Provision of Preventive or Maintenance Support in the form of Nutraceuticals/Dietary Supplements/functional foods/cosmeceuticals could be an effective health intervention for the needy populace at all life stages in diverse environmental conditions to deal with the direct and indirect effects of climate change. Indian Scenario: The Government of India needs to enhance the scope and implement additional strategic action plans for adaptation to health impacts due to climate change. Accordingly, thrust on nutritional and health supplements as preventive or maintenance strategy to counter the health impacts due to climate change is essential right from the planning stages.
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Presenter: Dr. Sridhar R Food and Nutritional/Health Supplements- An Adaptive (Preventive/Maintenance) Intervention for Addressing the Health Impacts due to Climate Change Dr. Sridhar Rudravarapu Consultant-R&D Bluemea Therapeutics Pvt. Ltd., Hyderabad E-mail: [email protected]Strategies for Climate Change Mitigation and Adaptation towards Sustainable Development National Conference- Organized by IPE , UCT-OU & CRIDA 20-21 Feb, 2013 – IPE, Hyderabad, INDIA
Transcript
Presenter: Dr. Sridhar R
Food and Nutritional/Health Supplements-
An Adaptive (Preventive/Maintenance) Intervention
for Addressing the Health Impacts due to Climate Change
Current Proposals/Suggestions- Adaptation to the Climate Change Stress
Conclusion
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
Presentation Contents
Presenter: Dr. Sridhar R “Strategies for Climate Change Mitigation and Adaptation towards sustainable development”
National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
Scenario
Climate change: The biggest global-health threat of the 21st century (The Lancet and UCL Report, 14 May 2009).
“Lambasingi” a remote village in Andhra Pradesh, India is witnessing temperatures as low as -1 C.
While this impact of climate change is generating exciting scope for winter tourism in Andhra Pradesh,
Otherwise it is impacting the health of Lambasingi’s population!
INDIA >1.2 billion people *
Nutritionally vulnerable groups due to climate change (include ones undergoing rapid
growth and development)
(India- Second National Communication to the United Nations Framework Convention on Climate Change,
2012, Ministry of Environment & Forests, Government of India).
*Representing various socio-cultural groups residing in diverse environs classified into
Mountainous terrain (Himalayan range, Western Ghats); Northern Plains;
Peninsular Plateau; Deserts; Coastal plains (East and West coast) &
Island groups (Andaman & Nicobar, Lakshadweep).
Presenter: Dr. Sridhar R
Climate Change-- Factors & Health Impacts
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
Indirectly through changes in
Ranges of Disease Vectors (e.g., mosquitoes); Water-borne Pathogens
Drought & coastal flooding increase the risks of infection from water & vector-
borne diseases, diarrheal diseases along with trachoma effects (WMO-No.1098, 2012, Atlas of Health and Climate, World Health Organization and World
Meteorological Organization, Geneva).
Water Quality- Increased acidity of water a Greater proliferation of microbes
a Spread of several food borne pathogens (NIEHS, 2010; A human health
perspective on climate change- A Report outlining the research needs on the human health
effects of climate change].
Air Quality- Increased average temperatures, frequent & severe heat events
increase the risks of heat-related illness. Air pollution results in adverse allergen-
induced respiratory responses due to increases in regional ambient
concentrations of ozone, fine particles, and dust.
Globally more than 300 million people are asthma affected due to higher
pollen and other aeroallergens triggered by extreme heat (WHO Fact sheet N°266, 2012).
Food availability & Quality
(Majra, JP & Gur, A 2009, ‘Climate change and health: Why should India be concerned?’
Indian J Occup Environ Med., vol.13, no.1, pp.11–16).
Directly
for example
Thermal stress
Death/injury in
floods & storms
Increased exposure to
UV radiation
(can lead to skin cancers,
cataracts and damage to
DNA)
Presenter: Dr. Sridhar R
Food borne illness and food insecurity
Leads to malnutrition and the resultant vulnerability to infectious diseases and illnesses (WHO 2012, Fact Sheet-10; Facts on climate change and health)
NNMB Surveys have shown that the agricultural laborers are worst affected in drought due to the above conditions.
The urban population fares slightly better with 27% consumption compared to 21% in rural population. [Ninth Five Year Plan (vol.2) 2001, Agriculture, Irrigation, Food Security and Nutrition, Planning Commission, GoI].
