Health not a destination but a journey
To counter the long-term effects of under-nutrition on fetal growth and development, one has to improve the nutritional status of women around the time of conception and during pregnancy. Under-nutrition is a major cause of stunting. It can lead to consequences such as anaemia, neurological issues, stillbirths in neonate and obesity and nutrition-related non-communicable diseases in adulthood. And while the damage done due to malnutrition is almost always irreversible and reaches far into the future, it is also entirely preventable.
To promote and support good maternal nutrition during pregnancy and lactation, it is important that women should be provided with adequate micronutrients, especially iron, folic acid, calcium, iodine, and vitamin A, through supplementation, fortification and diverse food consumption. Dietary diversification and selection of nutrient-rich foods, fortification or bio-fortification of staple foods, supplementation with multiple micronutrients and use of fortified food products is extremely useful for this target group.
Dietary diversification is an approach that aims to improve the availability, access, and utilisation of foods with a high content of micronutrients throughout the year, including animal-source foods. Such a strategy will lead to a better nutritional status of women and children. This should be the primary long-term goal, but this option requires overcoming barriers posed by restricted access and high cost of such foods. For example, even with a somewhat diverse diet, it may still be difficult to meet iron needs in pregnancy. Thus, other strategies have been considered and implemented to help close the nutrient gaps for pregnant and lactating women.
Another option is multiple micronutrient supplementations rather than iron-folate alone. Micronutrient deficiencies are common among women of reproductive age and women in low- and middle-income countries often have limited intake of animal products, fruits and vegetables resulting in multiple-micronutrient deficiencies. This deficiency can threaten intrauterine growth or development of the fetus and increase the risk of infant morbidity and mortality and later it may also lead to stunted growth, cognitive impairments and poor development of children.
Bio-fortification of staple foods is a relatively new technology and is another way through which increased intake of certain key nutrients such as iron, zinc and vitamin A can be promoted. One example of bio-fortification in
Yet another option is promotion of fortified food products that are designed for pregnant and lactating women and contain both micronutrients and macronutrients, thus providing essential fatty acids and high quality protein in addition to vitamins and minerals. In
Addressing malnutrition in a sustainable fashion in