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In India, severe forms of undernutrition such as \nmarasmus, kwashiorkor and keratomalacia have largely \ndisappeared, yet subclinical manifestations of undernutrition \nand anaemia persist as public health issues. A significant \nproportion of children suffer impaired nutritional status. \nConcurrently, there is a rising prevalence of overweight and | [
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Concurrently, there is a rising prevalence of overweight and \nobesity in several states, creating a dual burden of malnutrition \nwhere both undernutrition and overweight/obesity coexist \nwithin the same communities and even within households \n(Tables I & II).\n Estimates show that 56.4% of total disease burden in | [
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Estimates show that 56.4% of total disease burden in \nIndia is due to unhealthy diets. Healthy diets and physical \nactivity can reduce a substantial proportion of coronary heart \ndisease (CHD) and hypertension (HTN) and prevent upto 80% \nof type 2 diabetes. A significant proportion of premature deaths | [
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] |
of type 2 diabetes. A significant proportion of premature deaths \ncan be averted by following a healthy lifestyle.\n Data from the Comprehensive National Nutrition \nSurvey 2019 (CNNS) highlights that a substantial number of \nchildren, exhibit early indications of non-communicable \ndisease (NCD) and its related risk factors like diabetes and | [
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disease (NCD) and its related risk factors like diabetes and \nhypertension. The presence of altered metabolic biomarkers in \nover half of the undernourished and normal-weight children \nand adolescents (Table II) raises significant public health \nconcerns.\n Furthermore, the upsurge in the consumption of highly | [
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concerns.\n Furthermore, the upsurge in the consumption of highly \nprocessed foods laden with sugars and fats, coupled with \nreduced physical activity and the limited access to diverse \nfoods, exacerbate micronutrient deficiencies and the \noverweight/obesity problems. Research indicates that | [
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overweight/obesity problems. Research indicates that \nunhealthy, highly processed, high-fat, sugar and salt (HFSS) \nfoods have become more affordable and accessible than the \nhealthier alternatives. Aggressive advertising and marketing of \nthese unhealthy foods through different media channels, | [
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] |
these unhealthy foods through different media channels, \nincluding social media, are seen to influence dietary \npreferences among both children and adults, leading to CategoryAge (years)\n1–– –4 5 9 10 19 \nAnemia (%) 40.6 23.5 28.4\nMicronutrient deficiencies\nIron deficiency (%) 32.117.021.5\nFolate deficiency (%) 23.4 28.2 36.7 | [
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] |
Iron deficiency (%) 32.117.021.5\nFolate deficiency (%) 23.4 28.2 36.7\nVitamin B12 deficiency (%) 13.817.230.9\nVitamin A deficiency (%) 17.521.5 15.6\n25 Hydroxy vitamin D (%) 13.718.2 23.9\nZinc deficiency (%) 19.016.831.7\nNon-communicable diseases\nOverweight (%) - 3.74.9\nObesity (%) - 1.31.1\nPre-Diabetes (%) - 10.310.4\nDiabetes (%) - 1.20.6 | [
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] |
Pre-Diabetes (%) - 10.310.4\nDiabetes (%) - 1.20.6\nElevatedHbA1c(>5.8&<=6.4%) - 9.29.5\nElevated HbA1c (>6.4%) - 0.1 0.2\nHigh total cholesterol (%) - 3.23.7\nHigh LDL (%) - 3.33.8\nLow LDL (%) - 26.1 28.2\nHigh triglycerides (%) - 34.0 16.1\nHigh serum creatinine (%) - 7.06.6\nHypertension (%) - - 4.9Table I. Nutritional status and serum biomarkers of | [
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children aged 1 to 19 years\n (CNNS, 2019)CURRENT\x01DIET\x01AND\x01\nNUTRITION\x01SCENARIO\ndetrimental long-term effects. A large chunk of family income \nis spent on buying such unhealthy foods. This faulty dietary \npattern contributes to deficiencies in iron and folic acid, \nresulting in anemia and in the higher prevalence of overweight | [
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resulting in anemia and in the higher prevalence of overweight \nand obesity among population groups.\n Addressing the issue of anemia necessitates the adoption \nof the practice of dietary diversification among people and \nundertaking of measures to counter non-nutritional \ncontributors. Placing emphasis on eating a variety of foods also | [
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contributors. Placing emphasis on eating a variety of foods also \naids in tackling the problem of overweight and obesity.\nICMR-National Institute of Nutrition Dietary Guidelines for Indians | [
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] |
Table II. Undernutrition, overweight/obesity (WHO-Asian Cut-Offs), hypertension \nand diabetes among 18–69 year adults in India as per NFHS 5, 2021\nNutritional status/NCDs Men Women\n2016 2021 2016 2021\nCED 23.8 16.2 23.0 18.7\nOverweight/obesity 21.9 22.9 28.7 24.0\nHypertension 20.2 24.0 15.3 21.3\nDiabetes (Type 2) 10.5 15.6 9.7 13.5 | [
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] |
Hypertension 20.2 24.0 15.3 21.3\nDiabetes (Type 2) 10.5 15.6 9.7 13.5\nAbdominal obesity (as per NNMB) 55.5 47.7 63.5 56.7\nCED: Chronic energy deficiency or undernutrition among adults\n The ICMR-NIN, 'My Plate for the Day' recommends \nsourcing of macronutrients and micronutrients from a | [
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sourcing of macronutrients and micronutrients from a \nminimum of eight food groups, with vegetables, fruits, green \nleafy vegetables, roots and tubers forming essentially half the \nplate of the recommended foods per day. The other major \nportion is occupied by cereals and millets, followed by pulses, | [
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portion is occupied by cereals and millets, followed by pulses, \nflesh foods, eggs, nuts, oil seeds and milk/curd. Intake of cereals \nshould be limited to 45% of the total energy, while for pulses, \neggs and flesh foods, the total energy percentage should be \naround 14% to 15%; total fat intake should be less than or equal | [
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around 14% to 15%; total fat intake should be less than or equal \nto 30% energy, while nuts, oilseeds, milk and milk products \nshould contribute to 8%–10% of total energy per day \nrespectively.\n However, as per the data, cereals contribute to 50% to \n70% of total energy per day. Pulses, meat, poultry and fish | [
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70% of total energy per day. Pulses, meat, poultry and fish \ntogether contribute to 6% to 9% of the total energy per day as \nagainst the recommended intake level of 14% of total energy \nfrom these foods.\n In a large segment of the country's population, the intake \nof micronutrient-dense foods (whole grains, pulses, beans, | [
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of micronutrient-dense foods (whole grains, pulses, beans, \nnuts, fresh vegetables, fruits, etc.) is found to be lower than the \nrecommend levels, whereas, the intake of refined cereals is \nfound to be higher. A steady increase in the intake of unhealthy foods among people complicates the matters further. As a | [
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] |
result, majority of the population including children suffer from \nmalnutrition and its adverse health outcomes. \n While overall food grain production, especially of cereals, \nhas risen consistently over the past few decades, the per capita \navailability of food grains indicates adequacy in cereals (464g), | [
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] |
availability of food grains indicates adequacy in cereals (464g), \nwith pulses remaining low. Due to the limited availability and \nhigh cost of pulses and meat, a significant proportion of the \nIndian population relies heavily on cereals, resulting in poor \nintake of essential macronutrients (essential amino acids and | [
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intake of essential macronutrients (essential amino acids and \nessential fatty acids) and micronutrients. Low intake of \nessential nutrients can disrupt metabolism and increase the risk \nof insulin resistance and associated disorders from a young age \n(Table I).\n The most logical, sustainable, and long-term solution to | [
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