Filetype PDF | Posted on 04 Jan 2023 | 2 years ago
Authentication
digital resources
191x Filetype PDF File size 0.48 MB Source: www.nin.res.in
[Downloaded free from http://www.ijmr.org.in on Tuesday, March 19, 2019, IP: 14.139.95.100]
Review Article Quick Response Code:
Indian J Med Res 148, November 2018, pp 477-487
DOI: 10.4103/ijmr.IJMR_2061_18
National Institute of Nutrition: 100 years of empowering the nation
through nutrition
1,† †
SubbaRao M. Gavaravarapu & R. Hemalatha
1 †
Media, Communication & Extension Group, Extension & Training Division, ICMR-National Institute of
Nutrition, Hyderabad, India
Received November 11, 2018
The National Institute of Nutrition (NIN) has reached a remarkable milestone of completing 100 years
of exemplary service to the nation. The long journey that started in a humble one-room laboratory
at Coonoor (now in Tamil Nadu) in 1918 to a colossus of the nutrition research in the country today
is dotted with several interesting vignettes. The NIN has always been at the forefront of need-based,
pragmatic research. Its large-scale community-based interventions have been of great practical value in
the nation’s fight against malnutrition. The evolution of nutrition as a modern science almost coincides
with the growth of the Institute. Being the oldest in the fraternity of institutes under the Indian Council
of Medical Research (ICMR), the NIN has grown from strength to strength due to the sheer relevance of
its contributions in furthering nutrition science and promoting public health in the country. This article
provides a historical overview of the evolution and contributions of ICMR-NIN in the areas of nutrition,
food safety, public health and policy.
Key words Food safety - NIN - Nutrition Research Laboratory - nutrition - public health nutrition
Introduction unit transformed into Deficiency Diseases Enquiry
The long journey of the National Institute of in 1925 and then to Nutrition Research Laboratories
Nutrition (NIN) of the Indian Council of Medical (NRLs), which in turn metamorphosed into the NIN in
Research (ICMR) at Hyderabad, India, from a humble 1958. Being the oldest institute in the ICMR fraternity,
one-room laboratory at Coonoor to the picturesque the NIN has contributed significantly in the area of
sprawling campus in the historic city of Hyderabad is nutrition science and public health in the country.
dotted with several interesting landscapes. The NIN The story of genesis
has completed its 100 years journey in November Sir Robert McCarrison, the founder Director of
2018. The emergence of nutrition as a modern science NIN, is justifiably credited to be the father of nutrition
almost synchronized with the starting of systematic
nutrition research in 1918 when Beri-beri Enquiry Unit research in India. After some early studies on iodine
was established at Coonoor by the Indian Research deficiency disorders (IDDs) in the sub-Himalayan
Fund Association (IRFA) (now ICMR). This enquiry areas, McCarrison’s research was kept in abeyance due
© 2018 Indian Journal of Medical Research, published by Wolters Kluwer - Medknow for Director-General, Indian Council of Medical Research
477
[Downloaded free from http://www.ijmr.org.in on Tuesday, March 19, 2019, IP: 14.139.95.100]
478 INDIAN J MED RES, NOVEMBER 2018
to the First World War. Returning from the active war (ii) Continuously monitor diet and nutrition situation
service in 1918, McCarrison proceeded to south India of the country.
to join the Pasteur Institute in Coonoor. It is here, in (iii) Evolve effective methods of management and
the salubrious Nilgiri hills, that the journey of nutrition prevention of nutritional problems keeping the
research in India began from a one-room laboratory in existing economic, social and administrative
the Pasteur Institute. McCarrison was recalled to Britain set-up in view.
in 1920 and he returned only in 1922, but the Unit was (iv) Conduct operational research connected with
1 planning and implementation of national
axed on financial grounds in 1923 . Two years later,
due to McCarrison’s concerted efforts, it was restored nutrition programmes.
as the Deficiency Diseases Enquiry. Around the same (v) Dovetail nutrition research with other health
time, the Royal Commission on Agriculture was programmes of the government.
