INDIA’S NEW URBAN WORRY — RISING OVERNUTRITION

THE CONTEXT: India’s nutritional landscape is characterized by the coexistence of undernutrition and overnutrition, termed the “double burden of malnutrition”(WHO). While rural areas grapple with stunting (35.5% of children under five, National Family Health Survey-5 [NFHS-5], 2019-21) and micronutrient deficiencies, urban centers face a surge in obesity and non-communicable diseases (NCDs).

• • The Global Hunger Index 2024 ranks India 105th out of 127 countries, reflecting persistent food insecurity, yet 24% of women and 22.9% of men in urban areas are overweight or obese (NFHS-5). This dichotomy is driven by structural shifts in food systems, urbanization, and socio-economic disparities.

THEORETICAL FRAMEWORK: UNDERSTANDING OVERNUTRITION

Overnutrition results from an energy imbalance where caloric intake exceeds expenditure, leading to obesity and associated NCDs. The socio-ecological model explains this through multiple levels of influence:

• • Individual Level: Poor dietary choices, lack of physical activity, and low nutritional literacy.
  • Interpersonal Level: Social norms promoting calorie-dense foods and workplace cultures encouraging sedentary behavior.
  • Community Level: Urban food environments saturated with fast food outlets and limited access to fresh produce.
  • Systemic Level: Weak regulatory frameworks, aggressive marketing of ultra-processed foods, and economic policies prioritizing calorie-dense staples over diverse diets.

The “nutrition transition” theory further contextualizes India’s shift from traditional, nutrient-rich diets to energy-dense, nutrient-poor ones, driven by globalization, urbanization, and rising incomes. This transition exacerbates NCDs, with 65% of deaths in Chennai attributed to NCDs (Tamil Nadu STEPS Survey, 2023-24).

CURRENT SCENARIO: OVERNUTRITION IN URBAN INDIA

The prevalence of overnutrition is alarming:

• • Obesity Trends: NFHS-5 data indicates that obesity rises with age (7% in men aged 15-19 to 32% in men aged 40-49) and wealth (10% in the lowest quintile to 37% in the highest). Urban areas report higher rates (46.1% of urban men, 43.1% of urban women) than rural areas (35.4% and 31.6%, respectively).
  • NCD Burden: The Indian Council of Medical Research (ICMR) estimates that NCDs account for 61% of India’s disease burden, with diabetes and hypertension poorly controlled (only 9.8% of young diabetics achieve glycaemic control, Tamil Nadu STEPS Survey).
  • Childhood Obesity: A 2025 Lancet study projects India’s overweight and obese adult population to reach 450 million by 2050, with childhood obesity surging by 244% over the past three decades.
  • Dietary Patterns: The ICMR-National Institute of Nutrition (NIN) Dietary Guidelines for Indians (DGIs) note that 70% of caloric intake comes from carbohydrates, with inadequate protein (6-8% vs. 30% recommended by EAT-Lancet) and micronutrient-rich foods.

Urban food environments, characterized by cloud kitchens and late-night eateries, exacerbate this crisis. The Food Safety and Standards Authority of India (FSSAI) reports that 38% of Indians consume unhealthy foods, while only 28% meet the five recommended food groups (NFHS-5).

SIGNIFICANCE: IMPLICATIONS FOR GOVERNANCE AND DEVELOPMENT

Overnutrition undermines India’s demographic dividend and economic resilience:

• • Health Costs: The Global Food Policy Report 2024 estimates that food system failures cost $12 trillion annually globally, with India facing rising healthcare expenditures due to NCDs.
  • Economic Productivity: The 18-59 age group, India’s economic backbone, is increasingly vulnerable to early-onset NCDs, reducing workforce efficiency.
  • Social Equity: Socio-economic disparities exacerbate malnutrition, with the poorest relying on subsidized, calorie-dense grains (Public Distribution System [PDS]) and the affluent consuming ultra-processed foods.
  • SDG Targets: India is unlikely to meet SDG 3 (Good Health and Well-Being) and SDG 2 (Zero Hunger) without addressing overnutrition alongside undernutrition.

