Feasting Vs Fasting: Can Nutritional Literacy Protect our Future Health?

Sir, India is home of different cultural values, customs, traditions, practises, and civilization and similarly, generate different food practises. Due to a hectic lifestyle and poor focus on nutrition, India is “en route” to witness a doubling in the prevalence of both overweight and malnourishment and a tripling in the prevalence of obesity among the adult population by 2040. This increasing trend is not the good news with the impact of obesity on the overall health of men, women, and children. A forecast article predicts that the largest increase in the overweight and obesity will be seen among the older populations and in rural areas compared to urban areas.¹ Another alarming statistic reported by UNICEF's World Obesity Atlas for 2022 predicted that by 2030 India would witness 27 million obese children.² The increase in body fat is the underlying risk factor for various noncommunicable diseases, such as cancers, Type 2 Diabetes Mellitus, lungs and heart ailments, resulting in early deaths. Consuming large amounts of processed or junk foods are one of the leading causes of overweight and obesity. Other causes are lack of physical activity, genetics, or certain medical reasons.³ Similarly, malnutrition exists in our country, described by the World Health Organisation as excesses or deficiencies in the energy intake of nutrients. Maternal, infant and child health nutrition plays a significant role in the social status and scholastic functioning of children. Reports from the United Nations International Children's Emergency Fund, National Health and Family Survey and World Health Organization have highlighted that the rates of malnutrition are alarming.⁴

Both feasting and fasting are influenced by social and environmental factors such as availability of nutritious foods, food processing and cooking skills, differences in food supply based on races, cultural differences, etc. These factors influence nutrition behaviour (right food choices, eating habits, healthy cooking) of people, and it has been found from the evidence that nutrition behaviour is somewhere linked to nutritional literacy.⁵ In developing countries like India, above both extreme practices are found. Feasting in the form of overconsumption of commercially available fast foods and fasting which is either undereating or being on extreme calorie deficit or inaccessibility to appropriate food sources resulting in malnutrition. To improve the food security and at the same time to reduce the burden of both overweight and malnutrition related morbidities, it is fundamental to have food and nutritional literacy.⁶

Food and nutritional literacy are described as a set of skills and knowledge related to food. If these skills and knowledge are appropriately acquired by an individual, then it would empower oneself to make wise informed choices about food and its nutritional values.⁷ Learning about food and nutrition begins from the school age in India, yet the impact of this education has failed to reflect the required nutritional behaviour towards maintaining health. It is important to revise the curriculum to include more of skill focussed nutrition education and culinary training.⁸ As an initiative to promote healthy foods Ministry of Health and Family welfare jointly with Food Safety Standards Authority of India (FSSAI) declared the year 2023 as the Year of Millets. Guidelines to incorporate nutritious meals in hospitals, canteens and schools are in pipeline to integrate right nutrition.⁹

Various policies and programs were launched to promote nutritional literacy, but certain barriers are taking lead; for instance, in case of overeating such as advertisement of junk foods, availability of finger foods within few minutes at the doorstep, increasing trend of dining out. Similarly, in case of malnourishment, lower socioeconomic status, increase in calorie deficit to be in shape among new young's, lack of information about food practises and consumption, etc acting as major barriers.¹⁰

Concerning dramatic increase in lifestyle-related diseases, there is need of nutritional literacy among the population which can be achieved through nutritional advisors and instructors in the hospitals to educate the patients. Evidence suggests that it may be incorporated in the curriculum of students or implementation of school, college and community-based nutritional health intervention/ awareness programs to advance their nutritional literacy. There is need of involve stakeholders within the Government and outside both at the central and state level to formulate and implement the policies regarding nutritional health at the core level.^10,11

Very limited research studies are published from the developing countries to report regarding the parents, teachers or healthcare providers' knowledge and skills about food and nutrition literacy, therefore, more research is warranted for evaluating the barriers related to its proficiency and implementation of good nutritional practices.