A COMMUNITY-BASED STUDY OF MILK ADULTERATION AND CHILDHOOD MALNUTRITION IN BANGALORE RURAL DISTRICT, INDIA

Authors

  • Amita Mukhopadhyay Associate Professor, Department of Community Medicine, Dr. Chandramma Dayananda Sagar Institute of Medical Sciences and Research(CDSIMER), Harohalli, Ramanagara District, Karnataka http://orcid.org/0000-0002-1202-649X
  • Ipsita Debata Assistant Professor, Department of Community Medicine, Dr. Chandramma Dayananda Sagar Institute of Medical Sciences and Research(CDSIMER), Harohalli, Ramanagara District, Karnataka http://orcid.org/0000-0002-8012-2811
  • Ravikiran P Kamate Assistant Professor, Department of Community Medicine, Dr. Chandramma Dayananda Sagar Institute of Medical Sciences and Research(CDSIMER), Harohalli, Ramanagara District, Karnataka http://orcid.org/0000-0003-4368-6383
  • Nagaiah Nagendra MBBS student, Akash Institute of Medical Sciences and Research Centre, Prasannahalli Main Road, near Kempegowda International Airport, Devanahalli, Bengaluru, Karnataka http://orcid.org/0000-0003-3057-4024
  • Priyanka Rodrigues Statistician (Former), Department of Community Medicine, Dr. Chandramma Dayananda Sagar Institute of Medical Sciences and Research(CDSIMER), Harohalli, Ramanagara District, Karnataka http://orcid.org/0000-0001-9132-3726

DOI:

https://doi.org/10.26555/eshr.v4i1.4641

Keywords:

Malnutrition, Milk adulteration, Under-five, Stunting, Underweight, Wasting

Abstract

Background: Milk promotes child growth; however, adulterated milk reduces nutritional value and exposes children to harmful chemicals. Therefore, this study aimed to assess the nutritional status of children aged 1–5 years living in the selected study area and test milk samples from the children's households for common adulterants. The study further aimed to explore the association between malnutrition and milk adulteration.

Methods: We used a community-based cross-sectional study design conducted in the service area of a tertiary healthcare institute in Bangalore Rural District, Karnataka state, India. Systematic random sampling was used to recruit 180 children aged 1–5 years. Primary data was collected through interviews, anthropometry, and strip tests for milk adulteration. Statistical analysis consisted of descriptive analysis, Chi-square tests, odds ratios, and 95% confidence intervals.

Results: Prevalence of underweight, stunting, wasting, and low Body Mass Index (BMI) was 13.33%, 38.33%, 15.0%, and 26.7%, respectively. General adulterants detected were neutralizers in 97 (53.9%) and maltodextrin in 90 (50%) samples. Higher proportions of stunting, underweight and low BMI were found in children drinking adulterated milk. Low BMI was significantly associated with joint family and lower maternal education.

Conclusion: Our study found a high prevalence of malnutrition in children, particularly stunting. The study also detected widespread adulterants in milk and a potential association with malnutrition. The authors recommend further studies with a larger sample size to accurately delineate the relationship between milk adulteration and malnutrition.

Author Biographies

Amita Mukhopadhyay, Associate Professor, Department of Community Medicine, Dr. Chandramma Dayananda Sagar Institute of Medical Sciences and Research(CDSIMER), Harohalli, Ramanagara District, Karnataka

Associate Professor,

Department of Community Medicine

Ipsita Debata, Assistant Professor, Department of Community Medicine, Dr. Chandramma Dayananda Sagar Institute of Medical Sciences and Research(CDSIMER), Harohalli, Ramanagara District, Karnataka

Assistant Professor,

Department of Community Medicine

Ravikiran P Kamate, Assistant Professor, Department of Community Medicine, Dr. Chandramma Dayananda Sagar Institute of Medical Sciences and Research(CDSIMER), Harohalli, Ramanagara District, Karnataka

Assistant Professor,

Department of Community Medicine

Nagaiah Nagendra, MBBS student, Akash Institute of Medical Sciences and Research Centre, Prasannahalli Main Road, near Kempegowda International Airport, Devanahalli, Bengaluru, Karnataka

MBBS Student

Priyanka Rodrigues, Statistician (Former), Department of Community Medicine, Dr. Chandramma Dayananda Sagar Institute of Medical Sciences and Research(CDSIMER), Harohalli, Ramanagara District, Karnataka

Former Statistician

References

UNICEF. Stunting [Internet]. 2017 [cited 2017 Nov 29]. Available from: http://unicef.in/Whatwedo/10/Stunting

Helping India combat persistently high rates of malnutrition [Internet]. 2013 [cited 2017 Nov 29]. Available from: https://www.worldbank.org/en/news/feature/2013/05/13/helping-india-combat-persistently-high-rates-of-malnutrition

