NATIONAL NUTRITION MONITORING BUREAU
NATIONAL INSTITUTE OF NUTRITION
Indian Council of Medical Research
HYDERABAD - 500 007. INDIA
2000
Nutrition monitoring is the measurement of the changes over time in the
nutritional status of a population or a specific group of individuals
WHO, 1984
The paucity of reliable and comparable data from all parts of the country
is a definite obstacle towards a realistic and disaggregated problem
definition. This calls for a national-wide monitoring system. To achieve
this, it is necessary to restructure and strengthen the existing National
Nutrition Monitoring Bureau (NNMB) and to develop a mechanism for
generating nation-wide disaggregated data…
National Nutrition Policy, Govt. of India, 1993
Undernutrition continues to be a widespread problem in
India, despite significant improvement in food production and
advancement in science during the last fifty years, since Indian
independence. The National and the State governments have been
implementing a number of poverty alleviation programmes for the
overall socioeconomic development of the community and several
nutrition programmes to mitigate the sufferings of the vast
multitudes of the population at risk. The Government of India’s
National Nutrition Policy, apart from setting nutrition goals to control
and prevent malnutrition in the country, recommended that a
national nutrition surveillance system should be developed. For the
purpose of deciding policies and to formulate programmes to
control and prevent malnutrition, it is essential to assess What?
Where? How? and Why? of the nutrition problems in the country.
Monitoring of the nutritional status of population, therefore,
becomes an important aspect of any nutrition programmes to
assess the impact of these massive inputs and to determine the
direction in which the community’s nutrition is progressing, so as to
initiate appropriate corrective actions. The Indian Council of
Medical Research (ICMR), hence, established National Nutrition
Monitoring Bureau (NNMB) in the year 1972, with a Central
Reference Laboratory at the National Institute of Nutrition,
Hyderabad. To start with, the bureau was established in the States
of Andhra Pradesh, Gujarat, Karnataka, Kerala, Madhya Pradesh,
Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh and West Bengal.
OBJECTIVES OF NNMB
 To collect, on a continuous basis, on representative
segments of population in each of the states data on dietary
pattern and nutritional status adopting standardized and
uniform procedures and techniques, and

To periodically evaluate the ongoing national nutrition
programmes, to identify their strengths and weaknesses and
to recommend appropriate corrective measures.
ORGANIZATION
Separate teams of research investigators, who are either Medical
graduates or postgraduates in Nutrition/ Sociology, collect
information on diet and nutritional status of population. All the
members of the team are given intensive training in the methods of
data collection, analysis and interpretation. Each state has also
been provided with a vehicle for field survey.
ORGANIZATION
STEERING COMMITTEE
ICMR
NIN-CRL
Medical Officer
Nutritionist
Social Worker
10 State Units
Field Attendant
Driver
COLLABORATION WITH STATES
The NNMB was envisaged, at the outset, as a collaborative
exercise between the Indian Council of Medical Research and the
respective State governments. The team has, therefore, been put
under the administrative control of the State Nutrition Officer. The
team gets necessary cooperation from the local staff and is
provided with adequate facilities so that it could complete the
survey as per schedule. However, in the States of Andhra Pradesh,
Madhya pradesh, Orissa and Uttar Pradesh, the NNMB units are
attached to the ICMR Institutes/Regional Centers.
DATA
Well-trained investigators, in each state, collect information on
dietary pattern and nutritional status of population in rural, tribal or
urban areas on a representative sample, by adopting prescribed
standard procedures and using accurate equipment. The details of
data collected are indicated below

Household demographic and socioeconomic status,

Dietary intake of individuals and households,

Nutritional anthropometry on all the available members of the
households,

Village level information on population, agricultural
production, nutrition and other developmental programmes.
UNIQUE FEATURES OF NNMB
NNMB is not a routine data collecting organization. It has several
special features
The unique features are :

Organization of repeat surveys in 1988-90 and 1996-97,
in the same villages in all the States that were surveyed
during 1975-79, to assess time trends in diet and
nutritional situation.

NNMB generates data periodically on diet and nutritional
status of socially vulnerable groups of population like
the tribals living in the integrated tribal development
project areas, and the population at-risk physiologically
like elderly population and adolescents.

