Step into any Indian city and the paradox of plenty is hard to miss. From street stalls to fine dining, global fast-food chains to homegrown cafés, the options are limitless. Households can summon any cuisine to their doorsteps in minutes, and supermarket shelves are stacked high with choices for every budget and taste.
But beneath this abundance lies a sobering truth: the access and availability that should have translated into better nourishment and stronger health has instead fuelled a silent crisis. Rising obesity, diabetes, and hypertension now sit alongside widespread malnutrition and anaemia. The heart of the problem is this: we continue to equate more food, and more calories, with better nutrition, when what truly matters is the balance of what’s on our plates.
India today faces not just this double burden of malnutrition (undernutrition on one side and harmful excess on the other) but increasingly a triple burden that also includes hidden hunger from micronutrient deficiencies. The numbers are telling.
More than half of Indian women are anaemic, even as obesity among women has nearly doubled in the past 15 years. Rates among men have risen almost as sharply. Abdominal obesity, often overlooked by standard weight measures, is also spreading, particularly among women. These trends fuel a vicious cycle: poor diets weaken immunity and productivity, which in turn reduce incomes and reinforce poor food choices. Meanwhile, unhealthy diets and sedentary lifestyles are driving a surge in diabetes and cardiovascular disease, already responsible for most deaths in the country. Clearly, abundance has not translated into nourishment, and breaking this cycle means rethinking what we put on our plates.
Nutrition is not only about filling stomachs; it is about ensuring both variety and frequency of the right foods, including micronutrients, dietary fibre, and phytonutrients that protect against cardiovascular disease, diabetes, cancers, and even cognitive decline. Yet, fewer than one in ten children in India receive the Minimum Adequate Diet (MAD), which combines dietary diversity with meal frequency. Indian diets overall remain heavily cereal-based, with far too few fruits, vegetables, pulses, and nuts making it to our plates, even in wealthier households, while poorer families fare far worse. The consequences are visible.
The National Institute of Nutrition estimates that over half of India’s disease burden is linked to poor diets, with growing evidence that high consumption of foods high in fat, sugar, and salt (HFSS) is a major contributor to obesity, diabetes, and heart disease. Unless we move beyond calorie security to true nutrient adequacy, India will remain trapped in cycles of poor health and rising healthcare costs.
Yet making this shift from calorie security to nutrient adequacy is far from simple, because India’s food environment and systems are stacked against it. Foods high in fat, sugar, and salt (HFSS) are cheap, convenient, and aggressively marketed, while fresh fruits, vegetables, and pulses remain harder to access, and for many, simply unaffordable. In fact, more than 75% of Indians cannot afford a diet that meets recommended food group diversity and nutrient adequacy. Cultural preferences and taste habits also play a role, often reinforcing high-carbohydrate, low-diversity diets. Access to diverse and nutrient-rich foods remains uneven; urban areas benefit from supermarkets and modern retail, while rural households often depend on seasonal availability, limited market variety, and what they can grow themselves.
At a systemic level, policies and subsidies have long favoured cereals, leaving other nutrient-rich foods underproduced and underconsumed. Even where there is a policy push for healthier diets, implementation is uneven. Infrastructure gaps and affordability barriers make it hard to translate intent into impact. These challenges show that the problem is not awareness but access, affordability, and systemic support, making it clear that piecemeal fixes will not be enough.
If India is to escape this trap, the answer lies in reshaping our food systems so that diverse, nutritious diets become accessible, affordable, and desirable. Achieving this demands coordinated action across policy, markets, and communities. Three levers are particularly critical:
1. Policy and Production Realignment
India should shift incentives from cereals to diverse, climate-resilient crops like pulses, fruits, vegetables, and millets to enhance nutrition and food system resilience against climate challenges. The 2023 International Year of Millets sparked interest, but sustained efforts are needed. Strengthening Farmer Producer Organisations (FPOs) and local value chains can deliver diverse, nutrient-rich foods affordably while ensuring fair farmer returns. Projects like ‘RESILIENCE’ in Odisha and Assam and the Mission Organic Value Chain Development for the North-Eastern region show how crop diversification, climate-smart practices, and better market linkages can boost farmer incomes and local access to healthy foods.
2. Food-Environment Regulation
India’s food environment needs a reset so that healthier choices become the easier choices. This requires curbing aggressive marketing of unhealthy HFSS (high-fat, sugar, salt) foods, introducing clear front-of-pack labelling. Regulatory measures such as lowering salt and eliminating trans-fats in packaged foods, along with procurement rules that prioritise local crops, can further shift what the market supplies in favour of public health.
3. Community and Social-Protection Action
Lasting change depends on shaping behaviour and making diverse diets aspirational. The RajPusht model in Rajasthan, combining cash transfers to pregnant and lactating women with behaviour change communication, shows how social protection combined with targeted messaging can improve household food choices. Community platforms such as women’s collectives, village health committees, counselling by frontline workers, and engaging men in food-related decisions can encourage healthier diet practices, promote locally available foods, and shift social norms toward diet diversity.
Equally critical is embedding dietary diversity into public food programmes — the PM Poshan, Supplementary Nutrition at Anganwadis, and the Public Distribution System (PDS), for healthy eating for children and families, generate steady demand for farmer livelihood and strengthening local food systems.
Shweta Khandelwal serves as the Vice President IPE Global and is a public health nutrition expert working in the space of maternal and child health for more than 20 years. Shoba Suri is Senior Fellow, Health Initiative, Observer Research Foundation. Vinaina Suri leads Communications and Outreach at IPE Global’s Social and Economic Empowerment Practice. She has over 17 years of experience in health and impact-led initiatives. Views expressed in the above piece are personal and solely that of the authors.
