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Exploration of the myth of diversification of Indian diets and the reality of rising calorie deprivation

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There are understandable concerns over the state of nutrition of Indians, especially the poor in the wake of declining daily per capita dietary energy consumption. Notwithstanding these, a section of the academia and the governments of the day have tried to explain this as ‘voluntary diversification of diets’ by Indians in favor of high value foods by compromising cereal calories. Such explanations have directly fed into contentions that estimates of malnutrition in the country are a clear overestimate resulting from application of wrong standards. This paper examines the veracity of these claims by placing reliance on established laws of changes in food consumption with changes in material conditions of life to see if the observed changes in India’s case are in accordance with these laws and thereby supportive of the claims made by the government and a section of scholars in this regard. Our investigation shows these claims are myths that are tailored to suite the convenience of the powers that be while the falling dietary energy consumption in India remains a matter of serious concern.
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  GLOBAL JOURNAL OF MEDICINE AND PUBLIC HEALTH   ISSN#- 2277-9604   www.gjmedph.org Vol. 3, No. 1, 2014   Exploration of the myth of diversification of Indian diets and the reality of rising calorie deprivation   Vikas Bajpai, *   Suman Bhasker  1   ABSTRACT There are understandable concerns over the state of nutrition of Indians, especially the poor in the wake of declining daily per capita dietary energy consumption. Notwithstanding these, a section of the academia and the governments of the day have tried to explain this as ‘voluntary diversification of diets’ by Indians in favor of high value foods by compromising cereal calories. Such explanations have directly fed into contentions that estimates of malnutrition in the country are a clear overestimate resulting from application of wrong standards. This paper examines the veracity of these claims by placing reliance on established laws of changes in food consumption with changes in material conditions of life to see if the observed changes in India’s case are in accordance with these laws and thereby supportive of the claims made by the government and a section of scholars in this regard. Our investigation shows these claims are myths that are tailored to suite the convenience of the powers that be while the falling dietary energy consumption in India remains a matter of serious concern. Keywords: Indian nutrition, Indian development paradigm, NSSO  INTRODUCTION The development policy paradigm in India has been witness to a contentious debate over country’s  food security and the problem of hunger over the past few years. The household consumption data collected over successive rounds of NSSO show that per capita dietary energy consumption in the country has been falling. Table 1 gives the trends in consumption of total calories and calories derived from cereals over different rounds of NSSO for successive years. A persistent decline in the total dietary energy consumption and in consumption of cereal calories can be observed in case of the top quartile since 1983, and in case of the lower three quartiles from 1987-88 till 2004-05. It is noteworthy that this period has also been the period of the neoliberal economic reforms in the country and is the period to which the aforementioned debate on hunger refers to.   GJMEDPH 2014; Vol. 3, issue 1 1 Professor Department of Radiotherapy, All India Institute of Medical Sciences New Delhi *Corresponding Author PhD Scholar Center for Social Medicine and Community Health Jawaharlal Nehru University, New Delhi –  110067. Email:  drvikasbajpai@gmail.com Conflict of interest:  None Funding : None    www.gjmedph.org Vol. 3, No. 1, 2014   ISSN#- 2277-9604   Table 1: Total and cereal calorie consumption by decile and quartile of per capita expenditure, rural India, 1983 to 2004 – 05 across different National Sample Survey rounds Year   Bottom decile Bottom quartile Second quartile Third quartile Top quartile Total calories 1983   1, 359 1, 580 2, 007 2, 328 3, 044 1987 –  88 1, 488 1, 683 2, 056 2, 334 2, 863 1993 –  94 1, 490 1, 659 2, 000 2, 251 2, 702 1999 –  2000 1, 496 1, 658 1, 978 2, 250 2, 707 2004 –  05 1, 485 1,624 1, 900 2, 143 2, 521 Year   Bottom decile Bottom quartile Second quartile Third quartile Top quartile Cereal calories 1983   1, 150 1, 309 1, 589 1, 738 1, 974 1987 - 88 1, 221 1, 359 1, 598 1, 715 1, 894 1993 –  94 1, 203 1, 316 1, 504 1, 591 1, 690 1999 –  2000 1, 197 1, 289 1, 591 1, 509 1, 566 2004 - 05 1, 189 1, 259 1, 690 1, 430 1, 471 Source:  Deaton A and Jean Dre`ze. Economic & Political Weekly, February 14, 2009; Vol 44 (7  ) It is well known that there is variation in patterns of direct and indirect cereal consumption as a society moves up the development ladder. With rising affluence indirect consumption of cereals in the form of animal products forms a sizable part of the diets. 