The Double Burden of Malnutrition
Public health experts call it the “double burden of malnutrition”—the coexistence of undernutrition (like stunting and wasting in children) and overnutrition (overweight and obesity). Recent data from the National Family Health Survey (NFHS-6), conducted
in 2023-24, paints a clear picture of this dual challenge. On one hand, India has made significant strides in reducing chronic undernutrition among children. On the other, the same data shows a sharp increase in the number of adults who are overweight or obese, signalling a rapid and complex nutritional transition across the country. This means that at the same time, in the same communities, and sometimes even within the same households, India is dealing with the health consequences of both not enough food and too much of the wrong kind.
Progress Against Undernutrition
There is good news in the fight against hunger and poor nourishment for children. According to the latest NFHS-6 data, stunting—a measure of chronic undernutrition where a child has a low height for their age—has declined significantly among children under five. The prevalence of stunting fell from 35.5% in the previous survey (NFHS-5, 2019-21) to 29.3%. Similarly, severe wasting, an indicator of acute malnutrition, also dropped from 7.7% to 5.2%. These improvements suggest that national efforts, better maternal health, and child-care practices are having a positive impact. However, challenges remain, as nearly one in three children is still stunted, and only a small fraction of toddlers receive an adequate and diverse diet.
The Alarming Rise of Obesity
While undernutrition shows signs of receding, overnutrition is rapidly becoming a major public health crisis. The NFHS-6 data reveals a steep climb in the number of overweight or obese adults. The proportion of women who are overweight or obese jumped from 24% to 30.7%, while for men, it increased from 22.9% to 27.3%. This trend is closely linked to changing dietary patterns, including higher consumption of processed foods rich in sugar, salt, and fat, especially in urban areas. This dietary shift, combined with more sedentary lifestyles, is fuelling a surge in non-communicable diseases like diabetes and hypertension.
The Hidden Hunger of Anaemia
Beyond the visible issues of weight, a more insidious problem persists: micronutrient deficiency, often called “hidden hunger.” Anaemia remains a particularly stubborn challenge. Despite various public health interventions, recent data indicates that anaemia levels are still alarmingly high and in some cases, worsening. More than half of all women aged 15-49 and a significant percentage of children are affected. For instance, NFHS-5 showed that 57% of women in this age group were anaemic, an increase from the previous survey. This condition, often caused by iron deficiency, has severe consequences, including fatigue, reduced productivity, and higher risks during pregnancy.
A Tale of Two Indias
The national averages mask significant regional and social disparities. Some of the country's poorest states, like Jharkhand and Bihar, continue to report the highest rates of child stunting. Meanwhile, more affluent states in the south, such as Kerala and Tamil Nadu, are grappling with some of the highest rates of obesity and diabetes. There is also a stark urban-rural divide. Rural areas have a higher prevalence of undernutrition, while urban centers are hotspots for obesity. For example, among women, 42.8% in urban areas are overweight or obese, compared to 25.5% in rural areas. This highlights how economic development and lifestyle changes are reshaping India's health profile unevenly.
