Fifty Years of Biochemistry: Progress in Fifty Years of Biochemistry: Progress in Food and Nutrition Security in Food and Nutrition Security in

BangladeshBangladesh

by

Harun K.M. Yusuf, PhD, FBAS

Professor of Biochemistry and Human Nutrition,

Department of Biochemistry and Molecular Biology, University of Dhaka.

Currently

National Nutrition Advisor to FAO of the UN, National Food Policy

Capacity Strengthening Programme (NFPCSP)Presented at the Golden Jubilee Scientific Conference, Department of Biochemistry and Molecular Biology, Dhaka University, 30 November 2008.

PROFESSOR KAMALUDDIN AHMAD

- 2003

Establishment of the Department of Establishment of the Department of Biochemistry at Dhaka University in Biochemistry at Dhaka University in

1957 by Professor Kamaluddin Ahmad1957 by Professor Kamaluddin Ahmad

• A milestone - the birth of the science of biochemistry and nutrition in this part of the Sub-continent.

• This mother Department subsequently gave birth to the Departments of Pharmacy (now a Faculty of 3 Departments), Microbiology and Genetic Engg. & Biotechnology and the Institute of Nutrition and Food Science (INFS).

Nutrition Survey of East PakistanNutrition Survey of East Pakistan

1962-64 1962-64

Another milestone –

Revelation of widespread malnutrition, especially

among the children and women widespread vitamin-mineral deficiencies,

particularly vitamin A deficiency

nightblindness, iodine deficiency goitre,

and iron deficiency anaemia.

“This report presents the findings and recommendations of one of the most comprehensive nutrition surveys ever conducted. It is our sincere hope that this study will substantially contribute to improved nutrition and health of the people of Pakistan” ….

…..the organization direction of Dr. Kamaluddin Ahmad, Head of Biochemistry Department at Dhaka University was the “largest single factor in its success” …

Dr. Arnold E. SchaeferExecutive Director Interdepartmental Committee on Nutrition for NationalDefense, U.S. Department of Health, Education andWelfare

Major recommendations of the Major recommendations of the 1962-64 Survey1962-64 Survey

• Increase in food production and availability• Development of food processing and

preservation• A campaign to improve the nutrition of the

preschool children• Introduce an expanded school lunch

programme• Continued research on micronutrient

deficiencies – iodine deficiency goitre, Vitamin A deficiency nightblindness, iron deficiency anaemia

Fig. 1: Food production in Bangladesh, 1971-2008

5

15

25

35

Tota

l, m

illio

n M

T

00.511.52

Whe

at, m

illion

MT

Rice Total net Wheat

Fig. 2: Changing food intake pattern in Bangladesh, 1991-2005 (BBS HIES)

0200400600800

1000

Total food Rice Wheat Totalcereal

Total non-cereal

g/ca

pita

/day

1991-92 1995-96 2000 2005

Fig. 3: Increases in intake of some food items in Bangladesh, 1991-2005 (BBS HIES)

0

10

20

30

40

50

60

70

1991-92 1995-96 2000 2005

g/c

apit

a/d

ay

Meat and Egg Milk Fish Potato Fruits

Share of food groups as percentage of DES (FAOSTAT 2005) (Kcal/capita/day)

0% 20% 40% 60% 80% 100%

Bangladesh

Viet Nam

India

Sri Lanka

Philippines

Pakistan

China

Japan

Thailand

Italy

Germany

USA

Cereals

Sugar

Oil

Roots & tubers

Fruits + vegetable

Meat, milk, egg and fish

Other

Fig. 4: Fall in percent dietary energy supply from cereals in Bangladesh (1991-2005)(BBS HIES) and its

projection up to 2020 (author's own calculation)

72.2 69

6065

72.9

79.6

75.678.5

80.375.277.1

79.7

66.769.2 68.5

55

60

65

70

75

80

85

1991-92

1995-96

2000 2005 2010 2015 2020

DE

S c

ereal (

%)

National Rural Urban

Fig. 5: Association between DES Cereal% and % stunting in U-5 children (n = 20, p = 0.000)

(author's own calculation from

FAO RAP data, 2007)y = 0.7634x - 17.671

R 2 = 0.5154

0

10

20

30

40

50

60

35 40 45 50 55 60 65 70 75 80 85

DES Cereal%

% S

tun

tin

g

Fig. 6: Stunting and underweight in U-5 children in Bangladesh: Shall we attain MDG target?