Government of India. National Family Health Survey [Internet]. 2015 [cited 2017 Nov 29]. International Institute for Population Science. 2015. p. 1–5. Available from: http://rchiips.org/nfhs/pdf/NFHS4/KA_FactSheet.pdf

Longvah T, Toteja G, Upadhyay A. Iodine content in bread, milk and the retention of inherent iodine in commonly used Indian recipes. Food Chem. 2013;136(2):384–388. Available from: https://pubmed.ncbi.nlm.nih.gov/23122074/

Agrawal S, Millett CJ, Dhillon PK, Subramanian S, Ebrahim S. Type of vegetarian diet, obesity and diabetes in adult Indian population. Nutr J. 2014 Sep 5;13(89):1-18. Available from: https://pubmed.ncbi.nlm.nih.gov/25192735/

Harinarayan CV, Akhila H, Shanthisree E. Modern India and dietary calcium deficiency—half a century nutrition data—retrospect–introspect and the road ahead. Front Endocrinol. 2021 Apr 6;12:583654. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056136/

Dror DK, Allen LH. The importance of milk and other animal-source foods for children in low-income countries. Food Nutr Bull. 2011;32(3):227–243. Available from: https://pubmed.ncbi.nlm.nih.gov/22073797/

Misra S. Most Indians drinking adulterated milk, finds FSSAI survey [Internet]. 2012 [cited cited 2020 Feb 14]. Available from: https://www.downtoearth.org.in/news/most-indians-drinking-adulterated-milk-finds-fssai-survey--35646

Handford CE, Campbell K, Elliott CT. Impacts of milk fraud on food safety and nutrition with special emphasis on developing countries. Compr Rev food Sci food Saf. 2016;15(1):130–142. Available from: https://pubmed.ncbi.nlm.nih.gov/33371582/

Kandpal SD, Srivastava A, Negi K. Estimation of quality of raw milk (open & branded) by milk adulteration testing kit. Indian J Community Heal. 2012 Jul;24(3):188–192. Available from: https://www.iapsmupuk.org/journal/index.php/IJCH/article/view/248/248

Singh P, Gandhi N. Milk preservatives and adulterants: processing, regulatory and safety issues. Food Rev Int. 2015 Jul 3;31(3):236-261. Available from: https://www.tandfonline.com/doi/abs/10.1080/87559129.2014.994818

Government of India. Karnataka Population Census data 2011 [Internet]. 2017 [cited 2021 Aug 13]. Available from: https://censusindia.gov.in/2011-Common/CensusData2011.html

Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in medical studies. Gastroenterol Hepatol Bed Bench. 2013 Winter; 6(1): 14–17. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017493/

World Health Organization. Training Course on Child Growth Assessment. Geneva: WHO; 2008. Available from: https://www.who.int/childgrowth/training/module_b_measuring_growth.pdf

Food Safety Helpline. FSSAI shares testing methods to find adulteration in Milk & Milk Products [Internet]. 2014 [cited 2019 Jan 23]. Available from: https://foodsafetyhelpline.com/fssai-shares-the-testing-methods-for-adulteration-in-milk-milk-products/

United News of India. Milk testing strip developed by NDRI scientists of Karnal [Internet]. 2016 [cited 2019 Jan 23]. Available from: http://www.uniindia.com/milk-testing-strip-developed-by-ndri-scientists-of-karnal/states/news/443849.html

Sharma R. Revision of Prasad’s social classification and provision of an online tool for real-time updating. South Asian J Cancer. 2013;2(3):157. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3892518/pdf/SAJC-2-157.pdf

Meshram II, Rao MK, Reddy CG, Ravindranath M, Sharad Kumar S, Sreerama KK et al. Prevalence of under nutrition and its predictors among under 5 year children in Surat region, Gujarat, India. J Clin Nutr Diet. 2016;2(1):1-12. Available from: https://clinical-nutrition.imedpub.com/prevalence-of-under-nutrition-and-its-predictors-among-under-5-year-children-in-surat-region-gujarat-india.php?aid=8181

Sahoo DP, Dehmubed A, Jajulwar MB. An epidemiological study of acute malnutrition in children of age 6 months to 5 years in an urban slum of Mumbai, Maharashtra. J Datta Meghe Inst Med Sci Univ. 2017;12(3):181-186. Available from: http://www.journaldmims.com/article.asp?issn=0974-3901;year=2017;volume=12;issue=3;spage=181;epage=186;aulast=Sahoo

Popat CN, Chaudhari AI, Mazumdar VS, Patel SV. A cross sectional study to measure the prevalence of malnutrition and factors associated with malnutrition among under five children of an urban slum of Vadodara city. J Res Med Dent Sci. 2014;2(3):59–64. Available from: https://www.jrmds.in/abstract/a-cross-sectional-study-to-measure-the-prevalence-of-malnutrition-and-factors-associated-with-malnutrition-among-under-f-1549.html

