Healthy Soy Healthy Children

Vijaya Jain, MS,RD,CDN

Director, Community Nutrition Services

National Soybean Research Laboratory

University of Illinois, Urbana- Champaign

Urbana, IL

Nutritional Enhancement of

School Lunches in India

“ Education without children’s health

is missing the heart of the matter”

C. Everett Koop M.D.

Former Surgeon General of the United States

Malnutrition in India

40% of the world’s malnourished

children and 35% of low birth weight

infants live in India.

1/3 of the malnourished children in

the world live in India.

2.5 million children die in India,

accounting for one in five deaths in

the world.

About half of India’s young children

are undernourished.

Hunger Rates Among Children

Most affected states Least affected states

Madhya Pradesh Goa

Bihar Kerala

Orissa Mizoram

Maharashtra Tamilnadu

Malnutrition in South Asia

Malnutrition: Urban vs Rural Areas

SYMPTOMS OF MALNUTRITION

What happens when children are malnourished?Atrophy & shrinkage of brain

Impaired physical development & mental growth

Increased learning disabilities

Reduced IQ

Stunted growth

Nutritional deficiencies resulting in blindness, anemia,

weakened immune systems, increase in frequency and

type of infections

Irreversible damages unless addressed early in life

Cost to the Child

• Preterm birth, infant mortality, low birth weight

• Growth retardation, stunted growth, reduced IQ

• Impaired physical & mental development

• Nutritional deficiencies resulting in blindness,weakened

immune systems, increase in frequency and type of

infections

• Hormonal imbalances

• Reduced earning capacity: up to 10% decrease in life long

earnings (World Bank, 2006)

Cost to the Mother

• Maternal malnutrition was one of the most important factors contributing to death during pregnancy or childbirth (Mitra & Choudry 2002)

• Over 100,000 women worldwide die each year as a result of iron- deficiency anemia alone (UNICEF 2004)

• Deficiencies of iodine, folate, vitamin A, zinc, and protein also dramatically increase risk of maternal and infant mortality

Faces of Malnutrition

57 million children in India are malnourished.

Source: 2006 UNICEF Report Card on Nutrition

Recommended Dietary Allowances for

Infants & Children

Age Calories ProteinInfants 0-6 months 108/Kg 2.05g/Kg

6-12months 98/Kg 1.65g/Kg

Children 1-3 years 1240 22 grams

4-6 years 1690 30 grams

7-9 years 1950 41 grams

Boys 10-12 years 2190 54 grams

Girls 10-12 years 1970 57 grams

Boys 13-15 years 2450 70 grams

Girls 13-15 years 2060 65 grams

Boys 16-18 years 2640 78 grams

Girls 16-18 years 2060 63 grams

ADA Position on Vegetarian

Eating

• It is the position of the American Dietetic

Association and Dietitians of Canada

that appropriately planned vegetarian

diets are healthful, nutritionally

adequate, and provide health benefits in

the prevention and treatment of certain

diseases.

Soy in India

• One of nature’s wonderful nutritional gifts

• Cultivated for many centuries in south east Asia, a versatileand common food

• Grown in some parts of India, mainly for oil and animal feed

• Not yet a part of the staple diet in India

• Excellent, inexpensive source of plant protein with the potential to be used as substitutes for animal protein sources

• Highly acceptable in India where vegetarian diets are most prevalent

• Soy flour and textured soy products can easily be added in the ethnic foods served in the midday meal programs in India

Soy In The Schools

Soy is easy to add in children’s feeding programs

• Calcium and Vit D fortified soymilks and calcium-set tofu as

alternative calcium sources

• Dried and/or canned whole soybeans as meat alternatives

• Soy granules and soy flour as protein in ethnic foods:

rice, soups, vegetables and other foods

NATIONAL SCHOOL LUNCH PROGRAM

•India mandated a National School

Lunch program in 2004 for over a

hundred million school children.

•State Governments are trying to

meet this mandate

•Currently, only about a third of those

children are actually benefiting from

the program

• The program faces the challenge of

meeting the protein target (12gms. per

child per day)

WISHH SCHOOL LUNCH PROGRAM: BANGALORE

Names of Schools:

• Sri Sadguru SaiBaba School, Madivala

• Mathru, residential school for the visually impaired children

• Parikrma Humanity Foundation (3 schools)

Number of children: 1500

Duration of study: One year

Shri Sadguru Sai Baba School: Madivala

Children at this

government school

come from neighboring

slum dwellings.