1  Accordingly, there is lesser variation in the diets of those lower down the social ladder and the poor often derive large part of their calories through direct food grain consumption, unable to afford the costlier animal products, vegetables and fruits as they are. However, in case of India, during the period of the economic reforms, it is not just the cereal calories that declined, but there has been a decline in the total dietary energy consumption as well. This decline is particularly intriguing against the backdrop of the claims that poverty in India declined during the reform years. Understandably, this has fuelled a debate over the state of nutrition of Indians, especially the poor. Some authors have argued upfront that high levels of malnutrition in the country are an overestimate and a result of applying standards that are not in accordance with genetic, environmental, cultural and geographical factors; implying thereby that Indians, especially the children, have more or less been consuming diets in accordance with the physiological needs as governed by their essentially smaller body size. 2  Another section of academia and the official policy establishment have tried to explain the declining dietary energy consumption through the theory of ‘voluntary diversification of diets’ by Indians in favor of high value foods by compromising cereal calories. The food stocks that kept increasing during this period, lent further credence to the contention that decline in dietary energy consumption was despite availability of food and hence voluntary. The Economic Survey 2001 –  2002 reports that the excess of food stocks that existed then represented a “problem of plenty . ” 3  It said , “ the growth rate of superior cereals have been higher than the population growth owing to allegedly too high administered prices of rice and wheat (as an incentive for the farmers), and stocks have built up because all consumers voluntarily wish to reduce their intake of cereals and rather consume fruits,    www.gjmedph.org Vol. 3, No. 1, 2014   ISSN#- 2277-9604   vegetables and animal products (milk, eggs, chicken etc .) as their income rises.” 4  Further, it is said that “the poor seem to have opted for some diversification in consumption providing a more nutritious diet though not necessarily adequate energy.” 5  As opposed to these views, there is another opinion which acknowledges that hunger is a widespread problem in the country that requires urgent intervention; however, there are differing opinions within this school as to the causes of the observed decline in dietary energy consumption. Utsa Patnaik believes it to be due to decline in the purchasing power of the people i.e. rising poverty; others like Jean Dreze have described this as a multifactorial phenomenon owing to increasing mechanization, declining morbidity in face of increased availability of safe water, sanitary conditions and healthcare etc. However they all seem to believe that the problem is not of dearth of food, but that of its distribution.   Here we take a closer look at whether ‘diversif  ication of dietary intake’ explains the observed decline in daily dietary calories during the period of neo-liberal economic reforms. We shall look at the changes in food and non-food expenditure patterns to examine their consistency with well-established laws of food consumption and draw conclusions as to the veracity of ‘diversification of diet’ thesis . CONTEXTULIZING THE DECLINING DIETARY ENERGY CONSUMPTION The observed decline in the consumption of dietary calories despite claimed decrease in poverty is not only counter intuitive but runs contrary to the fact that there is hardly a country around the world where social and economic progress has meant a decline in calorie consumption. Even the World Health (WHO) projections (Table 2) show that dietary calories across different regions of the world, including South Asia, have been increasing (WHO, 2010). 6 Table 2:   Global and regional per capita food consumption (kcal per capita per day) Region 1964-66 1974-76 1984-86 1997-99 2015 2030 World 2358 2435 2655 2803 2940 3050 Developing countries 2054 2152 2450 2681 2850 2980 Near East and North Africa 2290 2591 2953 3006 3090 3170 Sub-Saharan Africa 2058 2079 2057 2195 2360 2540 Latin America and Caribbean 2393 2546 2689 2824 2980 3140 East Asia 1957 2105 2559 2921 3060 3190 South Asia 2017 1986 2205 2403 2700 2900 Industrialized countries 2947 3065 3206 3380 3440 3500 Transition countries 3222 3385 3379 2906 3060 3180 Source:  WHO (2010) 6 As to the other reasons that have been offered to explain the decrease in dietary energy consumption such as improvement in means of transport, better roads even to remote areas, easier availability of cooking fuel, increasing mechanization of agriculture, decrease in fertility