Statement: International Food Policy Research Institute (IFPRI), Family Health International (FHI) and John Hopkins study, funded by Bill and Melinda Gates Foundation (BMGF) puts meat eating women’s lives at risk

Findings of a collaborative study in Uttar Pradesh, India, by the International Food Policy Research Institute (IFPRI), Family Health International (FHI) and John Hopkins (JH), funded by the Bill and Melinda Gates Foundation (BMGF) have been tweeted out from the IFPRI Twitter handle on the 4th of June 2020 along with a graph, stating

 ‘Vegetarian women more likely to have probability of nutrient adequacy and diet diversity during pregnancy than non-vegetarian women”   

ezkayl6vcaaemtbSource: IFPRI twitter handle

A next tweet claims that this study ‘is a finalist for the Emerging Leaders in Nutrition Science Award”

On enquiry, another tweet was put out 24 hours later, with the addition of the text in bold.

“Vegetarian women were more likely to have probability of nutrient adequacy and diet diversity during pregnancy than non-vegetarian women, but these differences are likely confounded by socio-economic and caste status”.

We are shocked by this study as well as the way it has been projected in the public domain, for the reasons stated below

Vegetarian and non-vegetarian are not scientific categories. In the current politically and ideologically charged environment of India, specifically in State of Uttar Pradesh, even somewhat sensitive researchers would have been conscious of the ethical pitfalls and dangers of this kind of a nutritionally irrelevant discourse. Predictably, the projected ‘results’ show up the confusions and contradictions.

This study shows that only 8% of self-reported non-vegetarian women consumed flesh foods and only 4.2% consumed eggs. Although, this is not representative of meat eating statistics of the rural population in India, the authors make no attempt to explain this glaring inconsistency. The finding that ‘non-vegetarians are not eating enough animal foods’ should disturb anyone concerned about nutrition. Instead of being concerned about this important finding which highlights that only 8% of non-vegetarians actually get to eat some meat, the authors turn the findings on its head and try to appear on the right side of the political dispensation by projecting that vegetarians have more food diversity

Animal proteins are important for iron absorption and animal foods are a good source of Vitamin B12, Vitamin A and Riboflavin, in addition fish is a rich source of N3 fatty acids. These nutrients are especially vital during pregnancy because over 60-80 of pregnant women are known to be anaemic with multiple nutrient deficiencies.

As Natarajan and Jacob (2015)[1], point out, ‘self-identification’ into the categories of vegetarian/non-vegetarian is not reliable because even meat eating people may self identify as ‘vegetarian’ out of social pressure. For instance, if children in government schools where Akshaya Patra provides food were asked about what they eat at home, they are likely to say that they eat ‘sattvik[2] food without onion and garlic’. This could be attributed entirely to the current social and political pressures on eating choices, irrespective of what children eat or enjoy eating in reality.

As any well trained nutritionist would know, dietary diversity is one aspect of nutrition, but it cannot be taken in isolation while ignoring portion size, adequacy and nutrient density of food, especially in pregnancy. Several studies use a cut-off of ≥15 g for a food to be considered for dietary analysis. No effort has been made in the tweets put out by IFPRI to indicate what the cut-off quantity is and whether this led to exclusion of certain foods in the analysis. To give an example of nutrient density, 15 gm of meat or egg is not equivalent to 15 gm of cereal, so not representing these differences shows poor methodology and even poorer understanding of nutrition.

Since this is a study about pregnancy it should also be known that pregnant women in India have dismally low pre-pregnancy weights and heights, poor weight gains and anemia during pregnancy, resulting in low birth weights and post-partum complications, all closely related to consumption of a monotonous cereal pulse diet bereft of good quality protein, iron, and calcium. To repeat, focusing only on diversity while ignoring adequacy and nutrient density defeats the purpose of studying nutrition intakes in pregnancy.

