January 2014

In the 1940s and 1950s, the major nutritional diseases prevalent in large sections of the population were kwashiorkar (acute protein-energy malnutrition), keratomalacia (attributable to severe vitamin A deficiency), beri-beri (arising from vitamin B1 deficiency) and pellagra (nicotinic acid deficiency). Over the course of two to three decades, the most florid manifestations of these malnutrition diseases virtually disappeared. How did this happen in a poor country with a burgeoning population and limited resources? These “miraculous changes” did not come about through distribution of synthetic vitamins, drugs or special formulations, but through a better understanding of the diseases themselves, and through local-level health and diet-based interventions. There was a strong move to introduce a protein supplementation programme with fish concentrates and wheat fortification with lysine to tackle kwashiorkar. Indian nutrition scientists argued against these moves, and were ultimately proved to be right.