Gopinath TT, Logaraj M, John KR . Assessment of nutritional status of children aged under five years in tribal population of Jawadhu hills in Tamil Nadu. Int J Community Med Public Heal. 2018 Feb 24;5(3):1041-1046. Available from: https://www.ijcmph.com/index.php/ijcmph/article/view/2448/1859

Rao MK, Balakrishna N, Laxmaiah A, Venkaiah K, Brahmam G. Diet and nutritional status of adolescent tribal population in nine states of India. Asia Pac J Clin Nutr. 2006;15(1):64–71. Available from: https://pubmed.ncbi.nlm.nih.gov/16500880/

Mittal, Singh J, Ahluwalia S. Effect of maternal factors on nutritional status of 1-5-year-old children in urban slum population. Indian J Community Med. 2007;32(4):264-267. Available from: https://www.ijcm.org.in/article.asp?issn=0970-0218;year=2007;volume=32;issue=4;spage=264;epage=267;aulast=Mittal

Gopal BS, Devaramani YS. Infant mortality, its components and correlates: findings from a longitudinal study in rural Karnataka, India. Genus. 1991; 47(1-2): 89–108. Available from: https://pubmed.ncbi.nlm.nih.gov/12284827/

Huq MN, Tasnim T. Maternal Education and Child Healthcare in Bangladesh. Matern Child Heal J 2007 121. 2007;12(1):43–51. Available from: https://link.springer.com/article/10.1007/s10995-007-0303-3

Saleem AF, Mahmud S, Baig-Ansari N, Zaidi AKM. Impact of maternal education about complementary feeding on their infants’ nutritional outcomes in low- and middle-income households: a community-based randomized interventional study in Karachi, Pakistan. J Health Popul Nutr. 2014;32(4):623-633. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438693/

Johri M, Subramanian S V, Sylvestre M-P, Dudeja S, Chandra D, Koné GK, et al. Association between maternal health literacy and child vaccination in India: a cross-sectional study. J Epidemiol Community Heal. 2015;69(9):849–857. Available from: https://jech.bmj.com/content/69/9/849

Balogun SA, Yusuff HA, Yusuf KQ, Al-Shenqiti AM, Balogun MT, Tettey P. Maternal education and child immunization: the mediating roles of maternal literacy and socioeconomic status. Pan Afr Med J. 2017; 26 (April 2017):1-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491723/

Iftikhar A, Bari A, Bano I, Masood Q. Impact of maternal education, employment and family size on nutritional status of children. Pakistan J Med Sci. 2017;33(6):1401-1405. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768833/pdf/PJMS-33-1401.pdf

Sowmya R, Indumathi KP, Arora S, Sharma V, Singh AK. Detection of calcium based neutralizers in milk and milk products by AAS. J Food Sci Technol. 2015;52(2):1188–1193. Available from: https://pubmed.ncbi.nlm.nih.gov/25694738/

Food Safety and Standards Authority of India (FSSAI). National Milk Safety and Quality Survey 2018 Executive Summary. [Internet]. 2019 [cited 2019 Oct 25]. Available from: https://fssai.gov.in/upload/uploadfiles/files/Report_Milk_Survey_NMQS_Final_18_10_2019.pdf

Martin NH, Friedlander A, Mok A, Kent D, Wiedmann M, Boor KJ. Peroxide test strips detect added hydrogen peroxide in raw milk at levels affecting bacterial load. J Food Prot. 2014;77(10):1809–13. Available from: https://pubmed.ncbi.nlm.nih.gov/25285503/

Ivanova AS, Merkuleva AD, Andreev SV, Sakharov KA. Method for determination of hydrogen peroxide in adulterated milk using high performance liquid chromatography. Food Chem. 2019; 283 (15 June 2019):431–436. Available from: https://pubmed.ncbi.nlm.nih.gov/30722894/

Azad T, Ahmed S. Common milk adulteration and their detection techniques. Int J Food Contam. 2016; Dec 5;3(1):22:1–9. Available from: https://foodcontaminationjournal.biomedcentral.com/articles/10.1186/s40550-016-0045-3

Grace D, Baker D, Randolph TF. Innovative and participatory risk-based approaches to assess milk-safety in developing countries: a case study in North East India. Paper presented at the International Association of Agricultural Economists (IAAE) conference in Beijing, China, 17-22 August 2009. Nairobi (Kenya): ILRI 2009; Available from: https://cgspace.cgiar.org/handle/10568/1119

Singh R, Wright T. USDA Foreign Agricultural Service, Global Agricultural Information Network. FSSAI Conducts National Survey on Adulteration of Milk. [Internet]. 2012 [cited 2021 Sep 2]. Available from: http://agriexchange.apeda.gov.in/MarketReport/Reports/FSSAI%20Conducts%20National%20Survey%20on%20Adulteration%20of%20Milk_New%20Delhi_India_1-13-2012.pdf

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Published

2021-09-14

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Research Article