Women from better socio-economic background, are likely to have more food diversity with more access to animal foods like dairy. Women from dominant caste are also likely to be from better socio-economic background, which in turn can contribute to better pregnancy outcomes. Martin-Prével et al (2015)[3], observed that women of reproductive age who consume five or more food items are also highly likely to consume at least one animal-source food. Having being co-authors with Martin-Prével on other studies, it is inexplicable how the researchers from IFPRI have overlooked this point and reach the conclusion that vegetarians have more diversity.

The dietary data for this study comes from pregnant women enrolled at baseline from an Alive and Thrive maternal nutrition program in Uttar Pradesh, India – a project funded by the Bill and Melinda Gates foundation. Incidentally, BMGF has also funded this study. Considering the results of the study, it is surprising that these women have not benefitted from the BMGF project. Is it possible that the project itself has become a hostage to promoting vegetarianism in UP? In addition, being a population under a specific project, this group of women cannot be taken to represent the general population and especially not to make sweeping conclusions about “vegetarian and non-vegetarian” women.

The researchers claim that median intake of micronutrients was below the estimated average requirement (EAR) for 9 out of 11 micronutrients with only zinc and thiamine having a median intake slightly above EAR. Not surprisingly the results show that intake is low in both categories. This is a classic example of the pitfalls of relying on oral questionnaires for nutrition data collection in an atmosphere of fear and marginalization of meat eaters. Even a rigorously conducted 24 hour oral recall method can show variations of upto 25%. Biochemical estimations may have given us some insights into the actual intakes in the two groups

We are shocked by the fact that results of studies with potential large impact on women, especially pregnant women, are put out on Twitter like slogans or sensational headlines.  Sharing teasers on social media while withholding the full study wouldn’t fall into the category of serious or ethical research.

This valorising of vegetarianism and dismissal of meat eating is not isolated, but rides on the back of several years of false assertions that India is ‘vegetarian’. There has been criminalisation of meat (particularly beef) eating communities, vehement denial of eggs to children (who are often some of the poorest, most vulnerable and malnourished) in spite of the Right to food being a legal mandate.

Blatant promotion of religious, sattvik, casteist, vegetarian institutions like Akshaya patra irrespective of serious objections by public health people, food rights activists, doctors, researchers, are symptoms of imposition of a majoritarian view in India. This is made worse by the growing global push towards predominantly plant based diets through multilateral agencies like the Eat Lancet Commission and promoted by Indian counterparts, inspite of global criticism. This ‘study’ is therefore not innocent.

It is alarming that IFPRI, John Hopkins, FHI and BMGF are coming together to put out the message on social media that vegetarian food is superior – a pre-existing casteist and anti-minority myth in India. That this study is a finalist for the Emerging Leaders in Nutrition Science award, is probably the icing on this vegetarian cake.

We do hope that the authors will rethink about publishing this study in the present form.

Dr. Sylvia Karpagam (Public health doctor) and Dr. Veena Shatrugna (Retired deputy director, National Institute of Nutrition)

References

[1] Natarajan and Jacob “Provincialising’ vegetarianism putting Indian food habits in their place, Economic and Political Weekly, March 2018.

[2] A sattvic diet is a brahmanical vegetarian diet

[3] Martin-Prével, Y., Allemand, P., Wiesmann, D., Arimond, M., Ballard, T., Deitchler, M., Dop, M.C., Kennedy, G., Lee, W.T. & Mousi, M. 2015. Moving forward on choosing a standard operational indicator of women’s dietary diversity. Rome: FAO.

