New Delhi: India’s nutrition challenge is no longer about scarcity, it is about an excess of the wrong kind. As the country transitions from decades of food insecurity to an era of abundance, experts warn that poor dietary quality, rising obesity, and widespread micronutrient deficiencies are quietly undermining public health.
These concerns took centre stage at a panel discussion titled “Diet Gone Haywire: Fixing India’s Nutrition Crisis from the Ground Up” at the second edition of ETHealthworld’s Nutriwell Conclave.
The panel featured William Joe, Assistant Professor, Institute of Economic Growth, Delhi University; Dr Eram Rao, Food Technologist and Professor, University of Delhi; Ritika Samaddar, Regional Head – Dietetics, Max Healthcare; Rashi Chahal, HOD – Dietetics & Clinical Nutrition, Fortis La Femme; Manasa P S, Group Manager – R&D, Nutrition Science, Britannia Industries; and Shilpa Wadhwa, Head – Nutrition, Health & Wellness, Nestlé India. The session was moderated by Prathiba Raju, Senior Assistant Editor, ETHealthworld.
Contextualising India’s nutrition journey, William Joe said that post-Independence, the country’s primary focus was calorie sufficiency.
“After independence, India’s main challenge was food security ensuring enough calories for survival. Our nutrition systems were designed accordingly, with a strong focus on undernutrition. Today, however, we are facing a very different reality,” he said.
While undernutrition has declined by 20–30 percent, Joe noted that overweight, obesity, and micronutrient deficiencies are rising sharply. Among adults, obesity prevalence has increased by 20 to 30 per cent, with a particularly steep rise among people in their 20s and 30s.
He added that while obesity peaks in middle age, men tend to lose weight faster in their 40s often due to disease-related factors.
A key concern, Joe said, is the lack of granular data, especially for adolescents and young adults, who remain inadequately captured in national surveys. “This significantly limits our understanding of the full scale of the problem,” he noted.
On micronutrients, Joe pointed out that while comprehensive trend data is still missing, evidence from the Comprehensive National Nutrition Survey shows deficiencies in iron, zinc, and vitamins increase with age, affecting 20–30 percent of those aged 10–20 years and rising further in adulthood.
“About half of India’s children are deficient in at least one micronutrient, and nearly one-third suffer from multiple deficiencies,” he said, warning that these gaps are increasingly linked to lower life expectancy.
The double burden of malnutrition
Echoing these concerns, Dr Eram Rao said India is now grappling with multiple forms of malnutrition simultaneously.
“We are dealing with undernutrition, overnutrition, overweight, and obesity—often within the same household,” she said.
While children under five still show higher undernutrition levels, global trends reveal that overweight and obese children now outnumber undernourished ones. UNICEF projections suggest that if corrective action is not taken, India could have 27 million overweight or obese children by 2030.
Dr Rao attributed much of the crisis to India’s carbohydrate-heavy diet, where nearly 62 percent of calories come from refined cereals and sugars, while protein intake remains at about 12 percent.
Citing the ICMR India Diabetes Study, she said even a five per cent increase in protein intake could significantly delay the onset of diabetes and pre-diabetes.
“Fortification and supplementation are important, but the Public Distribution System (PDS) must be reimagined to ensure protein adequacy, not just calorie delivery,” she added.
What are clinicians seeing on the ground?
From the clinical front, Chahal said national surveys often underestimate the real burden of deficiencies.
“The most common deficiencies I encounter are vitamin B12, folate, non-anaemic iron deficiency, magnesium, ferritin, and vitamin D,” she said, adding that available data does not fully reflect the scale or urgency of the problem.
Ritika Samaddar highlighted the growing prevalence of what clinicians call “hidden hunger.”
“In OPD settings, preventive health check-ups often reveal deficiencies early, young professionals complaining of fatigue frequently turn out to have low iron or B12 levels,” she said.
However, in hospitalised patients—particularly those with cardiac or metabolic conditions—micronutrient deficiencies are often detected too late. “Calories and protein are discussed, but micronutrients are frequently overlooked, despite their critical role in hormone production, enzyme function, digestion, and metabolism,” Samaddar noted.
She also flagged post-discharge relapse as a key concern, underscoring the role of clinical nutritionists in sustained counselling and behaviour change.
The food industry’s balancing act
From an industry perspective, Manasa P S challenged the notion that healthy food must be unpalatable. “There’s a common misconception that nutritious food must taste bad. It doesn’t—it can be delightful,” she said.
However, consumer sensitivity remains a significant challenge. “Even minor changes in flavour or intensity prompt immediate feedback. As manufacturers, we operate at the intersection of consumer preference, market competitiveness, and public health responsibility,” she explained.
Companies, she said, are increasingly adopting science-driven reformulation, reducing sugar and salt, and working with technology partners to address challenges such as off-tastes from minerals like iron.
Affordability remains a major constraint. “India continues to be a highly price-sensitive market, even though consumers are willing to pay for perceived value,” she said.
Manasa also stressed the need for greater public investment in healthy food systems, improved data frameworks, and deeper engagement with the informal food sector, which plays a significant role in shaping diets but remains under-studied.
“Micronutrient deficiency is not a middle-class issue, it is a national problem,” she said.
Taste, affordability, and the nutrition trade-off
Adding to the industry perspective, Wadhwa said consumers increasingly want healthier choices, but not at the cost of taste.
“Consumers want healthier products, but they are not willing to sacrifice flavour. The challenge is to strike that balance, delivering products that are acceptable in taste while also having a positive health impact,” she said.
Affordability, she added, continues to shape dietary behaviour. “People are willing to pay for value, but India remains a highly price-sensitive market.”
While urban areas enjoy relatively better access to food, dietary diversity remains a challenge in several parts of the country, she noted. Another major barrier is the erosion of traditional cooking knowledge, driven by changing lifestyles and declining home cooking.
“With convenience increasingly replacing cooking at home, especially in urban areas, long-term health often takes a back seat,” Wadhwa said, pointing out that protein-rich foods remain among the most expensive, making them harder to prioritise.
Returning to food roots
Across the panel, there was broad consensus that solutions lie in nutrition literacy, awareness, and a return to traditional Indian diets, rich in whole grains, pulses, millets, nuts, seeds, fruits, and vegetables.
Millets, once a staple of Indian diets, must find their way back onto everyday plates, the panelists emphasised.
As India’s economic growth gathers momentum, experts cautioned that improvements in health and nutrition indicators must keep pace. They stressed that coordinated action by policymakers, nutritionists, clinicians, and the food industry is essential to ensure that the country’s health outcomes match the promise of its economic progress.
