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Poor nutrition is a food safety issue, as evidenced by this BBC article about an anorexic teenager with irreversible osteoporosis as a young adult:

Macro and micronutrient deficiencies brought about by poor nutrition contributes to a massive chronic disease burden in India. It also leads to early incidence of a host of lifestyle and metabolic diseases at a much earlier age in adults.

Calorie deficiencies are well understood, and so is excessive calorie intake. This is because it leads to visibly wasted or obese individuals. The relationship between these two conditions and the proclivity of wasted or obese people to a host of diseases is well understood and known.

However, in India, widespread problems arise from undernutrition of other kinds, which does not usually manifest itself as wasting or obesity.

The macronutrient deficiency that is widespread in India is protein. A very large percentage of Indian adults, across socio economic strata, do not get adequate protein in their diets. Poor musculature amongst adults is obviously one of its repercussions. In addition, protein deficiency causes a huge number of problems ranging from weak muscles, fatty liver disease, low immunity, obesity (due to increased hunger and resultant calorie intake), edema, skin/hair/nail problems and more. An adult weighing 75 kilos must get 65 grams or more protein every day from diet.

Micronutrient deficiencies are almost universal in India. My personal estimate is that over 95% of the population has micronutrient deficiencies.

While there is a lot of emphasis on looking for and fixing iron, zinc and vitamin D deficiencies, not much attention is given to inadequacy or inadequate intake of many more vitamins, minerals, trace minerals, metals, flavonoids, carotenoids and others.

It is not possible to run an adequacy test for all, and for many of these, medical science has not established adequacy levels yet.

However, it is quite clear that inadequacy will create problems, and many of the near term and long term issues caused by deficiency of the rarer minerals are not known to medical science.

Adequate and diverse nutrition is necessary. Inadequacy is a safety issue.

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