Endorsed by

  1. Dr. Amar Jesani, Independent researcher
  2. NAMHHR (National Alliance for Maternal Health and Human Rights), India Secretariat
  3. National Federation of Indian Women, New Delhi.
  4. Chaand Ohri, Campaign against racism
  5. Aarti Bhatt, MD, Campaign Against Racism
  6. Ayesha Khan, Right to Food campaign
  7. Anita Rego, Independent consultant
  8. S Chakraborty, IIT Bombay
  9. Latha, Homemaker
  10. Devassy Kadaparambil, Child rehabilitation Don Bosco
  11. Anisha Rimal, Campaign Against Racism
  12. Dr.Mohan Rao, Independent researcher in Bangalore
  13. Balu, Bangalore Dalit Forum
  14. Malleshwari, Bangalore Dalit Forum
  15. Sharmila, IIT Bombay
  16. Ramesh, IIT Bombay
  17. Siddharth K J , Independent Researcher, Bengaluru
  18. Prabhir Vishnu Poruthiyil, IIT Bombay
  19. Ramdas Rao, Human rights worker
  20. Patience Binali Ndovi, One community
  21. Latifa, Health for all
  22. Jerald D Souza, Ashirvad_ Centre for social concern.
  23. Smitha Nair, Tata institute of social sciences
  24. Swathi Seshadri, Researcher
  25. Sneha Visakha, Legal Researcher
  26. Ms.Firdose, Activist
  27. Ashwani Raj Volunteer, All India SC/ST Fisherman Council
  28. P R S Mani, All India People’s Forum
  29. Arul Anthony, Health for All
  30. S. Krishnaswamy Retired Professor, Madurai Kamaraj University
  31. John J R, IT
  32. Dr Sushrut Jadhav, Division of Psychiatry, University College London
  33. Samia Braxton, High School
  34. Sona Mitra, Researcher, New Delhi
  35. Nawasha Mishra, Right to Food Campaign
  36. Arundhati Dhuru, Suhas Kolhekar, Meera Sanghamitra, Madhuresh, Amulya Nidhi and others, National Alliance of People’s Movements (NAPM)
  37. S Sen Gupta, IIT Bombay
  38. Dr Sharfaroz Satani, Alt News science
  39. Sejal Dand, Anna suraksha Adhikar Abhiyan Gujarat
  40. Soma KP, Makaam
  41. Sameet, Right to food campaign
  42. Anupama K. French Institute of Pondicherry, Department of Ecology
  43. Jharkhand Women’s Health Network 
  44. Prerna Bharti, Jharkhand
  45. Moshe, Citizen
  46. Nidhin Sasi, IT Employee
  47. Shiva Shankar, Visiting Professor, IIT Bombay
  48. Sonal Kellogg, None
  49. Shazin Siddiqui, Human Collective
  50. Pushpa Achanta, Women Against Sexual Violence & State Repression (WSS)
  51. Chetana Kumari P, Freelance writer
  52. Dr Monica Thomas, Consultant Neurologist
  53. Teena Xavier, Public health activist
  54. Swathi Shivanand, Independent researcher
  55. Sreekanth, None
  56. Neeta Hardikar, Anna Suraksha Adhikar Abhiyan, Gujarat
  57. Samar Khan, Health Activist
  58. Ashalatha S, Makaam
  59. G THIRAVIYAM, FWF
  60. Vinay KS, Advocate
  61. Yogini, NGO
  62. Sangita Atram, NGO
  63. Brinda Adige , Global Concerns India
  64. Anita Cheria, OpenSpace
  65. Prasanna Babu Krishnappa, Activist
  66. Amrith Shenoy, Sahabalve, Udupi
  67. George M K, Loyola College of Social Sciences
  68. K. Sajaya, Independent Journalist and Social Activist
  69. Abrar Rashid, Student
  70. Vidya Iyengar, Citizen
  71. Varsha Bhargavi, Where Are The Women?
  72. Lissy, CFTUI
  73. Uma Bhrugubanda EFLU, Hyderabad
  74. Seethalakshmi. MAKAAM
