Nutrition in India

Nutrition in India represents a complex interplay of cultural, economic, agricultural, and health factors influencing the dietary status of its population. As a developing nation with vast regional diversity, India faces a dual burden of malnutrition—persisting undernutrition alongside rising obesity and lifestyle-related disorders. Despite considerable progress in food production and policy interventions, nutritional inequities continue to shape public health outcomes, especially among children and women.

Background and Overview

India’s nutritional landscape has historically been influenced by its agrarian economy and social diversity. Traditional Indian diets are plant-based, rich in cereals, pulses, vegetables, and spices, yet often lacking in adequate protein, micronutrients, and animal-based foods.
According to the National Family Health Survey (NFHS-5, 2019–21), although improvements have been observed in child nutrition and maternal health indicators compared to previous surveys, issues such as stunting, wasting, anaemia, and micronutrient deficiencies remain major public health challenges.
Malnutrition in India encompasses both quantitative deficiencies (insufficient caloric intake) and qualitative deficiencies (lack of essential nutrients such as iron, vitamin A, iodine, and zinc). These nutritional gaps have deep-rooted associations with poverty, gender inequality, sanitation, and access to healthcare.

Types of Nutritional Problems in India

1. Undernutrition: Undernutrition continues to affect a large section of India’s population, particularly children under five years and women of reproductive age. According to NFHS-5:
   • 35.5% of children are stunted (low height for age).
   • 19.3% are wasted (low weight for height).
   • 32.1% are underweight (low weight for age).
   • About 57% of women aged 15–49 years are anaemic.

   Causes include inadequate dietary intake, poor infant feeding practices, infectious diseases, and limited access to clean water and sanitation.

2. Micronutrient Deficiencies: Known as “hidden hunger”, these deficiencies affect individuals who consume enough calories but lack essential vitamins and minerals.
   • Iron deficiency anaemia is widespread among women and children.
   • Vitamin A deficiency causes vision problems and immune weakness.
   • Iodine deficiency contributes to goitre and developmental delays.
   • Zinc and folate deficiencies impair growth and reproductive health.
3. Overnutrition and Lifestyle Diseases: With economic growth and urbanisation, India faces an increasing prevalence of obesity, diabetes, hypertension, and cardiovascular diseases.Diets rich in refined grains, fats, and sugars, combined with sedentary lifestyles, have led to a nutrition transition, particularly among urban and middle-class populations.

Dietary Patterns and Regional Diversity

India’s diverse geography and culture have given rise to varied dietary habits:

• Northern India: Diets often include wheat, dairy, pulses, and ghee; however, high-fat consumption contributes to non-communicable diseases.
• Southern India: Rice-based diets with lentils, coconut, and spices provide balanced nutrients, though protein sources may be limited in vegetarian households.
• Eastern and North-Eastern India: Diets feature fish, rice, and fermented foods rich in probiotics but are often deficient in micronutrients.
• Western India: Millet, pulses, and vegetables form staples, but recurring droughts can affect dietary adequacy.

Socio-economic disparities, caste restrictions, and food taboos also influence access to and consumption of nutritious food across regions.

Government Policies and Programmes

The Government of India has implemented multiple schemes to combat malnutrition and promote nutritional security:

• Integrated Child Development Services (ICDS): Launched in 1975, it provides supplementary nutrition, health check-ups, and pre-school education for children under six and lactating mothers.
• Mid-Day Meal Scheme (MDMS): Provides cooked meals to schoolchildren to enhance school attendance and improve nutritional status.
• National Food Security Act (NFSA), 2013: Ensures access to subsidised grains for nearly two-thirds of India’s population.
• Poshan Abhiyaan (National Nutrition Mission): Initiated in 2018 to achieve convergence among various ministries to improve maternal and child nutrition through monitoring, community engagement, and awareness campaigns.
• Anemia Mukt Bharat (AMB): Targets reduction of anaemia through supplementation, deworming, and dietary diversification.
• Pradhan Mantri Matru Vandana Yojana (PMMVY): Provides maternity benefits to support women during pregnancy and lactation.

These programmes are complemented by the National Health Mission (NHM), Public Distribution System (PDS), and Fortification Initiatives such as adding iron, iodine, and folic acid to common foods like salt, oil, and wheat flour.

Nutritional Challenges and Determinants

Despite extensive policy frameworks, several challenges persist:

• Poverty and Food Insecurity: Economic inequalities prevent equitable access to diverse and nutritious foods.
• Gender Disparity: Women, especially in rural areas, often eat last and least, leading to chronic undernutrition.
• Sanitation and Hygiene: Poor sanitation and open defecation lead to recurrent infections that aggravate malnutrition.
• Cultural Beliefs and Dietary Restrictions: Myths around certain foods during pregnancy or illness contribute to nutritional gaps.
• Climate Change and Agriculture: Changing rainfall patterns affect crop yields and availability of nutrient-dense foods.
• Implementation Gaps: Leakages, irregular monitoring, and lack of community participation reduce programme effectiveness.

Emerging Trends and Innovations

Recent years have witnessed a shift towards scientific and sustainable approaches to improve nutrition:

• Biofortification: Development of nutrient-rich crops such as iron-fortified pearl millet and zinc-rich rice.
• Food Fortification: Adding micronutrients to staples like salt (iodine), wheat flour (iron), and edible oil (vitamin A and D).
• Community Nutrition Gardens: Encouraging households to grow vegetables and fruits to diversify diets.
• Digital Nutrition Monitoring: Use of mobile apps and data analytics under Poshan Tracker for real-time assessment of beneficiaries.
• Awareness Campaigns: Initiatives like Poshan Maah (Nutrition Month) aim to spread awareness of healthy eating practices.

The Double Burden of Malnutrition

India today faces the double burden of malnutrition, where undernutrition and overnutrition coexist. Urban populations show increasing rates of obesity and metabolic disorders, while rural and marginalised groups continue to suffer from chronic energy and micronutrient deficiencies.
This paradox calls for a holistic approach that balances nutritional adequacy with dietary moderation, ensuring that improvements in food availability translate into better health outcomes.

Way Forward

To achieve the national and global targets set under the Sustainable Development Goals (SDG 2 – Zero Hunger), India must strengthen:

• Nutrition-sensitive agriculture and food diversification.
• Public awareness and community participation in nutrition programmes.
• Maternal and child healthcare, especially in the first 1,000 days of life.
• Multi-sectoral collaboration across health, education, sanitation, and women’s empowerment.