Mothers who grow up in areas of good coverage for India’s Mid Day Meal scheme spend more time in education, delay having children and use antenatal care. Their children grow better too. These were the finding of a study by the International Food Policy Research Institute on data spanning more than 20 years. The study suggests that school feeding programmes can give intergenerational benefits.
Stunting, a failure to achieve full stature occurs as a result of chronic undernutrition and is its most visible sign. The consequences of undernutrition reach further than height however, affecting educational attainment and long term health (see WHO’s factsheet ). 38% of Indian children were stunted in 2015-2016, say Suman Chakrabarti and colleagues from the International Food Policy Research Institute, the authors of this study.
Research shows that in India, women’s height and educational status affect stunting in the next generation, according to Chakrabarti and colleagues. Their observation that stunting rates were lower in 2016 Indian States that had higher coverage of MDM in 2005 motivated the authors to study the school meals program.
The Mid Day meal program
The Mid-Day Meal (MDM) scheme launched across India in 1995 as a government scheme to address the nutritional status of primary school age children and promote universal primary education. The scheme sets a standard for nutritional content of 450 Kcal and 12 g protein for the mid-day meal for children aged 6 -10 years and is run jointly by central and state governments. It reached 97.8 million children in 2016-17, report Chakrabarti and colleagues, making it the biggest school meal programme in the world. They explain that while children receiving the meals benefit both in terms of growth and of education, little research has gone into intergenerational benefits. To examine that, the study authors examined a range of nationally representative datasets about wealth and health in India from 1993 to 2016.
What this study found
Mothers who lived in areas of good MDM coverage as measured by the proportion of girls in the MDM programmes, spent more time in education, delayed having children and used antenatal care more often. These mothers were less likely to have stunted children than mothers living in low coverage areas.
The height-for-age z-score (HAZ) of children born to mothers with high exposure to the programme was greater (+0.40 SD) than that in children born to non-exposed mothers. The scheme contributed 13–32% of the improvement of height-for-age z scores, seen between 2006 and 2016, estimates the study.
Chakrabarti and colleagues say the research literature often focuses on the first 1000 days of life. They advocate some attention to the “next 7000 days” in the shape of school meal programmes.
“This finding provides evidence that, when intergenerational effects are considered, the complete benefit of school feeding programs at scale for linear growth is much larger than previously understood” write the study authors.
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Chakrabarti, S., Scott, S.P., Alderman, H. et al. Intergenerational nutrition benefits of India’s national school feeding program. Nature Communications 12, 4248 (2021). https://doi.org/10.1038/s41467-021-24433-w