators that together capture the multidimensional nature of hunger:
• Undernourishment: the share of the population whose caloric intake is insufficient
• Child stunting: the share of children under the age of five who have low height for their age, reflecting chronic undernutrition
• Child wasting: the share of children under the age of five who have low weight for their height, reflecting acute undernutrition
• Child mortality: the share of children who die before their fifth birthday, reflecting in part the fatal mix of inadequate nutrition and unhealthy environments.
What indicators are used?
The prevalence of undernourishment value is 16.6 percent, as reported in the 2023 State of Food Security and Nutrition in the Worl (SOFI) report. The child mortality value is 3.1 percent, as reported in the United Nations Inter-Agency Group for Child Mortality Estimation’s (UN IGME) latest report, published in January 2023.
The child stunting value is 35.5 percent, and the child wasting value is 18.7 percent; these are the values from India’s National Family Health Survey (2019–2021) (NFHS-5) as reported in the Joint Malnutrition Estimates Joint Data Set Including Survey Estimates (2023 edition).
Why Hunger Index and not Nutrition Index?
To capture the complex problem of hunger, the GHI report reflects the consequences of deficiencies in calories as well as deficiencies in micronutrients (known as “hidden hunger.”) According to the World Health Organization and the UN Food and Agriculture Organization, hidden hunger occurs when the quality of food people eat does not meet their nutrient requirements, so that they are not getting the essential vitamins and minerals they need for their growth and development.
Deficiencies in calories and micronutrients may result from a range of underlying factors, including household food insecurity; inadequate maternal health or childcare practices; or inadequate access to health services, safe water, and sanitation.
Worsening of undernourishment: India’s per capita dietary energy supply has gone up somewhat in recent years. However, this increase has been offset by increases in the incidence of caloric losses at the retail distribution level, increased dietary energy requirements of the population, and an increased coefficient of variation (a measure of the inequality of caloric intake across a given population).
As a result, India’s prevalence of undernourishment has increased somewhat each year between 2016–2018 and 2020–2022.
Mall-Culture
The Great Indian Mall Boom began innocuously in the early 2000s, with just three malls in existence in the entire country. The rest is, as they say, history as Indian shoppers slowly but surely developed a penchant for shopping in clean, vibrant, climate-controlled and highly enabled malls rather than in the usual grocery shops and scattered individual stores.
Today’s top-performing shopping malls are essentially mixed-use businesses that incorporate social entertainment options, provide a unique appeal along with a considerable depth of shopping experience, and are in prime destinations that are easily accessible by both public and private transport.
Moreover, the ability to anticipate and align with changing consumer needs make malls successful today.
Mall-nourishment
Food courts in shopping malls are the gastronomic destination for shopaholics and foodies alike that are playing a pivotal role in increasing footfalls in shopping centers. With the trend of eating out on the rise, it is natural that malls are using this category to lure in visitors.
Fancy food courts organize various food festivals and carry cross-promotional activities to engage consumers. The new trend which is picking up these days is getting the food courts/restaurants reviewed by bloggers. As weekends attract more crowds, there are weekend offers which are communicated to consumers through various channels much earlier in the week so that they can organize their weekend plans well in time.
Increasing obesity in India
India could be facing an obesity epidemic with alarm bells ringing particularly for the young. A new global analysis, published by The Lancet, found that 12.5 million children (7.3 million boys and 5.2 million girls) in the country, aged between five and 19, were grossly overweight in 2022, up from 0.4 million in 1990.
This finding is significant at a time when India already has a high burden of non-communicable diseases — heart disease, strokes, and diabetes topping them. Obesity is a major risk factor and a trigger for early onset of these diseases, even Type 2 diabetes among teens.
According to UNICEF’s World Obesity Atlas for 2022, India is predicted to have more than 27 million obese children, representing one in 10 children globally, by 2030. It ranks 99th on the list of 183 countries in terms of preparedness to deal with obesity and the economic impact of overweight and obesity is expected to rise from $23bn in 2109 to a whopping $479bn by 2060.
A study shows that today’s malls have become places for over-nourishment.
What is to be addressed?
We witness a clear contradiction in the Indian society today. Mal-nourishment continues to be a serious problem among the socially and economically backward communities. This needs to be addressed on an emergency basis giving topmost priority.
At the same time, urban people need to be cautious about excess and over-nourishment in most shopping malls. There have been regular reports of food-courts in malls selling rotten food and packed food items even after the expiry dates. Socially responsible people need to create an awakening on this burning issue.
Malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients. The term malnutrition addresses 3 broad groups of conditions: under-nutrition, which includes wasting (low weight-for-height), stunting (low height-for-age) and underweight (low weight-for-age).
Despite India being a food surplus nation and sufficient stock of grain and pulses are maintained in Food Corporation of India (FCI) godowns, malnutrition is a huge concern in our country, because it directly impacts child education and basic health.
Malnutrition can be tested by MUAC tape measure (Mid-Upper Arm Circumference). MUAC is based on UNICEF guidelines. It is a simple measurement that can be used to identify children (06 – 59 months) who have malnutrition and are at risk of dying. It uses a coloured tape that is wrapped around the left upper arm. Parents and carers can be trained to measure the MUAC.
MUAC tapes are mainly used to measure the upper arm circumference of children but also of pregnant women to help identify cases of malnutrition. All MUAC tapes are graduated in millimetres and some are colour coded (red, yellow and green) to indicate the nutritional status of a child or adult. They are used to screen for malnutrition in community and hospital settings.
Children whose arm circumference falls within the red or yellow indicator on the coloured tape (see table below) should be referred to the nearest health or nutrition centre.
1. Technical specifications for CHILD MUAC Tape:
• Measurement range: Up to 26.5 cm.
• Graduation: 01 mm.
• Colour coded: Red (severe malnutrition) 0-11.5 cm; Yellow (moderate malnutrition) 11.5-12.5 cm; green (normal) 13.5-26.5 cm
2. Technical specifications for ADULT MUAC Tape:
• Measurement range: Up to 45.5 cm.
• Graduation: 1 mm.
• Colour coded: Red (severe malnutrition) 0-21 cm; Yellow (moderate malnutrition) 21-23 cm; green (normal) 23-45.5 cm.
• If a child has a MUAC coloured yellow or red on the tape, a referral to the nearest health or feeding centre should be made.
MUAC test for Children between 6 to 59 Months
• Red indicates severe malnutrition – Less than 11.5 cm
• Yellow indicates risk of malnutrition – From 11.5 cm to 12.5 cm
• Green may indicate risk of acute malnutrition – Between 12.5 cm to 13.5 cm
• Green Greater than 13.5 cm represents adequate nutrition.
For Pregnant Women and Postpartum
• If the value indicated by the arrows is less than 24 cm, it indicates acute malnutrition and nutritional treatment measures should be taken.
Malnutrition can be addressed in each of our parishes / a cluster of parishes by doing the above MUAC test on parishioners at fixed intervals, say once a month. The Family, Women’s and Youth Commissions in each parish can streamline the practice at the grassroots levels.