  75. Ashalatha, Seema , Sejal MAKAAM
  76. Ravali – Concerned citizen
  77. Tannu, Student
  78. Prashanti Ganesh, Total Strength System LLP
  79. Umesh, Research editor
  80. P Sunthar, IIT Bombay
  81. Shiba Minai, Journalist/Activist
  82. Aaron Abraham, N Concerned Citizen
  83. Rosamma Thomas, Journalist
  84. Khizer e alam, Covid frontline worker
  85. Ojas Shetty, Urban & Transport Practitioner
  86. Nusay Bah, Peace activist
  87. Sunil Kumar None
  88. Ashish Kajla, Researcher
  89. Paul Schaafsma, Political theorist and climate justice activist
  90. Avani Chokshi, CPI(ML)
  91. Dolly Arjun, PA-C Campaign Against Racism-Boston
  92. Zareen, Homemaker
  93. Kaneez Fathima, Activist
  94. Raees Muhammed, Dalit Camera
  95. Baijayanta Mukhopadhyay, PHM Canada
  96. Latha LR, Sanman society
  97. Ila Ananya, Azim Premji University
  98. Wan Manan, Alma Ata University
  99. Vaibhav, Researcher
  100. Sumithra, Researcher
  101. Manzar Jameel, Social activist
  102. Vidya, Assistant Professor, TISS Mumbai
  103. Alwyn, Health for all
  104. Vijay Dhama, None
  105. Sathyan, HIT
  106. Manavi, Student
  107. Pratap Bhai, Citizen
  108. Omar Farook, Human Collective
  109. Yousuf S., None
  110. Jayasree Subramanian, Academician
  111. Evita Das, National Alliance of People’s Movements
  112. Burnad Fatima, Makaam
  113. Soundarya Iyer, French Institute of Pondicherry
  114. Akash Bhattacharya, Azim Premji University
  115. Jayendra Kovur, Medical officer at Botalama community health center, Khorda, Odisha
  116. Swati Narayan, Institute for Human Development
  117. Ishrath Nisar, Social activist
  118. Abi Vanak, ATREE
  119. Nargis Ismail, Non vegetarian
  120. Reva Y, Signing as concerned individual
  121. Swaliha Asiya, Content Strategist & Consultant
  122. Sanjay Kumar Bharti, Social Development Sector
  123. Sumi Krishna, Independent researcher, Bengaluru
  124. Mayank Member
  125. Anjan Katna ATREE
  126. Lakshmi Kutty PhD scholar, Centre of Social Medicine and Community Health, JNU
  127. Anil Sadgopal, All India Forum for Right to Education (AIFRTE)
  128. Kirana, Baduku community college Bengaluru
  129. Shashi Mourya, All India Forum for Right to Education
  130. Veena Srinivasan, ATREE
  131. Shewli Kumar, Tata Institute of Social Sciences
  132. Susie Tharu, Retd Prof
  133. Radhika Desai, Independent Researcher
  134. Vasudev Charupa, Human Rights activist
  135. Vanisha N MSU, Baroda
  136. Samira Nadkarni, Journalist
  137. Sulakshana Nandi, Public Health Researcher, Chhattisgarh
  138. Sagari R Ramdas, Food Sovereignty Alliance, India
  139. Qais Khan, Engineering professional, self employed
  140. Sudeshna Sengupta, Independent Researcher and Consultant
  141. Jashodhara Dasgupta, Independent Researcher, New Delhi
  142. Rifath Ali, Health for all
  143. Sunayana Sajith, PhD student at Western Sydney University
  144. Chirashree Mobile Creches
  145. Srilata Sircar University College London
  146. JC Anthony, Retd. Senior Scientific Officer, Indian Air Force
  147. Dr. Imrana Qadeer, Distinguished Professor, Council for Social Development, New Delhi
  148. Prabir Chatterjee, Kolkata