NNMB is the only organization involved in continuous
collection of data on actual intakes of families, and
individuals belonging to different physiological and age
groups, in different states

Assessment of intra-family distribution of foods and
nutrients
Perhaps, one of the advantages of the bureau is availability of
expertise of the NIN to carry out detailed analysis of the data to
provide policy directions.
SAMPLING
The NNMB, in the beginning, adopted the sampling design,
developed in consultation with Prof. C.R.Rao, a world-renowned
statistician. Since 1990, to obtain better spatial distribution and
representativeness, a subsample of NSSO sample is covered.
AP
GUJ
KAR.
KER.
MP
.
MAH.
ORI.
T.N.
U.P.
W.B
States
16 Strata
5 Villages
Households
Nutrition Assessment : 20
Dietary Assessment : 10
TOTAL COVERAGE/STATE
Nutrition Assessment : 1600
Dietary Assessment : 800
For the purpose, the sampling frame of the National Sample Survey
Organization (NSSO) f or its Consumer Expenditure Surveys is
used. In each state, 80 villages are covered from 16 strata
(districts) in three subrounds. The strata are so selected that all are
represented in each subround so as to take care of any seasonal
variations.
COVERAGE
The cumulative coverage by the NNMB, so far, is indicated below:
CUMULATIVE COVERAGE
Type of Area
Rural
Tribal
Urban Slums
Other Urban
Groups
Total
Household
Diet Survey
29,514
Not done
1,633
Individual
Diet Survey
27,289
46,347
2,087
Nutrition
Assessment
3,79,062
1,32,416
13,699
2,379
3,628
24,080
33,526
79,351
5,49,302
SALIENT SCIENTIFIC OBSERVATIONS
Food and Nutrient intakes

About 30% of households consume less than 70% of energy
requirements. The diets of children under the age of 5 years of
age are more inadequate than those of adults and are well
below the recommended dietary allowances.

Woefully inadequate consumption of protective foods like
pulses, green leafy vegetables, and milk & milk products.

Dietary micronutrient deficiency, particularly with respect to
vitamin A and iron, is wide spread. About 80% of the individuals
consume diets, which provide less than half of the RDA for
these micronutrients.

Intra-family distribution of foods and nutrients reveals that
preschool children get less than their physiological needs as
compared to adult males and females.
INTRA-FAMILY DISTRIBUTION OF DIETARY ENERGY : PERCENT
HOUSEHOLDS ACCORDING TO ADEQUACY STATUS OF ADULTS Vs
PRESCHOOL CHILD
ADULT + CHILD
ADEQUACY
31%
ADULT INADEQUACY
CHILD ADEQUACY
10%
ADULT ADEQUACY CHILD INADEQUACY
25%
ADULT + CHILD
INADEQUACY
34%
Nutritional Status of Population
 About a half of the children are underweight and about 40%
are stunted. The prevalence of underweight and stunting is
considerably high even among adolescents
 About a half of the adults and elderly suffer from chronic energy
deficiency as measured by body mass index (< 18.5)
 There is no gender bias with respect to nutritional status of
females.
DISTRIBUTION (%) OF PRESCHOOL CHILDREN
ACCORDING TO WEIGHT FOR AGE BY SEX
SEVERE
5.8%
NORMAL
8.8%
MODERAT
E
44.8%
MILD
40.6%
BOYS
SEVERE
5.8%
MODERAT
E
44.8%
GIRLS
NORMAL
8.8%
MILD
40.6%
About a quarter of the adolescent girls are married before the age
of 18 years and among them about 25% are at risk of maternal
problems due to their short stature (<145cm).
 Nutritional status of tribals is worse than their rural
counterparts.
TIME TRENDS
 Repeat surveys, in the same villages surveyed about 20-25
years back, indicate improvement in the intakes of energy &
protein in all the age groups of individuals.
Percent
DISTRIBUTION (%) OF 1-6 YEAR CHILDREN WITH NUTRIENT INTAKES
BELOW 70% OF RDI
100
90
80
70
60
50
40
30
20
10
0
86.3
87.8
1975-79
71.6
71.4
1996-97
61.2
54.6
46.7
49.3
27.3
11.1
Energy
Protein
Vit.A
Nutrients
Iron
Ribo.
DISTRIBUTION (%) OF ADULT FEMALES WITH NUTRIENT INTAKES
BELOW 70% OF RDI
Percent
100
90
80
70
60
87.9
1975-79
82
1996-97
60.3
49.5
50
40
30
20
10
0
50.1
37.5
25.6
10
Energy
13.4
4.8
Protein
Vit.A
Nutrients
Iron
Ribo.

