DURING the last 32 years since Bangladesh became an independent nation in 1971 production of rice, the main staple food, has exceeded 19 million tons per year, whereas it was only about 8 million tons in 1971. In spite of the fact that population has increased steadily, the availability of rice today for every man, woman and child is nearly one pound per day according to the data provided by the Bureau of Statistics in 1999. This is indeed a remarkable achievement. Besides this, it is encouraging to note that food production is growing at a greater pace than the population. Even wheat the second major food grain used as staple is gaining popularity and its domestic production is reaching 2 million tons per year. Net availability of meat, fish, milk, egg and pulses has increased from 1994-95 to 1997-98, which is reflected in their increase in per capita consumption.

This advancement in agriculture and increase in productivity can be attributed to production of hybrid seeds, application of proper fertilizer, use of safe insecticide and pesticide, farm mechanisation, water and soil management and above all the will of the people. Bangladeshis have been in the forefront to receive the benefit of the cutting edge of technology. Development of agricultural colleges and universities, research institutes and extension services deserve mention in the success of Green Revolution in this small country of about 57000 square miles with 120 million people.

Apart from the technological advancement, Bangladeshis deserve special credit for developing the capability of disaster management. Taking precaution against natural calamities has become a part of life. The high frequency of floods and cyclones has taught the people to be prepared for handling such disasters

to avoid famine and death. Management of food grain storage and distribution during the times of natural disasters has been given top priority by the government that has set an example of cooperation between the private and public sector including the armed services. It is, therefore, expected that Bangladesh will keep the food production and distribution as a major priority. With this assumption one can be optimistic about the outlook for food grain availability and price stabilisation even if some import has to take place during times of need.

Present nutritional status is grim

Let us now examine the nutritional status of Bangladeshis. Mostly rice and some wheat provide the bulk of daily food on the plate. One pound of rice per person yields about 4 pounds of cooked rice that is consumed daily at breakfast, lunch and dinner. This source of high carbohydrate meal makes up at least 60 percent of the daily diet according to the 1995-96 Nutrition Survey conducted by Dhaka University. The remaining 40 percent of the diet consists of the following items in descending order -- leafy and non-leafy vegetables, roots and tubers, fish, meat, milk and eggs, fruits, pulses, edible fat and oil, sugar and molasses, and salt. An in-depth look at the consumption pattern shows protein and micronutrient rich food to be at 10 percent level of total intake in rural and 16 percent in urban areas.

The urban population gets slightly better nutrition in some cases than the rural even if the agricultural production mainly takes place in rural areas. It is most likely due to socioeconomic reasons and income disparity. The overall change in nutritional status from 1983-84 to 1995-96 can be seen in daily food energy intake from 2100 to 2250 kilocalories and protein intake from 61 to 65 grams or 2 ¼ ounces. Edible oil consump-

tion in the recent survey has been reported to be 8 grams per person per day. These figures clearly tell us that improvement in diet deserves immediate attention.

The human body requires about 40 nutrients that are supplied through diet. Energy substrate, essential amino acids, polyunsaturated fat, vitamins, minerals and indigestible fibre are required to be a part of a balanced diet. While it is difficult for Bangladesh to follow the recommended daily allowance (RDA) for the diet in the United

States, attempt has to be made to improve the oil consumption from 8 grams to 30 grams per person per day for every household in rural and urban areas. Similarly, protein intake should be maintained above 60 grams per person per day through fish, meat, milk and egg etc.

The low figures of dietary intake represent mostly low-income population be it urban or rural and their poverty and poor health is usually prevalent and linked together. Low protein in diet means low supply of essential amino acids, which are building blocks for body. Inadequate fats and oil consumption can cause hair loss, dermatitis and poor healing of wounds due to lack of essential fatty acid such as linoleic acid. Moreover, fats and oil act as a vehicle for the oil soluble vitamins namely A, D, E and K for mobilisation in the body. The vitamins and minerals essential for maintaining biochemical activity of cells in our body can be obtained through eating balanced diet that includes foods of animal and plant origin. It is extremely critical to provide such a diet during childhood and formative years of growth. Public health surveys at regional and national level during 1996-96 study at Dhaka University have confirmed prevalence of anemia, visual impairment, night blindness, goiter, rickets, scabies and memory impairment.

The nutritional status is quite alarming in spite of the bright picture of productivity gains in agriculture. About 50 per cent of

the population in rural and urban areas are not able to meet their nutrient requirements for protein, vitamin A, thiamine, niacin and vitamin C. Nearly 70 percent cannot meet the requirement for calories, fat and calcium. It is worse for iron because only 12.5 per cent of the population can meet this requirement. Riboflavin intake is almost none because only 1.3 per cent can meet the need. The above mentioned survey of 1996-97 provides data on nutritional deficiency disorders to confirm the alarming status. Night blindness is a major public health problem because it is around 1.5 per cent level in the under 15 population. This is directly related to vitamin A deficiency. Other vitamin A deficiency disorder such as xerosis conjunctivae is prevalent among 5 to 15 year old males at 2.5 per cent level of population. Goitre is prevalent in urban and rural areas. The percent of prevalence in the age group of 15 years and above is 22 for male and 32 for female. The national goiter rate is 24.5 per cent. It goes to nearly 40 per cent for pregnant and lactating female. These figures confirm that there is iodine deficiency in the diet.

