Why micronutrient awareness is vital to India's health

The Hindu

a day ago

As India is undergoing a nutritional transition with diets changing over the past two decades or so, conversations around diet should not just be limited to what fills the plate but also on what may be missing from it.
The World Health Organization (WHO) and Indian Council of Medical Research (ICMR) emphasise the importance of a balanced diet rich in fruits, vegetables, legumes, and whole grains. Aligning with these recommendations, India's dietary guidelines, led by the ICMR's National Institute of Nutrition (NIN), have incorporated them into national programmes like the Anaemia Mukt Bharat initiative. Moreover, the WHO highlights the significance of micronutrient supplementation, particularly for populations vulnerable to deficiencies.
However, despite the South Indian diet's richness in staples providing carbohydrates, fats, and proteins, micronutrients often remain overlooked. As eating habits and daily routines shift rapidly in both urban and rural parts of India, health professionals are increasingly highlighting the importance of meeting the body's need for essential vitamins and minerals. This growing concern stems from a larger global issue: more than 2 billion people are affected by deficiencies in crucial micronutrients such as vitamin A, iodine, iron, and zinc. These shortfalls are not merely nutritional -- they carry serious health consequences.
Across the world, micronutrient deficiencies are linked to conditions like anaemia, vision loss, reduced cognitive ability, and a weakened immune system, making individuals more vulnerable to infections. According to the WHO, anaemia affects 42% of children under the age of five and 40% of pregnant women. The burden is especially heavy in regions such as South Asia and Sub-Saharan Africa, where access to nutrient-rich diets can be limited.
The health impacts are far-reaching. A lack of iron, folate, vitamin B12, and vitamin A often leads to anaemia, while insufficient folate during pregnancy increases the risk of birth defects. Vitamin A deficiency, in particular, is a leading cause of preventable blindness.
What are nutrients and their subtypes?
Reshma Aleem, senior clinical dietician at Rela Hospital, Chennai, highlights the need to begin with a fundamental understanding of what constitutes nutrition. 'Nutrients are broadly classified into macronutrients and micronutrients,' she explains. 'Macronutrients -- carbohydrates, proteins, and fats are needed in large amounts and serve as the body's primary sources of energy and structural components. Micronutrients, on the other hand, are required in smaller quantities but are vital for enabling countless physiological functions.' These include vitamins, minerals, and trace elements essential for enzyme activity, immune function, hormone production, and overall cellular health.
Micronutrients fall into specific categories: water-soluble vitamins (such as the B-complex group and vitamin C), fat-soluble vitamins (A, D, E, and K), macrominerals (like calcium, phosphorus, and magnesium), and trace elements (including iron, zinc, and selenium). 'While water-soluble vitamins are generally excreted through urine and pose little risk when consumed in excess, fat-soluble vitamins are stored in the liver and can build up to toxic levels if taken without supervision,' Ms. Aleem says.
Micronutrients and personalised health needs
Micronutrients, though needed in minuscule amounts, play an outsized role in maintaining immune function, supporting growth and development, and facilitating energy metabolism. When these are deficient, the consequences can range from mild fatigue to serious health complications, particularly among vulnerable populations such as children, pregnant women, the elderly, and individuals with chronic illnesses or those recovering from surgery.
M. Anusuya, senior dietician at SIMS Hospital, Chennai, points out that although these deficiencies may not always manifest with immediate symptoms, their long-term impact on health is significant. 'People with gastrointestinal disorders, absorption issues, or those who have undergone bariatric or other major surgeries are at greater risk,' she says, adding that timely supplementation becomes crucial in such cases.
Micronutrient supplementation, when advised by a medical professional, can take the form of either single or multi-nutrient formulations. While the former is used to target specific deficiencies such as iron-deficiency anaemia or vitamin D insufficiency, the latter is typically recommended when multiple gaps in nutrition are observed -- often a reflection of poor dietary diversity.
The role of supplementation is particularly critical in maternal and infant health. According to Suparna Mukherjee, clinical nutrition & dietetics, Narayana Health City, Bengaluru, micronutrients --- comprising essential vitamins and minerals -- are also fundamental to the body's development and disease prevention mechanisms, despite being required only in minute quantities. 'Micronutrients including iodine, iron, folic acid, and vitamin D are not just supportive but regulatory elements in our metabolic systems. Their absence can quietly derail core functions such as hormone production, cognitive growth, and immune defense,' she explains. While she emphasises that a balanced diet should ideally meet most nutrient requirements, she points out that certain groups -- pregnant women, children, and those with malabsorption issues -- often require supplementation tailored to their specific needs.
Public health initiatives such as the distribution of iron and calcium tablets to expectant mothers, and the provision of fortified nutritional blends like sattva maavu under government schemes, reflect a growing recognition of the problem at the policy level.
Changing lifestyles and rising deficiencies
Vitamin D and B12 deficiencies are increasingly prevalent, often linked to reduced sun exposure and dietary patterns that exclude sufficient sources such as dairy, fish, or fortified foods. The result is a marked increase in patients presenting with fatigue, low immunity, and musculoskeletal complaints.
Compounding this are persistent dietary misconceptions. 'Many patients, particularly those attempting weight loss, avoid fruits due to concerns about sugar,' Ms. Anusuya observes. 'But in doing so, they also miss out on vital micronutrients.' She emphasises that natural sugars in fruits, unlike refined sugars, come paired with fibre, antioxidants, and vitamins --contributing positively to health when consumed in appropriate quantities.
Another area of misunderstanding is the categorisation of fruits like papaya, jackfruit, and mango as 'hot' foods, often considered unsafe during pregnancy or childhood. 'These are nutritional powerhouses when consumed in moderation and should not be arbitrarily excluded,' Ms. Anusuya adds, advocating for culturally sensitive but evidence-based dietary guidance.
Avoid self-supplementation, seek professional care
The widespread availability of supplements, coupled with the proliferation of anecdotal advice on social media, has led to a troubling rise in self-prescribed nutrition. 'Even seemingly harmless supplements like vitamin C, if consumed in very high doses for prolonged periods, can lead to side effects such as kidney stones,' Ms. Aleem says. Overuse of antioxidant supplements and fat-soluble vitamins can similarly cause more harm than benefit if not clinically indicated.
To mitigate such risks, clinicians and nutritionists increasingly rely on biochemical assessments -- blood tests that quantify nutrient levels before recommending supplements. This data-driven approach ensures that interventions are specific, personalised, and medically justified, rather than being blanket additions to one's routine.
Also, in the context of evolving health challenges, the focus on micronutrients is both timely and necessary. Ensuring adequate micronutrient intake -- whether through food, fortification, or supplements -- must be seen not as a corrective measure but as an integral aspect of preventive health care.
Experts add that the growing emphasis on micronutrients signals a larger shift in how nutrition is understood -- not just in terms of calories, but in terms of quality, diversity, and long-term impact.