The extent of undernutrition and stunting declined during the
past two decades.

There was reduction in the prevalence of nutritional
deficiency signs over time.

Secular trends in linear growth of adolescents were
observed.
GIRLS

There was reduction in the extent of chronic energy deficiency
in adults as compared to those studied in 1975-79.
USERS OF NNMB DATA
The State governments, the Planning Commission, Department of
Women and Child Development (nodal agency for nutrition),
UNICEF, WHO, FAO, Home Science college involved in Food and
Nutrition, international agencies like CARE and voluntary
organizations such as Nutrition Foundation of India make use of the
data generated by the NNMB.
The bureau published regularly the reports of all its annual surveys,
a compilation of 25 years of work of NNMB, reports on the
nutritional status of Indian adolescents, elderly population and a
report on the dietary intakes of individuals of different age and
physiological groups. Two Ph.D. theses have also been published.
EVALUATIION OF ONGOING PROGRAMMES
In fulfillment of its second objective, the Bureau undertook
process and impact evaluation of the following nutritional
programmes.
Sl.
No.
Nutrition Programmes
evaluated
Period
States concerned
1.
Applied Nutrition
Programme
1977-78
Kerala, Uttar Pradesh,
Maharashtra, Orissa,
Himachal Pradesh &
Manipur
2.
Vitamin A prophylaxis
programme
1977-78
Andhra Pradesh, Gujarat,
Karnataka, Kerala, Orissa,
Rajasthan and West Bengal
3.
India Population Project
(Rural)
1979
4.
Supplementary Nutrition
Programmes (Urban)
1980-81
5.
World Food Programme
assisted Supplementary
Nutrition Programme
1981-82
Bihar, Gujarat, Kerala,
Madhya Pradesh,
Maharashtra, Orissa,
Rajasthan, Uttar Pradesh
and West Bengal
6.
Mid-Day Meal Programme
1991-93
Andhra Pradesh, Gujarat,
Karnataka, Kerala, Orissa
and Tamil Nadu
Karnataka
Karnataka
These studies have focused on the corrective steps, which can be
communicated to the implementing agencies so as to improve their
functional effectiveness.
PUBLICATIONS BASED ON NNMB WORK
1. Pralhad Rao,N. Surveillance of growth and development during
childhood, Baroda J. Nutr. 1982, 9, 348-352.
2. Ramnath, T. Vijayaraghavan, K., Swaminathan, M.C. Cerealmillet intake as an indicator of calorie adequacy. Nutr. Rep. Int.
1983, 27 (4), 671-680.
3. Jaya Rao, K.S. Undernutrition among adult Indian males, NFI
Bulletin, 1984, vol.5 (3), 1-6.
4. Kullah, K.M., Ramnath, T. Nutritional status of the aged in rural
areas of Andhra Pradesh. Ind. J. Nutr. Dietet. 1985, 22, 3303336.
5. Brahmam, G.N.V., Ramnath, T., Sastry, J.G., Vijayaraghavan,
K. and Rao, N.P. Diet and nutrition status of urban population,
Nutrition News, NIN, Hyderabad, March 1985, Vol. 6, No.2.
6. Murthy, P.S.N., Ramnath, T., Vijayaraghavan, K., Pralhad Rao,
N. Nutritional profile of joint and nuclear families in rural Andhra
Pradesh. J. Family Welfare, 1985, 32: 80-87.
7. Kamala S.Jaya Rao. Urban Nutrition in India – 1, NFI Bulletin,
vol.6, (4), October 1985, 5-7.
8. Kamala S.Jaya Rao Urban Nutrition in India – 2, NFI Bulletin,
vol.7, (1), January 1986.