appointed to report on the Indian agricultural practices (vi) Develop a band of young scientists, teachers in
and policy under Lord Linlithgow (who later became medical schools and health workers, well trained
the Viceroy of India) and he was keenly interested in nutrition.
in McCarrison’s work. In 1926, the members of the (vii) Disseminate nutrition information for institutional
Royal Commission paid a visit to Coonoor to acquaint and community benefit.
themselves with the work, and McCarrison took this (viii) Advise governments and other organizations on
opportunity to submit a memorandum on ‘Malnutrition issues relating to nutrition.
as a cause of physical inefficiency and ill health among Establishment of research centres
masses in India’, which highlighted the connection In the 1970s, the Institute further widened its scope
between nutrition and agriculture. The memorandum of research with the establishment of the following
also emphasised the need for closer co-ordination three important centres:
of research among diverse fields such as nutrition, (i) National Nutrition Monitoring Bureau (NNMB)
medicine, veterinary and agricultural sciences in India. was set up under the ICMR in 1972 in 10
The Commission realized that nutrition research had States. The Bureau through regular and periodic
a fundamental role in agricultural development in surveys generated a dynamic database on diet and
India and soon recommended in their report that there nutritional status of the communities regularly till
was a need to establish a central institute for nutrition
2 since 1975. These studies included repeat surveys
research . Taking advantage of this recommendation, among rural, tribal and urban population.
McCarrison submitted a proposal to the IRFA that the (ii) Laboratory Animals Information Service (LAIS)
unit under him be recognized as equivalent to a central which was earlier housed in Haffkines Institute,
2
institution . It was in 1929 that the unit in Coonoor Bombay (now Mumbai) was shifted to the premises
came to be known as the NRLs and became the of the NIN in 1976. It was renamed as Laboratory
only institution in India to be exclusively devoted to Animal Information Service Centre (LAISC). In
research in human nutrition. By 1935, the NRL had six 1995, it was re-designated as the National Cancer
rooms including a lecture hall and a nutrition museum for Laboratory Animal Sciences (NCLAs). This has
3
on the second floor of the Pasteur Institute in Coonoor . been elevated as a full-fledged research institute,
In 1949, the IRFA was re-designated as the ICMR with National Animal Resource Facility for Biomedical
an additional scope of work and responsibilities. Under Research (NARFBR) in 2017.
ICMR, earlier institutes, including NRL, were expanded (iii) Recognising the significant contributions made
and many new research institutes were set up. The year by the NIN in food toxins research, Food and
1969 marked the Golden Jubilee celebrations of NRL Drug Toxicology Research Centre (FDTRC) was
on completion of 50 yr of its existence. In recognition established by the ICMR in 1978.
of its yeomen contributions to nutrition research, the
governing body of ICMR renamed and re-designated Highlights of research achievements
2,4
NRL as the National Institute of Nutrition (NIN) . Early studies on nutrient deficiency disorders
5
Objectives of NIN While epidemiological studies on beriberi were
(i) Identify various dietary and nutrition problems 1
continued during the early decades of its founding ,
prevalent among different segments of the special surveys were conducted on beriberi in endemic
population. areas as well as among tribal population in Bihar
[Downloaded free from http://www.ijmr.org.in on Tuesday, March 19, 2019, IP: 14.139.95.100]
GAVARAVARAPU & HEMALATHA: 100 YEARS OF NIN 479
region. The studies on parboiled and milled rice helped and rewritten with data obtained after updating some
to explain the incidence of beriberi among rice eaters in methods of nutrient estimation and was published as
17
the east coast of Andhra region where milled rice was ‘Nutritive Value of Indian Foods’ in 1970s . Analysis
consumed largely and no incidence in Madras where of foods for their nutrient composition has been the
6,7 basis for the periodical revision of this publication.
parboiled rice was consumed more . Systematic
epidemiological investigations have demonstrated that More recently, the database profiling the nutritive
beriberi has characteristic effects on the chronological values of Indian foods has been readied in 2017.
