1-Oct-2020: Ideal body weight of Indian men now 65 kg, women 55 kg

ICMR-National Institute of Nutrition (NIN) has redefined the ideal or reference Indian adult man and woman with regard to age to 19-39 years instead of 20-39 years. The body weight has been put at 65 kg for males and 55 kg for females while earlier, it was 60 kg and 50 kg respectively, which are a decade old.

This is based on the latest nationally representative data sourced from the National Family Health Survey-4 (NFHS-4, 2015-16), National Nutrition Monitoring Bureau (NNMB, 2015-16), the World Health Organisation (WHO, 2006-07) and the Indian Academy of Paediatrics (IAP 2015) to “derive acceptable reference body weight values through the lifespan”.

In the ‘Recommended Dietary Allowances’ and ‘Nutrient Requirements’ report prepared by NIN, the city-based nodal agency for recommending dietary allowances and nutrient requirements for Indians, includes Estimated Average Requirements (EARs) and Tolerable Upper Limits of nutrients for the first time.

Recommended Dietary Allowances (RDA) are daily dietary nutrient intake levels which would be sufficient to meet the nutrient requirements of nearly all healthy individuals while EARs are the average daily nutrient intake levels of the population.

The cereal-legume-milk composition of the diet for a moderately active man has been improved to 3:1:2.5 as compared to the earlier 11:1:3 within a given low cost window to meet daily protein requirements.

Visible fat intake for sedentary, moderate and heavy activity has been set at 25 gm, 30 gm and 40 gm a day for adult man and 20 gm, 25 gm and 30 gm a day for adult women as against the single level recommended earlier.

For the first time, fiber based on energy intake was recommended and the level of about 40 gm/2000 kcal has been considered as safe intake.

For carbohydrates, the EAR has been set at 100 gm/day for ages 1 and above with a RDA of 130 gm/day.

With regard to sodium due to emerging concerns on prevalence of hypertension a safe intake of 2000 mg/day which amounts to 5 gm/day of salt is recommended; while an intake of 3,510 mg/day is recommended for potassium.

It has also recommended a minimum of 400 gm/day of fruits and vegetables to obtain sufficient amounts of antioxidant nutrients such as beta-carotene, Vitamin C and certain non-nutrients like polyphenols and flavonoids which may protect against chronic diseases. This should be complemented with sufficient amounts of vegetable oil so as to obtain Vitamin E.

Water required from beverages for adult man ranges from 32-58 ml per kg body mass and for woman, it ranges from 27-52 ml per kg body mass, with sedentary working group at lower end and the heavy working group at higher end of the range.

For children, the requirement is greater than 60 ml per kg body mass and for adolescent boys it ranges from 47-60 ml per kg body mass, while, for girls it is 39-49 ml per kg body mass.

For pregnant woman, based on the working intensity, the water required from beverages ranges from 2.1 to 3.2 litres per day. For old-age, irrespective of gender, the present consensus for water requirement from beverages is 33 ml per kg body mass for sedentary activity and 38 ml per kg body mass for moderate activity.

3-Aug-2020: Electronic Vaccine Intelligence Network (eVIN) has ensured essential immunization services during the COVID pandemic

The Electronic Vaccine Intelligence Network (eVIN) is an innovative technological solution aimed at strengthening immunization supply chain systems across the country. This is being implemented under National Health Mission (NHM) by Ministry of Health and Family Welfare. eVIN aims to provide real-time information on vaccine stocks and flows, and storage temperatures across all cold chain points in the country. This robust system has been used with the requisite customization during the COVID pandemic for ensuring continuation of the essential immunization services and protecting our children and pregnant mothers against vaccine preventable diseases.

eVIN combines state-of-the-art technology, a strong IT infrastructure and trained human resource to enable real time monitoring of stock and storage temperature of the vaccines kept in multiple locations across the country.

eVIN has reached 32 States and Union Territories (UTs) and will soon be rolled-out in the remaining States and UTs of Andaman & Nicobar Islands, Chandigarh, Ladakh and Sikkim. At present, 23,507 cold chain points across 585 districts of 22 States and 2 UTs routinely use the eVIN technology for efficient vaccine logistics management. Over 41,420 vaccine cold chain handlers have been introduced to digital record-keeping by training them on eVIN. Nearly 23,900 electronic temperature loggers have been installed on vaccine cold chain equipment for accurate temperature review of vaccines in storage.

The Electronic Vaccine Intelligence Network has helped create a big data architecture that generates actionable analytics encouraging data-driven decision-making and consumption based planning that helps in maintaining optimum stocks of vaccines leading to cost savings. Vaccine availability at all times has increased to 99% in most health centers. An activity rate of more than 99% reflects high adoption of the technology across all health centers where eVIN is currently operational. While instances of stock-outs have reduced by 80%, the time taken to replenish stocks has also decreased by more than half, on an average. This has ensured that every child who reaches the immunization session site is immunized, and not turned back due to unavailability of vaccines.

To support the Government of India’s efforts to combat COVID-19, eVIN India is helping the State/UT governments monitor the supply chain of COVID response material. Since April 2020, eight States (Tripura, Nagaland, Manipur, Meghalaya, Arunachal Pradesh, Haryana, Punjab and Maharashtra) are using the eVIN application with 100% adherence rate to track State specific COVID-19 material supplies, ensure availability and raise alerts in case of shortage of 81 essential drugs and equipment.

This strong platform has the potential to be leveraged for any new vaccine including COVID-19 vaccine, as and when available.