Nutrition in India: Facts and Interpretations

Nutrition in India: Facts and Interpretations

Angus Deaton, Research Program in Development Studies, Center for Health and Wellbeing, Princeton University

Jean Drčze, Department of Economics, Allahabad University

“……In spite of India’s rapid economic growth, there has been a sustained decline in per capita calorie consumption during the last twenty-five years.

While the decline has been largest among better-off households, it has taken place throughout the range of household per capita total expenditure. For both adults and children, anthropometric indicators of nutritional status in India are among the worst in the world.

While these indicators have shown improvement over time, the rate of progress is slow relative to what might be expected based on international and historical experience. This paper presents the basic facts about growth, poverty and nutrition in India, it points to a number of puzzles, and it sketches a preliminary story that is consistent with the evidence.

The reduction in calorie consumption cannot be attributed to declining real incomes, nor to any increase in the relative price of food. Our leading hypothesis, on which much work remains to be done, is that, as real incomes and wages have increased, leading to some nutritional improvement, there has been an offsetting reduction in calorie requirements due to declining levels of physical activity and possibly also to various improvements in the health environment.

If correct, this analysis does not imply that Indians are currently adequately nourished; nothing could be further from the truth. Calorie intake has serious limitations as a nutritional intake; while calories are extremely important, there are too many sources of variation in calorie requirements for standard, invariant, calorie-norms to be usefully applied to large sections of the population.

We conclude with a plea for better, and more regular, monitoring of nutritional status in India…”

CONTENTS

1. Introduction

2. Trends in calorie consumption and nutrition indicators

2.1. Calories, food, and expenditures

Food, calories and cereal calories

Expenditure, poverty, and distribution

Calorie deficiencies and reported hunger

On calorie Engel curves

Total calories and cereal calories

Calorie Engel curves for rich and poor

Price paid per calorie

Spatial patterns of calorie and fat consumption

Is the decline in calories real: other evidence?

2.2. Trends in nutritional status

Anthropometric measurement

Nutrition status of Indian children

Recent trends in child nutrition

Adult weights and heights

3. Interpretations

3.1. The calorie decline

Food prices

Coarse cereal prices

Impoverishment?

Sen’s argument

Are the calorie Engel curves misleading?

Changes in food habits and non-market entitlements

Declining needs for calories?

Engel Curves reexamined

3.2. Nutritional status

Farewell to calorie-based nutrition assessment?

Multiple deficiencies of Indian diets

Nutrition status of privileged Indian children

4. Concluding remarks

* * * *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate information.

Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics; Information Technology - Virtual libraries; Research & Science issues. [DD/ KMS Area]

Available online as PDF file [80p.] at: http://weblamp.princeton.edu/chw/papers/deaton_dreze_india_nutrition.pdf

April 2008

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