Public Nutrition and Health

- Stunting: Present when the height is less than adequate for age; it means short stature due to chronic undernutrition.
- Low birthweight baby: A baby who weighs less than 2500 g or 2.5 kg at birth.
- IDD: Iodine Deficiency Disorders; a spectrum of disabling conditions affecting humans from fetal life through adulthood due to inadequate dietary intake of iodine.
- Wasting: When weight is not adequate relative to height.
- Double burden of malnutrition: The coexistence of both undernutrition and overnutrition in the same population.
- Marasmus: Severe undernutrition due to deficiency of food and energy.
- Kwashiorkor: Severe undernutrition caused by protein deficiency.
- Community: A specific group of people who share common characteristics such as a common language, similar conditions, common lifestyle, or the same health problem.

The chapter describes two broad ways of tackling public nutrition problems:

1. Food-based or diet-based strategies
- These are preventive and comprehensive.
- They use food as a tool to overcome nutritional deficiencies.
- They are sustainable, cost-effective, and can be adapted to different cultural and dietary traditions.
- They do not carry the risk of overdose or toxicity.
- Important examples are:
- Dietary diversification and modification
- Horticulture interventions such as home gardening
- Nutrition and health education
- Food fortification

2. Nutrient-based or medicinal approach
- Nutrient supplements are given to vulnerable groups, especially those at risk of deficiency and those who already have deficiency.
- It is mainly a short-term strategy.
- In India, it is used particularly for vitamin A, iron and folic acid.
- It is often more expensive and may have problems of coverage.

The chapter also mentions some policy and programme strategies:
- POSHAN Abhiyaan to monitor and review nutrition schemes.
- ICDS for children 0–6 years and pregnant/lactating mothers.
- Fortification of essential foods such as iodised salt.
- Low-cost nutritious foods from local raw materials.
- Control of micronutrient deficiencies through supplements and free tablets.
- Indirect long-term measures such as food security, better dietary patterns, poverty alleviation, employment generation, public distribution system, land reforms, health and family welfare, prevention of food adulteration, education, women’s status, and community participation.

The chapter says the long-term goal should be to shift away from supplementation towards food-based approaches.

Public health nutrition is defined in the chapter as the field of study concerned with the promotion of good health through prevention of nutrition-related illnesses/problems in the population, along with the government policies and programmes meant to solve these problems. It uses large-scale, organised and multidisciplinary approaches to improve the nutrition of the community.