Why majority Indians are short and underweight

'The reason why people are underweight and short is because they have not got quality food during their growing years.'
Ritwik Sharma reports.

Last month, a National Institute of Nutrition report was headlined in the media as an increase in the ideal' weight of Indians.

The decadal report, titled Nutrient Requirements for Indians 2020: Recommended Dietary Allowances & Estimated Average Requirements, raised the 'reference body weight' for men by 5 kg to 65 kg.

But unlike what was reported, the reference weight for women has not been increased.

In 2010, NIN had raised the reference weight for women by 5 kg to 55 kg.

A reference body weight represents what is optimal for age and sex of an apparently healthy representative population.

Nutrient requirements of individuals depend on criteria such as age, gender, weight, height and physiological status (pregnancy, lactation and so on).

The requirements are accordingly adjusted for body weight of different groups.

The report took into account anthropometric data for Indian adults from the National Nutrition Monitoring Bureau (2015-2016) and the National Family Health Survey-4 (2015-2016).

From these, the 95th percentile of height was taken as it represents the full growth potential for adults in the 19 to 39 age group.

The first recommendations on dietary intake of Indians -- for an adult man of 55 kg and an adult woman of 45 kg -- were made in 1944.

In the last revised recommended dietary allowances in 2010, the reference body weight of men was retained at 60 kg.

Asked if the numbers suggest that Indians have grown taller since the 1940s, Hemalatha R, director of NIN says "yes".

"This is attributable to a lot of factors like improved healthcare over the decades, food security, decrease in communicable diseases, better maternal nutrition et al,"she says.

However, the increase in reference weight and height numbers need not offer much to celebrate for the vast majority, as they essentially mean that 95 per cent of people still has to strive to attain these optimal standards.

A study by the Imperial College, London, found that since 1914, the average height of an Indian man grew by only 2.9 cm to 164.9 cm in 2014.

Indian women, on the other hand, fared better as they added 4.9 cm to stand at 152.6 cm a century later.

Veena Shatrugna, former deputy director at NIN and a clinical nutritionist, says the myth of genetics being the crucial determinant of a population's height has been busted.

"The reason why people are underweight and short is because they have not got quality food during their growing years. And it takes at least three-four generations to reach the desirable average, which is an international average that everybody can reach."

As the average height of Indians has remained low, she says, scientists couldn't rapidly increase the weight recommendations.

"If you are short and are told to increase weight, you could go on eating and only put on fat," she says, adding the new RDA report has raised the calcium requirements, which is welcome for ensuring better bone health.

The new RDA has also shifted to a newer protein quality index: Digestible indispensable amino acid score.

"What you see as a reduction in overall protein recommendation (42.9 gm per day for men, and 36.3 g/d for women) is actually one based on high-quality protein," says the NIN director.

Following the earlier method -- protein digestibility-corrected amino acid score -- the RDA in 2010 had proposed 60 g/d (men) and 55 g/d (women).

With good quality protein, every gram one eats gets absorbed, Shatrugna says.

"It comes from animal sources. But if you take protein from dal or soyabean, just about 60 per cent gets used up."

Given the current politics over food, with a focus on vegetarianism and marginalisation of some sections who consume meat, Shatrugna says the poor should not merely be provided with rations, but also encouraged to consume meat, eggs, milk, vegetables and fruits to ensure a balanced diet and growth.

That can be a starting point to making the average Indian healthier and taller.