Response from IFPRI researcher, Purnima Menon

From: Menon, Purnima (IFPRI-New Delhi) <P.Menon@cgiar.org>
Date: Fri, Jun 19, 2020 at 11:16 AM
Subject: RE: A critical response to a study in India by IFPRI, John Hopkins, and FHI
To: Veena Shatrugna <veenashatrugna@yahoo.com>, Sylvia Karpagam <sakie339@gmail.com>
Cc: alexandra.bellows@jhu.edu <alexandra.bellows@jhu.edu>, Kachwaha, Shivani (IFPRI-New Delhi <S.Kachwaha@cgiar.org>, sghosh@fhi360.org <sghosh@fhi360.org>, KKappos@fhi360.org <kkappos@fhi360.org>, JEscobar-alegria@fhi360.org <jescobar-alegria@fhi360.org>, Nguyen, Phuong Hong (IFPRI) <P.H.Nguyen@cgiar.org>, Sarswat, Esha (IFPRI-New Delhi) <E.Sarswat@cgiar.org>, Avula, Rasmi (IFPRI-New Delhi) <R.Avula@cgiar.org>

Dear Dr.  Shatrugna and Dr. Sylvia,

 Thank you for your letter.  I am responding to your note as the lead of the IFPRI research team on this paper, which is a sub-study of a much larger body of work to study the impact of maternal nutrition interventions– including the promotion of all foods, including animal-source foods – on diet quality.

 As we noted on the social media channels, the conference abstract and poster were the only materials available for review.  The full research paper, which addresses many of your concerns and those of your co-signees, is currently under peer review in an academic journal.   In addition to the peer review comments, we will also consider your feedback via this letter in our revisions.  We will let you know when that paper is available – we anticipate this will take a few weeks, if not more. 

 We are happy to jointly plan communications with you and others once the full paper is available to ensure that the findings are not misinterpreted.   Please be assured that we are aligned with your perspective that diverse diets that include animal source foods, for those who choose to consume them, are important for nutrition.

 Best regards,

Purnima.    

Response from Dr. Veeena Shatrugna

Dear Purnima, and Researchers from IFPRI, John Hopkins, and FHI,
 
 Greetings! I am writing this mail on my behalf and on behalf of Sylvia, and the 148 signatories to the above letter. (of course many more signed it later)

Thank you for your mail responding to our critique of your study on Pregnancy Nutrition in UP, India. Let me first apologise for the delay in responding…these are Covid times remember, and hope you will understand
 
You suggest that we wait for the publication of the paper which is under peer review which will also take into consideration our inputs provided in the critique. You further state that “We are happy to jointly plan communications with you and others once the full paper is available to ensure that the findings are not misinterpreted.etc.” and inform us that it “is a sub-study of a much larger body of work to study the impact of maternal nutrition interventions– including the promotion of all foods, including animal-source foods – on diet quality.”
 
I am not sure what you expect to achieve from your final paper when it is published. The damage to Nutrition science has already been done with your tweets. Our concern is not whether your final paper when published will redeems itself but rather the trend that your paper has set in areas of Nutrition research in India.
 
For lack of a better word I can only say that your paper is dangerously close to explaining the “Exotic Oriental” in the field of Nutrition. One of the reasons for this might very well be that there are very few areas of undernutrition left for serious study…Dr. Gopalan and the NIN have successfully laid bare and teased open the terrain of malnutrition, in terms of epidemiology of Malnutrition, RDAs, Clinical manifestations, Biochemical changes in undernutrition, Treatment and prevention of Malnutrition, Nutritive value of Indian foods to name a few areas. What is required at this time is food and more food for the large masses of people both urban and rural through a serious implementation of food programs and not calculations of the p value between 2 groups which are in any case not comparable in terms of caste and class (your observation).

  At a time when the country under the new dispensation is floundering on questions of food entitlements and right to food for the poor and specially children and pregnant women, your research serves to divert the attention to questions of vegetarians and non vegetarians.It is almost a surreal celebration of the food habits (vegetarianism)  of the people of a distant land.
 
