Abstract/Summary

Millets have been a traditional staple food in India for some 3000 years although this has declined since the 1960s due to increased replacement by wheat and rice. Millet-based foods are more nutrient dense than refined wheat and rice-based foods in part because they are essentially whole grain. Millets are a more climate-resilient food, which is an increasingly needed characteristic. The prevalence of a range of diet-responsive diseases such as stunting in children and anaemia in children and young women remain very high in India and in many low and middle-income countries. Other conditions such as obesity and related type 2 diabetes are also increasing. Many of the conditions mentioned affect children and young women to a greater degree than men suggesting that children and women of childbearing age should be the primary target of dietary support. Partly because of their high nutrient density compared with refined rice and wheat foods, there is increasing interest in how millet-based foods could help to reduce the prevalence of diet-responsive conditions. Millets are, however, very variable in their nutritional composition both within and between the different species of millet. Also, there is very little up-to-date information on the bioavailability of key nutrients and how these may be affected by food processing, cooking, etc. The development of a detailed database, at least for India, linking nutritional characteristics and findings from human studies with millet genetic data would seem to be a valuable way forward to capture and understand the factors affecting variability and would also highlight where gaps in knowledge exist. For example, it is notable that despite being the millet species with the highest production in India (62%), pearl millet has not featured very greatly in the studies reviewed in this chapter. This review chapter has highlighted several recent meta-analyses of prospective studies and related randomised control trials concerning the potential of diets containing millets to reduce the risk of some of the prevalent diet-responsive conditions. There is, for example, some evidence that high iron/biofortified millets can lead to improvements in iron status, which may reduce the risk/ prevalence of iron deficiency anaemia but as mentioned, not all anaemia is simply due to iron deficiency and in this regard, millets cannot enhance the dietary intake of vitamins D and B 12. It is also evident that many of the studies in the meta-analyses are quite old and have used a variety of techniques all reflected in high heterogeneity. Nevertheless, as shown by feeding studies, millets do have promise as part of more complex diets, but more focused and detailed human studies with children and young women are urgently needed in collaboration with the development of millets with enhanced nutritional composition and functionality.