|Year : 1992 | Volume
| Issue : 4 | Page : 106-108
Compendium of dietary sources of vitamin A in the Thar desert
Sanjiv Desai, Rajiv Desai, Navin Desai
Tarabai Desai Eye Hospital, E-22. Shastri Nagar, Jodhpur-342 00, India
UNICEF Project, The Tarabai Desai Eye Hospital, E-22, Shastri Nagar, Jodhpur - 342 003
Source of Support: None, Conflict of Interest: None
The undisputed long term solution to prevent nutritional blindness lies in changing the dietary habits of a given population through nutritional education, nutritional supplementation, and nutritional rehabilitation. Before such strategies can be successfully implemented, it becomes necessary to study the existing dietary pattern of the population and to identify locally grown foods rich in vitamin A. Seventy eight rural women were interviewed to determine the common dietary items in western Rajasthan. These items were then matched with their B-carotene contents, only to discover that, 100 grams of any of them would not provide the RDA for a 1-3 year old child, with the exception of Suva (Peucedanum graveolens) and Bathua (Chenopodium album) leaves. The B-Carotene contents of several food items is unknown at present and there is an urgent need to evaluate them.
|How to cite this article:|
Desai S, Desai R, Desai N. Compendium of dietary sources of vitamin A in the Thar desert. Indian J Ophthalmol 1992;40:106-8
| Introduction|| |
Xerophthalmia, the blinding scourge, is rampant in western Rajasthan. A prevalence rate of 14.6 percent has been elucidated for this desert region and it has been found to be of major public health importance . The six districts which comprise western Rajasthan are largely arid and desert. The region is home to the great Indian Thar desert which spans three administrative districts. Due to scanty rainfall and recurrent droughts and famine, morbidity due to Xerophthalmia is high  Studies have revealed that in drought years Xerophthalmia prevalence may rise threefold in this district . Several factors lead to the poor Vitamin A status in this region, prime among them being dietary. Production of Vitamin A rich foods is poor in this region and so is its consumption. A study has revealed that Vitamin A rich foods are cultivated in 0.049 percent of the total cultivated land and it accounts for 0.045 percent of the local annual produce . Furthermore, the problem is compounded by ignorance which leads inhabitants to believe that green leaves are cattle fodder unfit for human consumption . To combat Xerophthalmia in this region, one usually banks upon Vitamin A supplementation in the form of megadosing  which is time consuming and a short term strategy. The ultimate solution lies in changing the dietary habits of the community through nutrition education. But before such strategies can be implemented it becomes mandatory to study the existing dietary pattern of the population and to identify the locally grown food stuff which are rich sources of Vitamin A. This communication is a compendium of the dietary habits and sources of Vitamin A. available to the population of this desert region. The data presented herein can be used to design long range activities like home gardens or can be used as resource material in planning nutrition education programmes in this region.
| Recommended daily allowance|| |
The minimum daily requirement of nutrients which is commensurate with the well being of an individual have been determined for several groups of nutrients including Vitamin A. Knowledge of RDA is essential for planning any nutrition education or nutrition rehabilitation service. Daily intake of Vitamin A is essential both for adults and children. Since Xerophthalmia is common in the latter group we shall only consider the RDA of this important group. Since it is not uncommon to see Xerophthalmia in adolescents, an age group of 0-15 years has been considered in this study. [Table - 1] lists the RDA of Vitamin A, as determined by the Nutrition Expert Group of ICMR in 1968 . Weaning starts at the age of 6 months and by then the child has accumulated adequate liver stores of Vitamin A through breast milk (137 IU/100 ml.) to last a year. Between age 1 to 3 years an RDA of 250 ug. of Retinal has been determined. With growth of the child it increases and in the age range 10 to 12 years RDA is 600 ug. Beyond 12 years of age RDA approaches the adult status of 750 ug/day. Any food substances which are being considered for nutritional rehabilitation and home garden projects must, therefore, ensure that they provide enough dietary sources of Vitamin A to cover the RDA of the population under consideration.
| Daily diet in western rajasthan|| |
To determine the common dietary items in rural families, 78 adult women were interviewed in five villages which were close to Jodhpur. From these informal interviews, an inventory of food items consumed by the average rural family in western Rajasthan, was drawn [Table - 1]. Inclusion of the items in this list was based on the fact that at least 50% of the interviewees should have given an affirmative response against that particular food stuff. The B-Carotene values listed against these items has been derived largely from ICMR studies . The B-Carotene content of these foods ranges from nil in onions to 7182 ug/100 gms in Suva leaves (Peucedanum gravelens). The B-Carotene contents of several common dietary foods like kumathia (Acacia Senegal), Sangri (Prosopis cineraria), Kachra (Cucumis callosus), and Guarpatta (Aloe vera) have not yet been identified. A diet of Bajra roti (Sogra) and Onion or Green chillies which forms the staple diet of the vast multitudes of the rural poor can hardly be expected to maintain the RDA of Vitamin A. In fact 100 grams of any of these food items alone with the exception of Suva and Bathua leaves, would not provide the RDA to the three year old child.