8,9
pattern of infant mortality . NRL’s focus also turned Adopting the ‘key foods approach’, that contributes up
towards goitrogenic substances, epidemic dropsy, to 75 per cent of the nutrient intakes considered. Using
burning feet and bladder stones. Stomatitis associated latest techniques and precision tools, the new ‘Indian
with the deficiency of B group of vitamins, particularly Food Composition Tables (IFCT) 2017, were brought
riboflavin, was described for the first time in India, and out. The IFCT 2017 is the compilation of nutritional
a treatment with yeast and skimmed milk was found to information on 151 discrete food components for 528
2,10,11
be effective . key foods. The IFCT, for the first time in the Indian
The need to add a clinical dimension and conduct context, attempted to provide information on almost all
systematic clinical trials was felt, and C. Gopalan was regular nutrients in foods alongside a whole range of
18
appointed as the clinical assistant to study diarrhoea bioactive substances .
and nutritional disorders at the Clinical Unit established Formulation of recommended dietary allowances
at Stanley Hospital in Madras (Chennai). This clinical (RDAs)
unit was the first to describe a clinical condition called The first recommendations on Recommended
‘burning feet syndrome’, which was found to be due to Dietary Allowances (RDA) were made for the Indian
vitamin B deficiency, and prescribed its treatment with context in 1944 based on the recommendations of the
2, 12,13
vitamin B (pantothenic acid) . 3,4
Health Committee of the League of Nations (1937) .
Nutritive values of Indian foods Later, the RDAs were modified in the early 1960s, and
19
One of the important contributions of NIN has then in the early 1970s, 1980, 1991 and last in 2010 .
been the assessment of nutritive values of commonly An expert group constituted by the ICMR in 2008
consumed Indian foods. This was first taken up in 1935 revised and updated the nutrient requirements as well
and was completed in two years. Chemical analysis was as dietary allowances for Indians. Data generated in
performed on more than 200 foods for nutritive values India by NIN earlier became the basis and RDAs were
(energy, carbohydrate, protein, fat, vitamin and mineral revised compared to the previous versions of 1944,
contents). Besides employing the already established 1958 and 1968. Recommendations for minerals such as
methods for vitamin analyses, newer and improved calcium, phosphorus, zinc, selenium and iodine have
methods of analyses were employed, especially for the been included as separate chapters.
10,14 Dietary guidelines for Indians
estimation of niacin, carotene and some B vitamins .
‘The Nutritive Value of Indian Foods and Planning of A manual with information on the key practicable
Satisfactory Diets’ was published in 1937, in Health points for diets and physical activity for Indians to
Bulletin No. 23, which turned out to be a very popular ensure optimal health and freedom from disease was
15
contribution . Apart from this, the nutritive values proposed for the first time in 1998. In 2011, after the
of fruits and vegetables were also determined during RDAs were revised and the guidelines were redrafted,
1960s. The project on nutritive values of Indian foods 20
was initiated at four centres (Coonoor, Bombay, the revised version was released .
Ambala and Mysore) and this work helped to fill gaps in Studies on protein-energy malnutrition (PEM)
the earlier ‘Health Bulletin’. This work generated new Studies were conducted on protein-energy
data on nutrient as well as non-nutrient components malnutrition (PEM) among infants, and some feeding
in a number of foods. The data from all the centres trials were also conducted among children to study
were compiled, and Health Bulletin No. 23, brought the effect of skimmed milk on their nutritional status,
out earlier, was updated and revised. The revised which Aykroyd3 claimed as the first-ever studies to
edition was published as ICMR Special Report No. give reconstituted skimmed milk powder to children in
16
42 in 1962. This publication was thoroughly revised a developing country and to show that this supplement
[Downloaded free from http://www.ijmr.org.in on Tuesday, March 19, 2019, IP: 14.139.95.100]
480 INDIAN J MED RES, NOVEMBER 2018
accelerated growth and improved the general condition. nutritional status of children in rural areas and in urban
In fact, in later years, skimmed milk powder has been slums, which was operated under the Integrated Child
4
given to a large number of children suffering from Development Scheme (ICDS) .