20

25

30

35

40

45

50

55

60

65

70

7519

90

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2007

2009

2011

2013

2015

Pre

va

len

ce

(%

)Stunting Underweight MDG target (stunting) MDG target (underweight)

Fig. 7: Changes in maternal malnutrition rates in Bangladesh, 1997- 2005 (BBS)

53

45

3632

7 1116 17

0

10

20

30

40

50

60

1996-97 1999-00 2004 2005

Pre

vale

nce, %

CED (BMI<18.5) Overweight (BMI>=23)

Figure 8: Fall in nightblindness among under-5 children in Bangladesh, 1962-2006

4.13.6

1.781 0.6 0.3 0.2 0.1

0

1

2

3

4

5

1962-64

1982 1989 1995 1997 1999 2002 2005

Per

cen

t

Iodine deficiency, the mostIodine deficiency, the most corrosive nutritional corrosive nutritional

diseasedisease• Affects physical growth and

development

• Damages the brain - structurally and - functionally -----leading to loss

of intelligence quotient (IQ)

Implications of Loss of IQImplications of Loss of IQ

•Poor scholastic performance•Frequent failures/grade

repetitions•Absenteeism/drop outs•Reduced contribution to

socio-economic development

Economic cost of IQ loss due Economic cost of IQ loss due to Iodine deficiencyto Iodine deficiency

• The loss of just one IQ point is associated with an overall reduction in lifetime earnings of 2.39%.

• Iodine deficiency is associated with an average loss of 13.5 IQ points, equating to a loss of 13.5 x 2.39 = 32.3% of lifetime earnings. i.e. about 1/3rd of lifetime earnings.

Fig. 9: Change in goitre prevalence among women and children in Bangladesh, 1962-2005

6.217.2

49.9

2611.7

24.2

55.6

32.7

0

10

20

30

40

50

60

1962-64 1993 1999 2004-5

To

tal g

oit

re r

ate

(%

)

Children Women

Figure 10: Fall in iodine deficiency (UIE<100 ug/L) in school aged children and women, 1993 -2004/5

71

42.5

70.2

38.633.8

45.6

20304050607080

1993 1999 2004-5

Perc

ent

Children Women

IQ points saved during the last decade IQ points saved during the last decade in Bangladeshin Bangladesh

Goitre prevalence in 1962-64 = 29% Goitre prevalence in 1993 = 47% Annual incremental rate (in 30 years) = 0.6% Projected goitre prevalence in 2004-05 = 54% Actual goitre prevalence in 2004-05 = 6% IQ lost in goitre on average = 13.5 points Population in 2005 = 139 million Projected loss of IQ in 2005 = 1.01 billion Estimated loss of IQ in 2005 = 1.12 billion

IQ points saved in 12 years (1993-2005) = 0.9 billion

It is indisputable that the National IQ is the nation’s greatest single economic asset.

It must be protected at all costs.

Figure: Anaemia prevalence in Bangladesh, 2001-03 (BBS/UNICEF, 2004)

76.5

58.3

41.949.2

26.2 29.9 30.3

45.5

20304050607080

6-11

m

12-2

3 m

24-5

9 m

6-59

m

Boy

s

Gir

ls

Non

-pr

egna

nt

Preg

nant

Under-5 children Adolescents Women

Perc

enta

ge

Policy actionsPolicy actions

• Bangladesh Food and Nutrition Policy

• Bangladesh National Plan of Action for Nutrition

• National Food Policy 2006

The National Food Policy 2006 is one of the most comprehensive, pro-poor, gender-sensitive equitable food policy government documents.

The global objective of the Policy

is to ensure food and nutrition security for all.

A Plan of Action (PoA) has been developed with the technical assistance of the National Food Policy Capacity Strengthening Programme (NFPCSP), a project being jointly implemented by GoB (Government of Bangladesh) and FAO of the UN.

The PoA covers areas of action to address all three dimensions of food security - food production and availability, food accessibility and food utilization for nutrition.

The PoA is now under active implementation.

THANK YOU