Varadharajan Kiruba S, Thomas Tinku, Kurpad Anura V
Department ofPhysiology, St John's Medical College, Bangalore, India.
Asia Pac J Clin Nutr. 2013;22(3):326-39. doi: 10.6133/apjcn.2013.22.3.19.
India is often thought of as a development paradox with relatively high economic growth rates in the past few years, but with lower progress in areas of life expectancy, education and standard of living. While serious inequalities in growth, development and opportunity explain the illusion of the paradox at the country level, still, a significant proportion of the world's poor live in India, as do a significant proportion of the world's malnourished children. Poverty and undernutrition coexist, and poor dietary quality is associated with poor childhood growth, as well as significant micronutrient deficiencies. Food security is particularly vulnerable to changes in the economic scenario and to inequities in wealth distribution. Migration from rural to urban settings with a large informal employment sector also ensures that migrants continue to live in food insecure situations. While food production has for the most part kept pace with the increasing population, it has been with regard to cereal rather than of pulses and millet production. Oil seeds, sugar cane and horticultural crops, along with non-food crops are also being promoted, which do not address nutrition security, and, coupled with the increase in the consumption of pre-prepared food, may indeed predispose towards the double burden of malnutrition. Access to food is also particularly susceptible to poverty and inequality. Many strategies and policies have been proposed to counter undernutrition in India, but their implementation has not been uniform, and it is still too early to assess their lasting impact at scale.
在过去几年中经济增长率相对较高，但在预期寿命、教育和生活水平等方面的进步却较小。虽然增长、发展和机会方面的严重不平等解释了国家层面上这种悖论的假象，但世界上仍有很大一部分贫困人口生活在印度，世界上很大一部分营养不良儿童也在印度。贫困与营养不良并存，不良的饮食质量与儿童生长发育不良以及严重的微量营养素缺乏有关。粮食安全特别容易受到经济形势变化和财富分配不平等的影响。从农村向城市的迁移，加上庞大的非正规就业部门，也确保了移民继续生活在粮食不安全的状况中。虽然粮食生产在很大程度上跟上了人口增长的步伐，但这主要是就谷物而言，而非豆类和小米的生产。油籽、甘蔗和园艺作物以及非粮食作物也在得到推广，这些都无法解决营养安全问题，而且，再加上预制食品消费的增加，实际上可能导致营养不良的双重负担。获得食物的机会也特别容易受到贫困和不平等的影响。印度已经提出了许多应对营养不良的战略和政策，但其实施并不统一，目前评估它们在大规模实施后的持久影响还为时过早。
