Table 4B.

Table showing strategies to combat dietary calcium deficiency governmental and digital in rural and urban region.

Solutions/Approaches for Rural Regions.
Communication through digital channels	•Educate the community about the nutritious food through broadcast on digital channels. Program aired on Vande Gujarat Channel-1 and streamed through YouTube/Facebook has nutrition experts providing guidance through digital channels (146). This initiative can be extended across multiple channels and programs to expand reach across regions, including Mann-ki-Baat and through smartphones.
	•Deliver educational content in classrooms, availability of educational games in the mobile apps and television programs can shift the attitude towards consuming of nutrient rich food (147).
	•Drawing parallels from the agriculture industry where mobile phones are used as a fast and easy access to communicate and deliver information (148), another proposition is to set-up a framework of telephonic information delivery system wherein the call center can address the queries and concerns regarding the intake of nutritious food and the impact thereof. Since this proposition can be delivered through the voice calls and does not require internet availability, it will help expand accessibility to remote regions and increase awareness of nutritious foods.
Increase awareness	•Information about importance of nutrition rich food through educational toys for children, targeted advertisements by the local community and local governance bodies helping to increase awareness and availability of calcium rich foods.
	•To address the problem of digital exclusion among marginalized communities and to educate them of importance of calcium rich diet, verbal education about importance of strong bone health can be delivered through local nutrition experts or Anganwadi workers. This can also be taken up at the public distribution centers for cereals and grains.
Aadhar-based milk banks	•Aadhar-based milk banks can also be set-up, wherein IoT-based scanners can be used to scan card and provide milk supply twice a day for each person which will need to be consumed immediately.
Solutions/Approaches for Urban Regions
Use of mobile apps	•Technology solutions act as a guidance for self-management of adequate intake of nutrient rich food including calcium for bone health. There are many mobile apps available to track the calcium intake in the daily diet. The mobile apps inputs information of the user’s daily intake of calcium through recall, which is used to estimate the gap between daily intake and RDA, thereby suggesting the additional intake required based on RDI. These apps provide basic information and needs to be built for a holistic approach of providing personalized service including periodic monitoring.
Use of analytics and AI	•There are many apps available based on analytics and artificial intelligence (AI) to help users maintain nutritious and balanced diet. These apps use predictive analytics, artificial intelligence and natural language processing to help track and monitor nutrition intake (149). These apps are mostly marketed as lifestyle requirements rather than necessities. Most of these apps do not allow monitoring of historical data of user which can help devise long-term goal setting and suggest behavior changes in lifestyle (150).
	•Nestle India has launched artificial intelligence (AI) based nutrition assistant with a voice-activated functionality which responds to nutrition queries. •Nestlé India Nutrition Assistant (NINA), built in association with Google, focuses on parents and caregivers of children up to 12 years of age and suggests custom meal plans personalized to user preferences. AI fuels automated learning system in the app and drives self-learning as the usage of the app increases (151). The adoption of this assistant is still in the beginning phase and additional emphasis on calcium intake will be required for children. This app can be used to across India in local vernacular languages and should be made accessible through a mobile app.
Increase awareness	•In India, there is a need for industry endorsed calcium management apps which allows self-tracking of calcium intake through periodic recording of food and nutrient intake as well as risk assessment.
	•There are many computer-based tools available for guided dietary intake of nutrition which can also be used for bringing the awareness and importance of calcium intake for bone health. It has been proven that computer-based self-management tools for calcium intake has led to higher level of calcium intake over a period of time (152).