The survey includes 12 different signs and symptoms to manifest the poor nutritional status of the rural and urban population. They include clinical observation from head to toe to show 28 per cent with sparse hair, 38 per cent with eye pallor and 21 per cent with dental decay. These do not include the daily onslaught of infectious diseases such as malaria, cholera,

dysentery and typhoid. If we examine the status of anaemia, the survey paints a very depressing picture. According to the World Health Organization criteria 77 per cent of rural and 63 of urban population in Bangladesh are anaemic. The overall public health status due to nutritional deficiency should undoubtedly receive greater attention by the planners and those who are at the helm of affairs.

The malnutrition problem can be solved

In 1971 at the time of achieving nationhood Bangladesh was in a state of disarray. Strong will power of Bangladeshis for survival coupled with assistance from overseas governments, compassionate people and charitable institutions turned this fledgling nation into a country full of success stories. The stories of famine and starvation have changed to high productivity of food and lower growth rate of population near 2.2 percent. The 1997-98 per capita consumption data can boast of 177 kilograms of food, 13 kilograms of fish, 5 kilogram of meat and 23 eggs. The life expectancy has moved up to 61 years and infant mortality rate has gone down to 57 per 1000.

But the above mentioned growth and development in food and agriculture have been overshadowed by the poor nutritional status and that includes deficiency of vitamins and minerals in the daily diet of common masses in rural and urban areas. It appears to be related to three main factors.

The first and foremost factor is related to availability and affordability of foods across the length and breadth of Bangladesh. Secondly, a major drive is needed for nutrition education to give incentives for eating balanced diet. Finally, a concerted effort should be given to make food enriched and nutritious at low cost so that less empty calories are consumed.

The Government of Bangladesh has actively participated in the framing of a national food and nutrition policy. It embraces the recommendations of the United Nations. The advancement has been manifested in the publication of Bangladesh National Food and Nutrition Policy in 1997. It was a quantum jump in the pursuit of improvement in national nutritional status of the people of Bangladesh. The policy clearly states that increase in the availability of "nutritious food" not just food should take place. It further stresses the need: "To develop our own Desirable Dietary Pattern (DDP) based on availability of various food groups. The quantum of these food groups required in the desired dietary pattern should be worked out to satisfy requirement at production, supply and consumption levels." The policy is well written that includes the strategies and operational details required for its implementation.

Implementation of the National Food and Nutrition Policy has remained a goal of the government of Bangladesh. The Prime Minister's office has taken charge of nutritional programmes. The World Bank, UNICEF, WHO, USAID, CIDA, JICA, DANIDA, DIFID, EU and many large and small donors and non- governmental agencies have all extended their support for solving the food and nutrition problems. UNICEF has donated vitamin A capsules for distribution to the under 5-year old children. The capsule distribution twice a year has been successful with coverage above 80 per cent of the target population. USAID and CIDA have provided assistance in this effort. UNICEF has supported the salt iodization programme and the private sector has responded very well for production and marketing of packaged iodized salt to help reduce iodine deficiency disorder and goitre. Iron, Calcium, Zinc, vitamin B and folic acid supplementation to the diet are under consideration. USAID has recently demonstrated through a feeding trial in Bangladesh that wheat flour fortification with multiple vitamins and minerals can be a good delivery mechanism of the micronutrients in Bangladesh.

Besides these, programmes like Food for Education, Food for Work, Fortified Biscuits and Milk for school children under US and UN support, are aimed at improving the nutritional status. A home gardening program supported by the US has assisted in vegetable production, improvement in income and dietary diversification.

The time for action is here and now

The food and nutrition outlook in Bangladesh would improve rapidly if all the policies and programmes mentioned can be translated into action. Indeed, they should be taking place with deliberate speed and should be well orchestrated to achieve the national goal. Development of the Desirable Dietary Pattern for Bangladeshis with the design of nutrition education to promote them should be considered as an excellent goal that deserves priority. A food pyramid based on Bangladeshi diets may be of interest in this regard. It may assist in nutrition education. We are certainly at a critical juncture. Resources are dwindling and time is fleeting. A concerted effort is needed to unite all the donor agencies, nongovernment organisations, government departments, private sector and academic institutions so that duplication of efforts are minimised and the results are obtained in shorter time to benefit the population.

In conclusion, we can expect that Bangladesh will continue to attach great importance to sustain the level of development. The emphasis should not only be on research and development in improving production and usage of improved seeds for staple foods, but also in the diversification of food of plant and animal origin. One can hope that the question of meeting the goal of providing better and balanced nutrition will stimulate the Bangladeshi planners towards diversification of crops in all segments of agriculture that includes cereal, oilseed, horticulture, aqua-culture, beef and mutton production and poultry and dairy farming.

Kamal Hyder, a doctorate in Food Science and Technology from Texas A&M University, is professional member of the Institute of Food Technologists of USA and member of the American Institute of Chemical Engineers.