INDIAN CONTEXT: DRIVERS OF OVERNUTRITION

Several factors contribute to India’s overnutrition crisis:

• • Urbanization: Rapid urban growth (34% of India’s population is urban, Census 2011) fosters sedentary lifestyles and access to energy-dense foods.
  • Workplace Culture: IT sectors promote prolonged desk hours and provide free, nutrient-poor snacks, as seen in Hyderabad’s IT corridors.
  • Food Systems: The PDS prioritizes calorie security over nutritional diversity, while fast food outlets proliferate (e.g., 13% of South Indian diets comprise processed foods, International Food Policy Research Institute [IFPRI] 2020).
  • Socio-Cultural Norms: Traditional diets high in carbohydrates and festive overeating clash with modern sedentary lifestyles.
  • Gender Disparities: Maternal obesity increases risks of gestational diabetes and childhood metabolic disorders, perpetuating intergenerational malnutrition (WHO).

POLICY FRAMEWORK IN INDIA: EXISTING INITIATIVES

India has implemented several programs to address malnutrition:

• • Eat Right India: Led by FSSAI, this initiative promotes nutritional literacy through campaigns like “Aaj Se Thoda Kam” and proposes Health Star Rating (HSR) labels. However, HSR’s efficacy is debated among experts.
  • Makkalai Thedi Maruthuvam (MTM): Tamil Nadu’s multisectoral NCD program screened 3,79,635 employees in 2024, incorporating workplace interventions and the “Eat Right Challenge.”
  • POSHAN Abhiyaan: Focuses on undernutrition but includes nutrition counseling to promote dietary diversity.
  • ICMR-NIN Dietary Guidelines: Recommend balanced diets with 45% calories from cereals, 15% from pulses, and adequate fruits and vegetables.
  • Public Distribution System: Provides subsidized grains but lacks diversity, contributing to carbohydrate-heavy diets.

GLOBAL PERSPECTIVE: LEARNING FROM BEST PRACTICES

• • Saudi Arabia: Vision 2030 integrates NCD prevention through calorie labeling, a 50% tax on sugary drinks, and sodium limits in processed foods, achieving WHO sodium reduction benchmarks.

• • Mexico: A sugar-sweetened beverage tax reduced consumption by 7.6% (The Lancet, 2017), demonstrating fiscal measures’ efficacy.
  • Chile: Strict front-of-pack warning labels for high-fat, sugar, and salt (HFSS) foods improved consumer choices (WHO, 2020).
  • Singapore: The Healthier Choice Symbol incentivizes reformulation of packaged foods, aligning with nutritional standards.

THE ISSUES:

• • Weak Regulatory Framework: Subjective food labeling laws allow junk food marketing to thrive (Arun Gupta, The Hindu, 2025). The HSR system lacks consensus on effectiveness.
  • Urban Food Environments: Proliferation of fast food outlets and cloud kitchens (e.g., 13% of South Indian diets from processed foods, IFPRI) overshadows traditional diets.
  • Economic Barriers: Healthy diets cost $3.36 PPP per day, unaffordable for 55.6% of Indians (FAO, 2022). Subsidized PDS grains lack nutritional diversity.
  • Low Nutritional Literacy: Only 28% of adults consume all five food groups (NFHS-5), reflecting poor awareness of dietary diversity.
  • Gender and Socio-Economic Disparities: Maternal obesity and undernutrition coexist, perpetuating intergenerational malnutrition. The poorest rely on carbohydrate-heavy diets, while the affluent consume ultra-processed foods.
  • Climate Vulnerabilities: Climate change threatens crop yields, reducing access to diverse, nutrient-rich foods (FAO, 2024).
  • Implementation Gaps: Programs like MTM and Eat Right India face challenges in scaling, enforcement, and inter-sectoral coordination.
  • Data Deficiencies: Inaccurate metrics (e.g., capillary vs. venous blood for anaemia) and lack of national surveys on nutrient deficiencies hinder targeted interventions.

THE WAY FORWARD:

CONCLUSION:

India’s nutrition discourse must graduate from calorie sufficiency to dietary quality. Tackling the urban overnutrition wave demands the same whole-of-government urgency that the country mustered for digital payments or COVID-19 vaccination—backed by smart taxes, aggressive reformulation, community nudges and evidence-powered governance.

UPSC PAST YEAR QUESTION:

Q. Poverty and malnutrition create a vicious cycle, adversely affecting human capital formation. What steps can be taken to break the cycle? 2024

MAINS PRACTICE QUESTION:

Q. India’s urban landscape is now battling an epidemic of over-nutrition even while under-nutrition persists. Analyse the structural drivers of this ‘double burden of malnutrition’.

SOURCE:

https://www.thehindu.com/opinion/lead/indias-new-urban-worry-rising-overnutrition/article69626123.ece#:~:text=Urban%20India’s%20crisis,in%20overweight%20and%20obesity%20prevalence.