In reference to nutrition there is this term referred to as RDA. Can you briefly explain for our readers what it means? Does RDA have a lot of relevance to children’s diet?

The RDA is the ‘Recommended Dietary Allowance set by the Food and Nutrition Board of the National Research Council of the National Academy of Science. It sets the recommended (not ‘required’) nutritional intake for healthy human beings. The main RDAs include recommendations for energy (calories), proteins and many other vitamins and minerals. The RDA for a nutrient is based on the amount needed to prevent a deficiency.

It does have a lot of relevance for children, especially the mother’s diet during pregnancy. The fact of the matter is that there is no single nutrient that provides everything with the exception of breast milk especially during the first 6 months of life. So one needs a variety of nutrients and those nutrients are present in a variety of foodstuffs. There is a lot of information on the nutritional values of various foods. The biggest challenge is to convert that knowledge into something practical so that individuals can understand which foodstuffs are available in their environment that they should take to constitute a balanced diet.

In some communities of Hala, Sindh we found something extremely astonishing. The children as well as the adults ate just chapatis (whole meal bread) and red chilies. That’s a very narrow range of nutrients! So that’s the challenge. That’s also one of the things that we are working on. To convey messages about a variety of foods that contains a range of nutrients required.

When you talk of access of nutritious foods the usual response is well you know these people are too poor to afford a good diet. No doubt there is a problem but it’s those same people that can afford cigarettes, paan, tobacco, supari and so forth. So the issue is where you assign the resources that you have. What factors do you take into consideration when allocating those resources? This is the question that households need to be cognizant about. But there is no doubt there is a need also for economic growth of such households.

What do you suppose is the best way to inform parents about the need for good nutrition habits?

What we’re trying is a home-based approach. There is a direct contact, between the early child development worker and the mother, i.e. the women folk in the house, who really control the food; and the idea is to get these nutrition based messages permeated through the household. This process can only be meaningful if there is also an understanding of what’s available in the bazaar so that the household can have access easily to nutritious foods.

There is also the realization that people don’t change their practices readily. They know what is necessary but they still don’t change at times. Perhaps the most useful lever of change is the ability to exchange ideas with others. Among those who can exchange ideas, the most effective are the ones who have already benefited from those certain ideas. The fact that someone has tried something different is a stimulus for more change, for other people to try. So we try and create forums where individuals who have adopted proper nutrition habits share their experiences with other community members.

What should parents and schools be teaching children to ensure they know the importance of having a wholesome and healthy life?

Well, at a very early stage of course children don’t have much control, i.e. they take what they are given and often don’t know any different. Also later on in life say during the early schooling years there is not enough information available to inform children broadly about nutrition. One should be aware about human biology. Nutrition is just one aspect; the others include lifestyle, exercise, adequate rest and a host of other factors including exposure to cigarettes.

In the event that a mother was unable to have a healthy diet during pregnancy, what chances does a child have of overcoming the consequent ill-effects on his own development as a result of that pre-birth malnourishment?

The first twelve weeks of the child’s life are crucial since all organic structures are being formed. Some of the effects are never overcome, for e.g. if the mother is deficient in folic acid. Well one of the structures that isn’t formed properly (owing to a lack of folic acid) is called the neural tube and the neural tube then closes. If it doesn’t close it causes a condition called the spina-bifida where the lower part of the spine is open. Such people are paralyzed in the lower half of the body, and they may have a whole set of other neurological problems as well. It’s an absolute disaster. There is nothing you can do. The incidence of that kind of problem has gone down since the regular introduction of folic acid in a mother’s diet, during antenatal care.