The Right to food activists with an army of barefoot nutritionists are monitoring the Government’s non serious attempt at providing some bare cereals during the lockdown phase. We would have appreciated a well thought through statement from your team urging the Govt. to at least provide food/cash or both to rural and urban poor families. This has been advocated by all economists of the left or right. As scientists from prestigious institutes like IFPRI, John Hopkins and FHI it was imperative that you rise to the occasion, show concern and help prevent severe malnutrition in terms of underweights, anaemia, children with SAM and other manifestations of prolonged hunger. We would have liked to collectively persuade the Indian Government to take food seriously.
 
Even earlier we would have appreciated your intervention in the cultural onslaught on the school kids when egg was being denied to them by the Government funded central suppliers, a self proclaimed vegetarian sattvic outfit called the Akshaya Patra.

Some of you are maybe aware of the political minefields you are treading in the area of Nutrition. Is it a result of a total disregard for the serious questions of hunger and even starvation haunting our land? or is it just the novelty of the variables thrown up by the majoritarian and dominant ruling dispensation?

In future we do hope you will take India and its people seriously in terms of understanding our issues of health and Nutrition.
 
Regards

Veena Shatrugna


Former Deputy Director,
National Institute of Nutrition,
Hyderabad.

26 comments

  1. […] Findings of a collaborative study in Uttar Pradesh, India, by the International Food Policy Research Institute (IFPRI), Family Health International (FHI) and John Hopkins (JH), funded by the Bill and Melinda Gates Foundation (BMGF) have been tweeted out from the IFPRI Twitter handle on the 4th of June 2020 along with a graph, stating…Read more […]

    Like

  2. […] food were asked about what they eat at home, they are likely to say that they eat ‘sattvik[2] food without onion and garlic’. This could be attributed entirely to the current social and […]

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  3. […] which in turn can contribute to better pregnancy outcomes. Martin-Prével et al (2015)[3], observed that women of reproductive age who consume five or more food items are also highly likely […]

    Like

  4. […] [3] Martin-Prével, Y., Allemand, P., Wiesmann, D., Arimond, M., Ballard, T., Deitchler, M., Dop, M.C., Kennedy, G., Lee, W.T. & Mousi, M. 2015. Moving forward on choosing a standard operational indicator of women’s dietary diversity. Rome: FAO. […]

    Like

  5. […] Findings of a collaborative study in Uttar Pradesh, India, by the International Food Policy Research Institute (IFPRI), Family Health International (FHI) and John Hopkins (JH), funded by the Bill and Melinda Gates Foundation (BMGF) have been tweeted out from the IFPRI Twitter handle on the 4th of June 2020 along with a graph, stating…Read more […]

    Like

  6. […] food were asked about what they eat at home, they are likely to say that they eat ‘sattvik[2] food without onion and garlic’. This could be attributed entirely to the current social and […]

    Like

  7. […] which in turn can contribute to better pregnancy outcomes. Martin-Prével et al (2015)[3], observed that women of reproductive age who consume five or more food items are also highly likely […]

    Like

  8. […] [3] Martin-Prével, Y., Allemand, P., Wiesmann, D., Arimond, M., Ballard, T., Deitchler, M., Dop, M.C., Kennedy, G., Lee, W.T. & Mousi, M. 2015. Moving forward on choosing a standard operational indicator of women’s dietary diversity. Rome: FAO. […]

    Like

  9. […] Findings of a collaborative study in Uttar Pradesh, India, by the International Food Policy Research Institute (IFPRI), Family Health International (FHI) and John Hopkins (JH), funded by the Bill and Melinda Gates Foundation (BMGF) have been tweeted out from the IFPRI Twitter handle on the 4th of June 2020 along with a graph, stating…Read more […]

    Like

  10. […] Findings of a collaborative study in Uttar Pradesh, India, by the International Food Policy Research Institute (IFPRI), Family Health International (FHI) and John Hopkins (JH), funded by the Bill and Melinda Gates Foundation (BMGF) have been tweeted out from the IFPRI Twitter handle on the 4th of June 2020 along with a graph, stating…Read more […]

    Like

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