9. Pralhad Rao, N. Information system for Monitoring Nutrition
Status of children in “Monitoring Survival and Development of
the Young Child”, by Dr.A.B.Bose, 1986, NIPCCD, New Delhi.
10. N.P.Rao, J.G.Sastry. Changes in diet and nutrition profile in 10
States in India. Nutrition News, NIN, Hyderabad, March 1986,
vol. 7, No.2.
11. K.T.Achaya. Fat intake in India. NFI Bulletin, 1986, vol. 7 (2) 17.
12. Pralhad Rao, N., Ramnath, T., Sastry, J.G. Diet and nutrition in
urban areas, Proc. Nutr. Soc. India, 1986, 32, 1-9.
13. Pralhad Rao, N., Sastry, J.G. Monitoring Nutrient intakes in
India. Ind. J.Ped. 54, 1987, 495-501.
14. K. Ramachandran. Food consumption in rural Indian
households – Has it increased in recent years? NFI Bulletin,
1987, Vol. 8 (1), 1-3.
15. Pralhad Rao, N., Hanumantha Rao, D. and Narasinga Rao, B.S.
(1987). Drought and Nutrition, Nutrition News, 8 (7), 1-4.
16. Pralhad Rao, N., Hanumantha Rao, D. and Narasinga Rao, B.S.
(1988). Drought and Nutrition, ICMR Bulletin 18 (7).
17. C.Gopalan, National Nutrition Monitoring Bureau – its
importance to nutrition research and National Planning, NFI
Bulletin, 1989, Vol. 9 (2), 4-6.
18. C.Gopalan, Consumption of edible oils in India – the present
picture. NFI Bulletin, 1988, Vol. 9 (2), 6-8.
19. S.G.Srikantia. The National Nutrition Monitoring Bureau, NFI
Bulletin, 1988, Vol. 9, (2), 1-4.
20. Brahmam, G.N.V., Sastry, J.G., Pralhad Rao, N. Intra family
distribution of dietary energy – an Indian Experience. Ecol.
Foods Nutr. 1988, 22, 125-130.
21. Pralhad Rao, N. Diet and Nutrition during drought – an Indian
experience. Disasters, 1989, 13, 61-72.
22. Sastry, J.G., Vijayaraghavan, K., Pralhad Rao, N. Indian
preschool children – A profile of stunting and wasting. J. Trop.
Ped. 1989, 35,22-25.
23. N.P.Rao, Sastry, J.G., Nadamuni Naidu, A., Vinodini Reddy.
Trends in Nutrition – NNMB surveys, Nutrition News, NIN,
Hyderabad, May, 1991, Vol. 12, No.3
24. K.Vijayaraghavan, National Nutrition Monitoring Bureau, Swasth
Hind, 1992, XXXVI: 241-43.
25. Ramnath, T., Vijayaraghavan, K., Pralhad Rao, N. Nutritional
Anthropometry – Validation of cut-off points. J. Trop. Ped. 1993,
39: 200-204.
26. Naidu, A.N. and Pralhad Rao, N. Body Mass Index: a measure
of the nutritional status in Indian populations. European Jour. of
Clin. Nutr. 1994, 48, Suppl. 3, 5131-5140.
27. Grace Maria Antony, Visweswara Rao K and Balakrishna N.
Suitability of HDI for assessing health and nutritional status.
Economic and Political Weekly, August 2001; XXXVI: pp 29762979.
28. K. Venkaiah, K. Damayanthi, M. Uma Nayak and
K.Vijayaraghavan,. Diet and nutritional status of rural
adolescents in India. European Journal of clinical nutrition 2002;
56: pp 1119-1125.
29. Vijayaraghavan, K., Surya Prakasam, B and Laxmaiah, A.
“Intra Family Distribution of Dietary Energy in Rural India
and Time trends Food and Nutrition Bulletin. 2002; 23: pp 390394
30. Arlappa, N., Balakrishna, N., Sharad Kumar, Brahmam, G.N.V.,
andVijayaraghavan, K. Diet & Nutritional Status of the Rural
Elderly in India. J. Nutr. For the Elderly, Vol.22, (4) 2003 (in
Press).