rates and hence lesser need for increased dietary allowances for pregnant and lactating women, expansion in availability of piped water and improvement in sanitary conditions that have reduced morbidity and thereby the need for extra calories during diseased condition, 7  there is no denying that all these factors impact on dietary energy needs, but each of these factors needs to be examined in the overall perspective. For example, mechanization of agriculture with increasing concentration of land in a few hands could very well mean that vast numbers of rural    www.gjmedph.org Vol. 3, No. 1, 2014   ISSN#- 2277-9604   poor who depend on agriculture for a living are thrown out of work and pushed down the poverty line, thus unable to afford enough food. Given their numbers in India, this section of landless agricultural workers and marginal peasants alone could pull the average calorie consumption down. Angus Deaton and Jean Dreze have argued - “Under -nutrition levels in India remain higher than for most countries of sub-Saharan Africa, even though those countries are currently much poorer than India, have grown much more slowly, and have much higher levels of infant and child mortality .” 7  Given these facts it would amount to an irrational behavior for people to opt for ‘diversification of diets’ at the cost of remaining undernourished and thereby endangering the very prosperity which is supposed to have afforded them ‘voluntary choice  for diversification’ in first place. While some people might behave irrationally sometimes, but it is difficult to presume that all the people in the country, cutting across expenditure classes (Table 1) could have behaved so irrationally for so long. This mandates extreme caution while accrediting the observed decline in dietary calories to any kind of ‘voluntary choice’.  Further, while defining poverty lines in 1973-74 the Government of India prescribed the minimum dietary energy norms of 2400 and 2100 calories per capita per day for rural and urban poverty lines respectively. 8  The poverty lines were defined as the ‘minimum income’ that could be “considered adequate to ensure minimum energy requirements for an active and healthy life and also minimum clothing and shelter. It did not include expenditures on health and education, which are to be provided by the State as per the Indian Consti tution.” It was further stated that “the minimum itself should be revised upwards with economic progress. ”  8 Given this, if the economic reforms had resulted in increasing prosperity, this should have resulted in upward revision of the initial minimum calorie norms for poverty. But the developments have been much in the reverse direction. We have more and more people consuming less and less calories. The poverty head count as measured by the initial calorie norms, have consistently increased since the launch of the Neoliberal Economic Reforms both in the rural and the urban India. 9, 10  Using NSSO data Utsa Patnaik demonstrates that the population in rural areas consuming less than 2, 400 calories was 87 percent, while the population consuming less than 2, 100 calories in urban areas was 64.5 percent in 2004-05 (NSSO 61 st  round). 9,10  By way of an explanation Patnaik says –   “a very large increase in the inequality of income distribution during the nineties owing to income deflationary policies impacting the poor, and also in the poor being institutionally denied access to grain since 1997-98 owing to the misconceived targeting system under which large numbers of the actually poor are not being identified as such and are not being issued ration cards for accessing cheap food. ” 3 Further, the Tendulkar Committee set up by the government in 2009 to ‘ Review the Methodology for Estimation of Poverty’ de facto brought down the poverty line level calorie consumption to a much lower level. Because of the methodology of estimation adopted by the Committee, not only did the MPCE suggested by the Committee as the new poverty line become a subject of public ridicule (for being extraordinarily parsimonious) but it actually corresponded to a per capita calorie intake of 1776 and 1999 in urban and rural areas respectively. 12  In support of this the Committee cited that –   “This actual intake is very close to the revised calorie intake norm of 1770 per capita per day currently recommended for India by the Food and Agriculture Organization (FAO). ” 12 It is another thing that FAO’s assessment of 1770 calories per capita per day for India is a national statistical average for ‘m inimum dietary energy requirement’ per capita per day for sedentary life style. The poor however can hardly afford the luxury of a sedentary life style. Ironically this coup de tat against poverty was staged under the garb of moving away from calorie based poverty norms because the Committee argued that along with food the people have to incur expenditure on essentials like education, healthcare, housing,
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