New Delhi: India is home to 194.6 million (19.5 crore) undernourished people – the highest in any country in the world. This has come to light in this year’s ‘State of Food Security and Nutrition in the World’ (SOFI) report released yesterday, July 24.
The UN’s Food and Agriculture Organisation (FAO) prepared this report and jointly published it with four other UN agencies, including the UN and UNICEF.
The FAO describes undernourishment as a condition in which an individual’s habitual food consumption is insufficient to provide the amount of dietary energy required to maintain a normal and active life. The prevalence of undernourishment is used to measure hunger.
India’s figures this year are still a little bit of an improvement over past ones: the number of undernourished people in the country in the 2004-06 period, for instance, was 24 crore.
The SOFI report also highlighted that more than half of Indians (55.6%) are still unable to afford a ‘healthy diet’. This proportion is the highest in South Asia. In terms of numbers, this translates into 79 crore people in India.
In other words, it is one thing to not be ‘undernourished’ and to eat enough food to have the energy for routine activities on a normal day. A majority of Indians are able to do that. But it is another thing to have a quality or a ‘healthy diet’. More than half of Indians are not able to afford this.
The FAO describes a ‘healthy diet’ as comprising four key aspects: diversity (within and across food groups), adequacy (sufficiency of all essential nutrients compared to requirements), moderation (foods and nutrients that are related to poor health outcomes) and balance (energy and macronutrient intake).
India’s current proportion of people who are unable to afford a healthy diet (as of 2023) is about three percentage points better than what it was in 2022. Over the past five years, the decline in the proportion of these people has been happening at this rate only.
The NITI Aayog report on ‘Sustainable Development Goals India Index 2023-24’, which was released earlier this month, claimed that 99% of eligible beneficiaries were covered under the National Food Security Act, 2013 in 2023–2024.
The PDS operates under this Act. It entitles 35 kg of foodgrains per ‘antyodaya anna yojana household’ per month and 5 kg of foodgrains to ‘priority households’ per month. Coarse grains, wheat and rice are provided at the subsidised prices of Re 1, Rs 2 and Rs 3 respectively.
Over and above the NFS Act, the Narendra Modi government launched the Pradhan Mantri Garib Kalyan Yojana in April 2020 and from January 1, 2023, this was extended for five more years. Under this scheme, each eligible household receives 5 kg of rice or wheat per person and 1 kg of dal per family each month, free-of-cost. About 80.48 crore beneficiaries are covered under this scheme.
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The SOFI report’s findings suggest it will take more than just these two schemes for progress on the nutrition front.
Apart from these two indicators on the quantity and the quality of diets, the report also describes what is called simply ‘hunger’, or chronic undernourishment (which prevails over a much longer period of time rather than simple undernourishment, which is incidental or habitual, as described above).
“It is an uncomfortable or painful sensation caused by insufficient energy from diet. In this report, the term hunger is synonymous with chronic undernourishment and is measured by the prevalence of undernourishment (PoU),” the report says. This is considered to be the worst form of malnutrition in any cohort of the population.
About 13% of the population of India suffers from chronic undernourishment.
Incidentally, the Global Hunger Index (GHI) report, which came out last year, ranked India 111th, indicating that only 14 countries were worse than India. ‘Concern Worldwide’ and ‘Welt Hungerhilfe’, two NGOs from Ireland and Germany respectively, had prepared this report. The Indian government rejected it in line with its trend of rejecting unflattering global reports.
The GHI report had qualified that a high GHI score could be evidence of a lack of food, a poor-quality diet, inadequate child care-giving practices, an unhealthy environment, or a combination of these factors.
Other indicators
As far as childhood nutrition is concerned, the prevalence of wasting (low weight for one’s height) in children under five years is 18.7% in India. This is the highest in South Asia. The prevalence of stunting (low height for one’s age) in children under five years of age is 31.7%.
Wasting is considered to be the worst of all forms of malnutrition in children. Only Pakistan and Afghanistan have a higher portion of stunted children in South Asia.
The prevalence of low birth weight in India is 27.4%, the highest in the world. If a baby weighs less than 2,500 grams at birth, it is termed a low birth weight baby. According to the WHO, low birth weight babies are 20 times more likely to die than high weight infants (children under one year of age). Low birth weight is an indicator of malnutrition in another set of the population – pregnant women.
“At a population level, the proportion of infants with a low birth weight is an indicator of a multifaceted public health problem that includes long-term maternal malnutrition, ill-health and poor health care in pregnancy,” says the WHO.
It is projected that 14.2% of newborns will have a low birth weight in 2030, falling short of the 2030 global target of a reduction of 30% compared to 2012 levels.
The same SOFI report also says more than half of women in India, at 53.0%, are anaemic – the highest in South Asia and also among the highest in the world. The prevalence of anaemia in women, especially during reproductive age, can not only impact them but also the health of the foetus during childbearing.
Globally, the prevalence of anaemia in women (15 to 49 years) increased from 28.5% in 2012 to 29.9% in 2019.
Also read: Despite ‘Solutions’, Anaemia Remains an Unsolved Problem in India
“It is projected to reach 32.3% by 2030 – far from the 2030 target of a 50% reduction (as compared to 2012 levels). The largest contribution in the upward trend is made by countries in South Asia and in Western and Central Africa.
While undernourishment in children and adults is a matter of worry, what this report also highlights is the epidemic of obesity in India.
It is hitting children at a young age. About 2.8% of all children under five years are overweight. This has gone up from 2.2 % in 2012.
In adults, the prevalence of obesity is 7.3%. It was 4.1% in 2022. A recent WHO report says every second person is physically inactive in India.
The steady increase in obesity is a worldwide trend. “New estimates of adult obesity show a steady increase over the last decade, from 12.1% in 2012 to 15.8% in 2022. The world is off track to achieve the 2030 global target to halt the rise, with more than 1.2 billion obese adults projected for 2030,” the SOFI report says.
The report adds that least developed countries have much higher levels of stunting in children under age five and of anaemia in women aged 15 to 49 years, as well as the same worrying rise in adult obesity.
“The double burden of malnutrition – the co-existence of undernutrition together with overweight and obesity – has surged globally across all age groups. Double-duty actions will simultaneously tackle undernutrition, overweight and obesity by leveraging the common drivers shared by all forms of malnutrition,” it adds.
Quoting two recent studies of the British Medical Journal and several others, the SOFI report said there were associations between “ultra-processed food” consumption and adverse health outcomes.
“A review of 35,550 products manufactured by the global top 20 food and beverage companies (representing 22% of worldwide sales in the sector) in a few key countries including Brazil, China, India and South Africa found that the overwhelming majority were unhealthy according to the World Health Organization,” it adds.