Adding Soy in Rice and Sambhar

Children eating Soy Enhanced Rice & Sambhar

Soy enhanced Lunch at Parikrma

Children getting ready to eat

a soy enhanced lunch at

Parikrma.

Mathru: Children at lunch

Mathru is staffed with

trained visually

impaired instructors

Mathru: School for the blind

Start

1 year later!

GOVERNMENT FUNDING

Karnataka Rs.1.61 for grades 1 to 7Rs.2.13 for grades 8 to 10

Uttar Pradesh Rs.2.00 for grades 1 to 5Rs.2.50 for grades 6 to 9

Rajasthan Rs.2.00 for grades 1 to 5Rs.2.50 for grades 6 to 8

Orissa Rs.1.65 for grades 1 to 5

Gujarat Rs.2.00 for grades 1 to 7

Three- item menu in

South India

1. Rice

2. Sambar (vegetable and lentil curry)

3. Yogurt

Three item menuin North India

1. Chapattis (Indian bread)

2. Dal (lentils) or Sabji (vegetables)

3. Vegetable Rice or Kheer (Indian rice pudding)

RURAL MODEL

Training,

educating, and

employing

impoverished

women

Primary schools

Control schools

Secondary schools

Teachers Students Households

Bangalore 15 5 5 50 500 500

Hubli / Dharwad

15 4 5 46 480 480

Jaipur 14 5 36 359 359

Baran 10 5 26 300 300

Vrindavan 15 4 38 380 380

Bellary 9 4 6 36 380 380

Ahmedabad 14 6 40 300 300

Total 92 33 16 2699

Impact Assessment with

the Nielsen Company

INDICATORS

• Attendance and enrollment

• Grades and year-end exams

• On-site reading and math assessments

• Household socioeconomic level

• School conditions

• Anthropomorphic measurements

• Dietary variety

• Interviews with students, teachers, and parents

Jaipur Attendance

Program Schools Control Schools

Bangalore Nutritional Status

Program Schools

Control Schools

Teachers stated: “…..the TAPF mid day meals have brought revolutionary changes in education. Enrollment and attendance have improved…”

BELLARY PARENTS

• 90% found Akshaya Patra meals clean and hygienic

• 90% reported that their children’s health has improved as a result of Akshaya Patra meals

MENU ANALYSIS

• 2004 Supreme Court Order: 300 calories and 8-12 grams of protein per day (primary schools)

• 2008-09 Indian Government Work Plan: 450 calories / 12 grams protein (primary schools) and 700 calories / 20 grams protein (middle schools)

Date Day Menu

01.02.08 Fri Rice, Sambar, Curds

02.02.08 Sat Bisi Bele Bath, Sweet Pongal

03.02.08 Sun Sunday

04.02.08 Mon Rice, Rasam, Kootu

05.02.08 Tue Rice, Sambar, Curds

06.02.08 Wed Special Rice , Raita

07.02.08 Thu Rice, Sambar, Curds

The Akshaya Patra Foundation, Bangalore HK HillMid-day meal program in Government schools

Menu for the month of Feb 2008

��

Calories Protein, gm Calories Protein, gm % Change

192 Middle 111 6.16 108 8.29 35%

171 Primary 99 5.49 96 7.39 35%

108 Middle 78 0.84 48 1.54 83%

98 Primary 71 0.76 43 1.40 84%

VEGETABLE PULAV

SAMBAR

Serv. Size

(gm)School

WITHOUT SOY WITH SOY

Calories Protein, gm Calories Protein, gm % Change

Primary 357 12.01 352 13.9 16%

Middle 378 12.82 373 14.95 17%Bangalore

SAMBAR + RICE + YOGURT

Location SchoolWITHOUT SOY WITH SOY

MENU ANALYSIS WITH SOY

Invest in Childhood Nutrition

• Easy to accomplish

– Education

– Basic health care

– Availability of nutritious complementary foods

– Pre-school and school feeding programs

• It pays for itself

– Increases attendance in schools

– Improves academic performance within a year

– Improves social life

– Increased productivity

Eradicate Malnutrition

A wholesome lunch in schools can help protect children from hunger.

Conclusions:

Soy products are easy to use in school lunch menus

Soy enhanced school lunch items are highly acceptable

Soy helps increase protein and other nutrients in the meals