PEM and has proved a lifesaver3. The two severe Contribution to the National Prophylaxis Programme
forms of protein-calorie malnutrition investigated against nutritional blindness due to vitamin A
during the 1960s by the Institute were kwashiorkor and deficiency (NPPNB due to VAD)
21-23
nutritional marasmus . Detailed studies have been
undertaken on the dietary intakes and the biochemical During the 1960s, after some preliminary clinical
status of children manifesting these different forms of trials , the effect of oral administration of a large dose
malnutrition with a view to understand the common of vitamin A on serum vitamin A of 2500 children
aetiological background. It was around this time that was studied. Based on this study outcome, the NIN
the dietary intake data from urban-rural multicentric recommended administration of 200,000 IU each to
community studies on the diets of preschool children children at six-monthly intervals to avoid immediate
were thoroughly examined for their energy and protein toxic manifestations and for providing effective and
intakes. It turned out to be a surprising revelation consistent cover against vitamin A deficiency (VAD)2.
that the protein concentration of their diets was This paved the way for a nationwide vitamin A
nearly adequate contributing to about 10 per cent of prophylaxis programme with its inclusion in the Fourth
26
their energy; however, the average energy intake was Five-year plan in 1969 .
24
grossly deficient . This analysis paved way for a new Another landmark operational research carried out
hypothesis that the malnutrition among underprivileged by the NIN was the feasibility study to link the National
children was due to energy deficiency and not solely Programme for Vitamin A Supplementation to prevent
due to protein deficiency. The large-scale community nutritional blindness among young children with a
studies were initiated to test this hypothesis and this universal immunization programme (UIP) to increase
view was soon endorsed even by UN organizations like its coverage. In spite of its implementation for over two
WHO and UNICEF2. decades, the coverage for vitamin A supplementation
Studies were carried out to assess whether the poor was very poor. The NIN had carried out the above
mental performance of the children is solely attributable operational research in seven States of India and showed
to the earlier episode of kwashiorkor or to other causes that it was feasible to link Vitamin A Supplementation
as well. The observations showed that non-nutritional Programme with the existing high-coverage trends of
factors, particularly maternal attitudes, played an UIP27. Based on the recommendations of the NIN, it
equally important role in the mental development of became a national programme and is being implemented
25 throughout India, and the coverage of vitamin A
children . supplementation has increased to over 70-80 per cent in
Contribution to national programmes and policies the later years. The prevalence of VAD disorders such
Providing nutrient requirements for national as Bitot spots and other ocular signs has significantly
2
programmes aimed at vulnerable groups declined in later years .
The NIN through NNMB carried out nutritional Supplementation of iron and folic acid to pregnant
assessment surveys on individuals as well as on women
families, covering different age groups and different In 1968, a professional body that emanated earlier
socio-economic groups. NNMB reports have been from NIN, the Nutrition Society of India, set up a study
used by nutritionists, epidemiologists, policymakers group on nutritional anaemias under the leadership of
and more so by the Planning Commission in those Gopalan with leading nutritionists and haematologists
days. One of the most significant research findings of of those times as members. After carefully examining
the Institute in the 1960s was that the prevalence of various studies carried out in India till then, the study
severe forms of malnutrition among preschool children group recommended that a programme of iron folate
was mainly due to energy deficiency and not due to supplementation be taken up for pregnant women
24
protein deficiency, as was assumed for many decades . and preschool children as a prophylactic measure.
This was one of the bases for the Government of The government introduced the National Nutritional
India in the 1970s, to launch a supplementary feeding Anaemia Prophylaxis Programme aimed at pregnant
28
programme to provide 300 Kcal/day to improve the women and young children in 1970 .
no reviews yet
Please Login to review.