Deficiency of micronutrients
e.g., copper, zinc, pyridoxine and vitamin B12 can also lead to anemia resulting in weakness, diminished physical and
mental capacity; increased morbidity from infectious diseases, premature delivery, low birth weight in women, and
impairment of cognitive performance, motor development, and scholastic achievement in children [Steering Committee-Nutrition Report 2001, Planning Commission, GoI;
Working Group Report on Nutrition for the Twelfth Five Year Plan 2011, Ministry of Women and Child Development, GoI].
Chemicals and metals accumulated in foods
may affect fetal development, immune function; exacerbate neurological deficits and learning disabilities in children [NIEHS 2010].
In the face of limited access to health facilities, the poor, elderly, children, disabled and those with preexisting respiratory
and cardiovascular diseases are likely to be most vulnerable to the climate change impacts . [Centers for Disease Control and Prevention 2010, Health effects, Climate and Health Program, NCEH, USA]
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
Climate Change– Food Factors & Health Impacts
Climatic changes could affect variedly at different stages of life starting from the human
development in the womb to the later lifelong developmental deficits.
Presenter: Dr. Sridhar R
Planning Commission, Government of India
National Action Plan on Climate Change
Supported by eight national missions to meet the challenges
of climate change and towards its adaptation
(The state governments get involved in this planning and
implement actions in pursuance of the goals of NAPCC).
The NAPCC objectives
mostly deal with the UNFCCC identified responses i.e.,
mitigation of climate change by reducing greenhouse-gas
emissions & enhancing sinks, and adaptation to the impacts
of climate change.
A suggestion for provision of enhanced public health care
services and assessment of increased burden of vector-borne
diseases due to climate change was mentioned last in this list !
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
ICMR – Initiative
•Specific Sector Recommendations
for health protection in four areas of risks arising
from climate change, such as
(a) Vector borne diseases
(b) Aerosols and respiratory diseases
(c) UV-A, UV-B, corneal damage and cataract
(d) Environment and heart diseases,
•Suggestions
for additional focus on diarrheal and viral
diseases, heat stress and certain types of cancer
such as skin cancer (Sub-Group Report on Climate Change 2011, Climate
Change & 12th Five Year Plan, Planning Commission, GoI).
Adaptive Interventions– Health Diseases INDIA- In the case of the health sector, most of the adaptation responses have been reactive instead of preventive.
Health impacts projected due to climate change necessitate being prepared and responding for the adaptation.
* The Strict technical definition for adaptation according to international convention
on climate change, does not address the health impacts due to climate change.
Presenter: Dr. Sridhar R
Health- Plans & Strategies Nutrition INDIA - General Nutritional Interventions
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
The Central and State Governments in India are tackling the under-nutrition problem by direct interventions through
an array of health & nutrition schemes, such as the NNM, NRHM, ICDS, mid-day meal and R&CH programs.
The outcome of these nutritional programs is that
Child mortality rate 250/1000 in 1960 a 65.6/1000 in 2009
Infant mortality rate 64.9/1000 in 2000 a 47.57/1000 in 2011
10th Five Year Plan - A welcome paradigm shift from ‘Food Security’ to ‘Nutrition Security’ to meet the needs of the
macro, micro and phyto nutrients through dietary diversification has been suggested.
It was surmised that adequate intake of micronutrients achieved through consumption of variety of inexpensive plant
foods will go a long way in prevention of many micronutrient deficiencies. [Saha, P.K. 2007, Food based interventions for improving malnutrition in India, Presentation-Ministry of Agriculture]
While this could hold well in the normal conditions, alternative quick replenishment arrangements are necessary during the
critical situations of climate change impacts.
Nutrition Security: The Food & Nutrition Board, 2011 (Ministry of Women & Child Development) suggested the
inclusion of processed cereal-based foods (with minimum of 50% cereal content, 12% protein content and 1g/kcal
energy density content of the product) by community food and nutrition extension units to the infants, underweight
and young children.
Adequate intake of vitamins, minerals, essential fatty/amino acids is vital for maintenance of a wide variety of metabolic
functions critical for health.
Presenter: Dr. Sridhar R
Nutritional Interventions – Further Steps ‘Nutrition Specific’ or ‘Nutrition Sensitive’ intervention is a mandate of this age.
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
Longer the period of rehabilitation consequent to a climatic adverse event, greater is the gap
for compensating the catch up growth in children affected with under nourishment due to
continuously inadequate dietary intake.
While adult humans exposed to mild famine usually recover quite well when food again
becomes plentiful, nutritional reductions to a fetus in the womb appear to have lasting effects
throughout life (NIEHS, 2010).
