Living in a country like India, which is home to one-fifth of the world's population, we cannot help but worry about the state of health and nutrition. The recent National Nutrition Survey conducted by the Ministry of Health and Family Welfare was an eye-opener. It showed that despite economic growth over the last few years, India continues to battle malnutrition. It is distressing to learn that almost 14% of India's population is undernourished. Moreover, more than 30% of children under five are stunted, and over 50% of children, young girls, and women are anaemic (a nutritional deficiency of iron and other essential minerals and vitamins).
In addition to undernutrition, changes in diet and lifestyle have led to obesity, which is a risk factor for non-communicable diseases such as cancer, heart disease, and Type 2 diabetes. It is estimated that 19% of men and 21% of women are obese, and 73 million adults are affected by diabetes.
There is no quick fix to this alarming problem. It requires a more careful and holistic approach to health and nutrition. Of course, a well-balanced, wholesome diet is essential, and the Food Safety and Standards Authority of India (FSSAI) has been emphasising its importance through its "Eat Right Movement". It is heartening to see that more and more people are becoming conscious of their health and focusing on nutrient intake. Nutrition-rich foods have become a growing trend. However, despite this shift, India continues to grapple with the triple burden of malnutrition.
Could poor gut health be a contributing factor? It is quite possible that, despite consuming high-quality food, poor gut health hinders nutrient absorption, leaving the body deprived. This can result in poor physical and mental growth and development. Nutrition loses its meaning if the food we eat is not digested properly, and the nutrients are not absorbed effectively. Therefore, alongside food availability, food bioavailability is crucial, highlighting that nutrition and gut health go hand in hand to ensure our dietary intake meets energy and health requirements.
So, what determines gut health? Among many factors, gut bacteria have been suggested to play a vital role. Referred to as the "forgotten organ", the gut houses nearly 100 trillion bacteria, weighing about 2 kg, which are indispensable to its function. These microbes possess the remarkable ability to break down food into smaller particles for easier nutrient absorption. They also help maintain a healthy gut environment, eliminate toxins, ensure regular bowel movements, and protect against digestive disorders. Poor nutrition, unhealthy lifestyles, antibiotic use, stress, and inadequate sleep can reduce beneficial gut bacteria and increase harmful, disease-causing bacteria, resulting in compromised gut health and immunity.
Among the many ways to improve gut health, probiotic foods-designed to increase beneficial gut bacteria-have gained immense importance. These are scientifically tested bacteria that reach the gut alive and positively influence its microbial environment. Consuming probiotic foods can help enhance the absorption of micronutrients like calcium and iron. Interestingly, studies conducted on children and young women in India have shown significant improvement in iron levels following the intake of milk fortified with probiotics and prebiotics. In some cases, probiotic bacteria can also produce B-group vitamins, which are often destroyed during cooking, resulting in widespread deficiency. Probiotic vitamin B producers could help address this issue.
Pregnant women are among the most neglected yet nutritionally vulnerable groups. They often suffer from digestive disorders and are unable to extract the full benefits from food, leading to deficiencies in key nutrients like iron, zinc, folic acid, and iodine. These deficiencies can result in premature births and low birth weight. It is well established that some scientifically tested probiotics can improve overall health during pregnancy and may be a valuable addition to dietary regimes.
Studies using probiotics in Indian children have shown that specific strains can reduce the incidence of diarrhoea, thereby preventing the loss of essential vitamins and minerals.
It is estimated that many countries will soon have a larger population aged over 65 than under the age of five. Ageing brings with it gastrointestinal complications, poor digestive health, and weakened immunity. Research shows that specific probiotics can help improve the health of the elderly by reducing inflammation, increasing beneficial bacteria, and enhancing digestion and immunity.
Gut health has taken centre stage today, not only because of its role in nutrient absorption but also because it is the largest immune organ in the human body. The COVID-19 pandemic, which caused global alarm, reminded us of the critical role of immunity. Those with stronger immune systems were less affected than those with weaker ones. Interestingly, nearly 70% of the body's immune system is located in the gut, which plays a key role in our protection. It also houses the enteric nervous system, comprising 500 million neurons, and is often referred to as the body's "second brain". Around two-thirds of neurotransmitters are influenced by gut bacteria, linking the gut directly or indirectly to brain health, and potentially impacting mood, depression, and anxiety.
In line with the teachings of Greek physician Hippocrates and our very own Ayurveda-both of which state that "death sits in the bowels" and that "bad digestion is the root of all evil"-maintaining a healthy gut to maximise nutrient absorption, strengthen immunity, and reduce the risk of infections could be a powerful strategy in overcoming India's malnutrition epidemic.
About the Author: Dr Neerja Hajela is the Head of the Department at Yakult Danone India Pvt. Ltd.