| Discussion|| |
Adequate body stores of Vitamin A are necessary not only for prevention of Xerophthalmia, but are equally important in preserving the integrity and maintaining the function of several organs in the body.Recent evidence conclusively establishes the role of this Vitamin in preventing neonatal and childhood morbidity and mortality . The breast fed infant depends on its Vitamin A supply from maternal milk. Deficiency of this prosperity Vitamin in maternal milk is detrimental to the health of the infant . The consumption of Vitamin A rich foods by the people of western Rajasthan is known to be poor . This area is arid in nature and houses the sandy plains of the great Indian Thar Desert. Because of recurrent droughts and the attendant social evil of poverty, the production and consumption of such foods by pregnant and lactating mothers is bound to have far reaching consequences on infant mortality and morbidity also. The solution to this problem lies in changing the dietary habits of not young children but also of pregnant and lactating mothers through nutrition education. This compendium can help one to choose or recommend a diet which is best suited to supply adequate B-Carotenes in a given situation.
Obviously, a sea change in the dietary habits of the population can only be effectuated gradually over time. In children this can begin in school by the judicious use of nutrition education and supplementary feeding programmes. For neonates, motivational efforts with the mother should be begun during the antenatal visits, when the gynecologist or the nurse could show her the benefits of consuming vitamin A rich foods.
In the desert region of Rajasthan if such knowledge has to be imparted there is very little to choose from[Table - 2]. With the exception of Suva and Bathua leaves all the other common edible items are poor in Vitamin A content. We expect Onion leaves and Guarpatta (Aloe Vera) to contain a high quantity of B-Carotene but until a biochemical analysis is done we cannot comment with certainty. A biochemical study of these and other dietary items identified in this report [Table - 2] is urgently called for.
Suva (Peucedanum graveolens) and Bathus leaves (Chenopodium album) have been identified to contain an abundant source of Vitamin A.
Unfortunately they are eaten very occasionally because the proud rural folk dismiss all edible leaves as cattle fodder, unfit for human consumption . Nutrition education to children, adults and specially to pregnant women and young mothers should drive home the point that these leaves are not only nourishing to them but also instrumental in protecting the infant from blindness and general morbidity and mortality Furthermore any nutritional supplementation and horticulture programmes, planned for western Rajasthan should have as their key ingredients these two edible leaves as they are cheaply available in abundant quantities in the desert expanse.
| References|| |
Desai NC : The Xerophthalmic profile in desert regions; Afro-Asian J. Ophthalmol., 5(1) 20-22, 1986.
Desai NC, Desai S, Desai R: Xerophthalmia clinics in rural eye camps; Proc. XXVI Int. Cong. Ophthalmol., Singapore, 1990 (impress).
Annual Report, Desert Medical Research Centre (DMRC), Jodhpur, 1987.
Annual Report, Desert Medical Research Centre (DMRC), Jodhpur. 1988.
Desai NC, Bhargawa G : The Xerophthalmia clinic - an essential appendage to the rural eye camp: Raj. J. Ophthalmol., 11:50-52, 1986.
Gopalan C, Ramashastri B V, Balasubramanian SC: Nutritive value of Indian Foods, 1st ed; National Institute of Nutrition, Hyderabad pg. 26-28, 1982.
Vijayaraghavan K, Radhaiah G, Suryaprakasam B et al: Effect of massive dose Vitamin A on morbidity and mortality in Indian children; Lancet, 336: 1342-45, Decl, 1990.
Rahamatulla L, Underwood B A, Thulasiraj R D et al; Reduced mortality among children in Southern India receiving a small weekly dose of Vitamin A; New. J. Med., 323(4): 929-35, 1990.
Sommer A, Katz J, Tarwotjo I : Increased risk of respiratory disease and diarrhoea in children with preexisting mild Vitamin A deficiency; Am. J. Clin. Nutr., 40:1090-95, 1984.
Sommer A, Tarwatjo I, Djunaedi E et al: Impact of Vitamin A supplementation on childhood mortality: a randomised controlled community trial; Lancet 1 : 1169-73, 1984
Gautam M: Dietary influence of Vitamin A intake among mother and children of the hills/mountains of Nepal; Abstracts of the National Symposium and XIII IVACG meeting, Kathmandu, November 1989, pg. 71.
[Table - 1], [Table - 2]