An Approach Paper to the 12th Five Year Plan regarding food and nutrition security (2011)
underlined the importance of disease prevention and identified nutrition as a preventive
determinant of health. It also highlighted the need for convergence of schemes across ministries
as an important investment in this exercise.
[Working Group-1 Report for the 12th Five Year Plan (2012-2017), Progress and Performance of National Rural Health Mission
and Suggestions, Planning Commission, GoI].
“Better health is not only about curative care but also about better prevention”
(Working Group-7 AYUSH Report for the 12th Five Year Plan (2012-2017) ; 2011, Planning Commission, Government of India).
Presenter: Dr. Sridhar R
The Government of India needs to enhance the scope and implement
additional strategic action plans for adaptation to health impacts due to
climate change.
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
Current Proposals/Suggestions
Five year plans applicable in the near future and further hence need to incorporate
preventive health/maintenance strategies & enhance the emergency health response
features for the climate change affected people
*Based on census information from reliable data sources covering diverse regions.
*It is important for the relevant working groups and steering committees to thrust on nutritional
and health supplements as preventive or maintenance strategy to counter the health impacts of
climate change.
Effective and enhanced focus on health intervention is possible only with
advance preparation by first identifying the critical needs, prioritizing and
timely executing with a close collaboration between climate and health
services along with other supportive institutions and mechanisms.
Presenter: Dr. Sridhar R
Current Proposals/Suggestions Adaptation to Climate Change Stress
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
Research & Development:
While a ready cooked and packaged food serves immediate hunger needs by
saving cooking time and overcoming inaccessibility of fuels,
on the deficient nutritional support and preventive health/maintenance front,
R&D efforts in the Government and Industry sectors need to focus on
Nutraceuticcals/Dietary Supplements:
Preparation of low cost and effective concentrate forms
(tablets/capsules/ rehydratable powders/gels) or any other convenient
forms and in condensed packs amenable for easy transportation and
utilization to support short and mid-term requirements due to climate
changes.
Functional Foods:
Enriched/Fortified grain/nut powders including Quinoa, Amaranthus, Small millets etc.;
vegetable/fruit concentrates; canned soups, ketchups, sauces etc.
Presenter: Dr. Sridhar R
Current Proposals/Suggestions -Adaptation to Climate Change Stress
Nutraceuticals/Dietary Supplements:
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
Predigested Protein/Amino acid formulations
Milk powders fortified with omega-3 fatty acids; Enriched curd/yogurt powders
Probiotic powders (National research institutes and industry could be engaged for cheaper microbe production and ready cultures)
Bio-available essential nutrients (e.g., vitamin D3 for vitamin D),
Beneficial fatty acids/metabolites in convenient forms (syrups, nano-emulsions etc.)
Appropriately packaged water containing mineral micronutrients in concentrated form amenable
for dilution prior to consumption (Natural springs; salts; effective chelate forms could be made use of)
Health supplements focusing on body care- eye, ear, nose and dental care
Cosmeceuticals in the form of various topical applications to protect from various skin ailments &
radiation effects in addition to providing soothing and nourishing effects
Protein powders/concentrates; Dietary fibers; Digestive enzymes
(Personal care support an important complementary part of the total health care
hitherto was least focused during public response operations).
Presenter: Dr. Sridhar R
Conclusion
“Strategies for Climate Change Mitigation and Adaptation towards sustainable development” National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
Nutramobile
Provision of Preventive or Maintenance Support in the form of Nutraceuticals/Dietary
Supplements/functional foods/cosmeceuticals could be an effective health intervention for the needy
populace at all life stages in diverse environmental conditions to deal with the direct and indirect
effects of climate change.
Various Government schemes in operation in India along with setting up of Community Food Banks
could be of help to route the proposed health interventions.
The Government of India also needs to enhance the scope and implement additional strategic action
plans for adaptation to health impacts due to climate change. Accordingly, thrust on nutritional and
health supplements as preventive or maintenance strategy to counter the health impacts due to
climate change is essential right from the planning stages.
A mobile vehicle to support the dispensation/distribution of the food/health supplements
“Nutramobile” is proposed herewith.
(Nutramobile can be basically defined as a vehicle for transportation of nourishing food and
nutritional/health supplements to the needy populace in all regions affected by climate change impacts).
Presenter: Dr. Sridhar R “Strategies for Climate Change Mitigation and Adaptation towards sustainable development”
National Conference- 20-21 Feb, 2013 Organized by IPE , UCT-OU & CRIDA- Hyderabad, INDIA
