Nutritional poverty represents a silent yet profound inequality that affects the quality and longevity of life for many individuals. To effectively tackle this issue, India must go beyond mere subsidies or fortified foods and develop a comprehensive health system that emphasizes education alongside treatment.
The narrative of poverty reduction in India often highlights economic achievements. Over the past thirty years, millions have risen above the income poverty line, yet the burden of disease has plunged many back into poverty. However, beneath these economic statistics lies a more insidious form of deprivation: nutritional poverty. Unlike income poverty, which is easily quantifiable, nutritional poverty is insidiously reflected in health reports, persistent fatigue, and the gradual decline of well-being across generations.
It is paradoxical that both rural communities and urban elites in India experience poor nutrition. The underprivileged lack access to nutrient-rich food due to financial constraints, while the affluent often lack awareness about healthy dietary choices. This duality creates a national crisis that economic indicators fail to capture.
According to the Global Hunger Index 2024, India ranks 102nd out of 123 countries. The findings from the National Family Health Survey-5 (2019-21) reveal that 33% of children under five are stunted, and 19% are wasted. Furthermore, 12% of the population is undernourished, with 19% of women of reproductive age suffering from anemia. Although some progress is being made, these figures remain alarmingly high on a global scale.
Interestingly, nutritional inadequacy extends beyond the impoverished sectors. The ICMR-National Institute of Nutrition (2021) indicates that average adults in India consume excessive calories and carbohydrates but are deficient in protein and micronutrients. This imbalance contributes to rising obesity rates, with NFHS 5 data showing that 24% of women and 23% of men are classified as overweight or obese, a figure that has tripled over the last decade across various demographics.
Child obesity rates have also surged, increasing from 2.1% to 3.4% among children under five between NFHS-4 and NFHS-5. In higher socioeconomic groups, one in three adults is overweight or obese, and one in four suffers from hypertension or diabetes. Urban diets, characterized by an abundance of ultra-processed foods and sugary drinks, have resulted in a situation where the affluent are overfed yet undernourished. Poor dietary choices are now responsible for up to 56% of India”s disease burden.
Diversity in diet—defined as the consumption of more than three food groups—plays a crucial role in achieving balanced nutrition. A healthy diet should include cereals, legumes, nuts, oils, meats, seafood, eggs, fruits, and vegetables. Enhanced dietary diversity is closely associated with improved nutritional outcomes, with public policy being a pivotal influence.
Government initiatives such as the Integrated Child Development Services (ICDS) and Poshan Abhiyaan have made strides in combating undernutrition among children and women. However, the nutritional status of adults and the prevalence of diet-related non-communicable diseases remain largely neglected. The take-home rations provided under these programs primarily consist of cereals, specifically rice and wheat, with insufficient representation of protein-rich and micronutrient-dense foods.
The National Food Security Act (NFSA) of 2013 transitioned food access from welfare to rights, facilitating the availability of affordable staple cereals and reducing hunger. Nonetheless, this shift has prioritized wheat and rice at the expense of dietary diversity, sidelining traditional, nutrient-rich crops like sorghum, pearl millet, finger millet, and foxtail millet. Despite their resilience to climate change and rich micronutrient content, these indigenous millets have been largely overlooked in mainstream food policies.
Moreover, higher income does not guarantee improved nutrition. Data indicates that middle and upper-middle-class households tend to purchase more ultra-processed foods—high in sugar, salt, and unhealthy fats—compared to both lower and upper classes. This trend illustrates India”s ongoing “nutrition transition,” wherein increasing incomes and urban lifestyles lead to a shift away from traditional, nutrient-dense foods towards energy-dense processed alternatives. Dining out and consuming packaged foods have become markers of status, with online food delivery services further exacerbating this trend.
While food options may appear more diverse, actual dietary diversity has not kept pace. The consumption of processed snacks and sugary drinks has surged, displacing traditional diets rich in legumes, fruits, vegetables, and millets. Consequently, the widening access to food has not correlated with improved nutrition, underscoring the fact that economic growth alone is insufficient to enhance dietary quality.
At its core, nutritional poverty stems from a lack of education. A national analysis comparing Indian diets against the EAT-Lancet reference diet reveals significant discrepancies. Most Indians consume fewer calories than recommended, except for the wealthiest 5%. Diets are heavily reliant on cereals, while intake of fruits, vegetables, and protein—especially from non-cereal and animal sources—falls significantly short of healthy benchmarks.
Alarmingly, the average Indian household derives more calories from processed foods than from fruits. This issue transcends mere access or affordability; it reflects a profound ignorance surrounding healthy dietary practices. India urgently requires comprehensive efforts to enhance nutrition education and encourage sustainable food choices. Complicating this challenge is the cultural perception of food as primarily a source of comfort, celebration, or social status, rather than preventive health.
The education system frequently neglects to teach the science of nutrition, while urban living and workplace environments normalize convenience-eating practices. The consequence is a widespread prevalence of metabolic diseases, even among the educated and affluent population.
Nutritional poverty is now a leading factor contributing to the rising incidence of non-communicable diseases (NCDs) across all income brackets in India, imposing significant financial burdens on families and the healthcare system. Nearly two-thirds of households affected by NCDs experience catastrophic health expenditures, with out-of-pocket costs exceeding 10% of income, consequently driving families into poverty. This creates a vicious cycle: poor dietary habits lead to chronic illnesses, which in turn deplete household income, further diminishing access to nutritious food.
Without immediate intervention to promote dietary diversity and shield families from the financial strains associated with chronic diseases, millions will remain both nutritionally and economically vulnerable. Nutritional poverty is not merely an individual health concern; it represents a systemic economic challenge.
India is facing a “double burden of malnutrition,” with both undernutrition and obesity existing side by side. Poor dietary habits are now responsible for over 60% of all deaths in the country. Projections indicate that by 2030, NCDs related to nutrition may cost India nearly ₹382 lakh crore in lost productivity and healthcare expenses. Ironically, funds allocated for treating lifestyle-related diseases could be redirected to prevent them by investing in nutrition education, behavioral interventions, and primary healthcare. Yet, less than 2% of India”s health budget is devoted to healthcare overall, with most nutrition funding still directed toward maternal and child programs.
To effectively combat nutritional poverty, health systems must integrate nutrition as a fundamental component rather than a supplementary one. Several actions can help achieve this transformation: embedding nutrition counseling within primary care, ensuring every primary health center, community health center, and private outpatient clinic includes trained nutrition counselors; incorporating nutrition literacy into school curricula to foster early awareness about food diversity; training healthcare professionals in nutrition science so that every doctor can provide meaningful dietary guidance; utilizing technology to enhance food literacy through smartphone applications linked to government health portals; and fostering collaboration among agriculture, education, and health ministries to improve access to affordable, nutrient-rich foods.
Nutritional poverty is a subtle and insidious form of inequality that transcends statistics, affecting the quality of life and longevity. Addressing this issue requires a comprehensive system that prioritizes education as much as it does treatment. Regardless of socioeconomic status, every Indian deserves more than mere sustenance; they deserve access to the knowledge and resources that facilitate a healthy life. True progress lies not just in food availability, but also in nutrition education.
