Interviewed by Dinesh Balam, WASSAN (OMM) | April 5, 2020
An Interview with Prof Sumantra Ray, Founding Chair & Executive Director, The NNEdPro Global Centre for Nutrition and Health in Cambridge (UK)
Q. Can you give a brief intro about the work of The NNEdPro Global Centre for Nutrition and Health?
The NNEdPro Global Centre for Nutrition and Health is an award-winning interdisciplinary think-tank, anchored in Cambridge (UK). It convenes central as well as regional networks across six continents as part of the International Knowledge Application Network Hub in Nutrition-2025. We develop adaptable and scalable educational models for nutrition capacity building in health systems and conduct a range of training courses as well as primary research studies and syntheses to fill key evidence gaps related to nutrition.
Q. Given the The NNEdPro expertise in Nutrition, can you please suggest dietary recommendations for combating COVID-19?
The World Health Organization (WHO) has recently emphasized the importance of appropriate diet and lifestyle measures including adequate nutrition to protect the immune system. Micronutrients, commonly known as vitamins and minerals, are required in small quantities but are critical for health and pivotal in ensuring the immune system can function properly. Multiple micronutrients are essential for good immune function, particularly vitamins A, C, D, E, B2 (riboflavin), B6 (pyridoxine), B12 (cobalamin) and B9 (folic acid) and minerals iron, selenium, zinc, magnesium and copper (Calder, Carr, Gombart & Eggersdorfer, 2020) and these are found in a variety of foods that form part of a balanced diet in line with national guidelines. More information can be found at https://www.nnedpro.org.uk/post/combatting-covid-19
Let me be very clear, Diet and lifestyle measures are not a substitute for current public health advice on mitigation and suppression of the epidemic through our individual and collective actions. Neither is it possible to ‘boost’ the immune system beyond its normal function. But what we can do is to preserve normal immune function through ensuring that people are adequately nourished.
Q. In the Indian context, do you think the consumption of millets can help in supplying micronutrients to the body and building immunity?
Millets are certainly richer in certain key micronutrients than rice or wheat. Hence the consumption of millets will be helpful towards meeting overall dietary requirements. Wherever they are locally available, they may be consumed along with other food items that make up a well-balanced diet.
Q. In addition to social distancing and medical treatments, Whatdo you think the Government can do through its food security schemes such as ICDS, MDM and PDS?
Certain individuals are at greater risk of micronutrient deficiency; this includes women of childbearing age, particularly pregnant and lactating women, infants and toddlers, children, adolescents (particularly females), older adults (Maggini, Pierre & Calder, 2018), obese individuals, and the critically ill, plus individuals with inflammatory bowel disease (Kilby, Mathias, Boisvenue, Heisler & Jones, 2019) and other chronic inflammatory and malabsorptive conditions.
The ICDS (pregnant ladies and small children), MDM (For children) and PDS schemes that distribute/provide the food might consider including higher micronutrient value foods in their schemes based on local availability. Relevant medical authorities such as ICMR/AIIMS and others should also be consulted concerning high-risk groups with underlying disease conditions for specific recommendations.
In many high-risk groups, a balanced diet alone may not be sufficient to meet these requirements and deficiencies can contribute to impaired immune function. This can be due to a variety of factors affecting intakes, absorption and also due to increased utilisation of micronutrients during times of infection. In such cases, the immune system can be supported by micronutrient supplementation particularly to help correct deficiencies.
Q. What are the other suggestions do you have for combating COVID-19?
In addition to deadly health issues for patients, COVID-19 is causing inevitable psychological distress due to social isolation with a profound impact in much larger populations i.e. countries such as India. The lockdown of a billion people is unprecedented. It may cause depression, anxiety, loneliness and irritability in some segments of the population. Hence utmost care must be taken for both physical and mental well being. Increasing the availability and access to digital and phone-based support networks as well as judicious use of the media can be particularly important during this challenging time.
Q. What do you suggest the Government can do in the long term for promotion of nutrition beyond current food security programmes?
The NNEdPro has been running a pilot project known as the Mobile Teaching Kitchen to train women from urban slums to become culinary health educators and champions for social change. They are initially trained by a multi-professional group of doctors, dietitians and social workers in preparing low-cost nutritious food. This work arose from the idea of tackling malnutrition in the slums of Kolkata. With over 1.5 million people living in 3,500 unregistered slums in Kolkata the concept of a mobile teaching kitchen was envisaged to serve as a hub for nutrition and health education as well as a micro-enterprise. The trained champions now operate a mobile unit which not only serves low-cost, healthy, tasty, safe and nutritious meals to all sections of the city across socio-economic groups. These meals are served with key health education messages and efforts are underway to internalise key parts of the food supply chain for local sustainability.
We are now in plans to scale up the intervention in Odisha in partnership with Odisha Millets Mission through NCDS and Mission Shakti SHGs in Bhubaneswar in partnership with Army Wives Association (AWA). In the long run, the Government might focus on the creation of ecosystems so that self-sustaining nutrition centric micro-enterprises/startups can flourish. This may play an important role in a socially devolved system towards strengthening both food and nutrition security.