What Indians eat, and how being unhealthy is easier and cheaper

Indian Express

I. AUTHOR’S CENTRAL ARGUMENT

The authors argue that India’s food environment pushes citizens—especially the poor—towards unhealthy, ultra-processed, calorie-dense foods because they are cheaper, more accessible, and aggressively marketed, while nutrient-rich, healthier foods remain expensive and less available. This mismatch is driving a nationwide nutrition crisis, rising non-communicable diseases (NCDs), and a heavy economic burden on households and the health system.

The core thesis: India’s diets are shaped not by choice, but by broken food systems, affordability distortions, and regulatory gaps, making unhealthy eating the easiest option.

II. KEY ARGUMENTS PRESENTED

1. High Food Expenditure Yet Poor Nutrition
   – Indians spend a large share of income on food, but nutritional outcomes remain poor.
   – Per-capita consumption of high-quality proteins, fruits, and vegetables is below recommended levels.
2. Ultra-Processed Foods Are Cheaper and More Accessible
   – Industrially processed foods with unhealthy levels of sugar, salt, and fat are inexpensive.
   – Aggressive marketing targets children and low-income households.
3. Healthy Foods Are Unaffordable
   – The recommended intake of fruits (100 g/day) is too costly for poorer quintiles.
   – Protein sources (eggs, dairy, meat) remain financially out of reach for millions.
4. Dietary Patterns Increasingly Linked to Disease Burden
   – Poor diets contribute to diabetes, hypertension, obesity, anaemia, and micronutrient deficiencies.
   – Diet-related NCDs account for a large proportion of India’s premature mortality.
5. Food Environment Determines Behaviour
   – Availability, pricing, marketing, and convenience shape dietary behaviour more than personal choice.
   – India lacks a supportive environment that nudges populations toward healthy eating.
6. Need for Food Companies to Take Responsibility
   – The food industry must reformulate products, reduce harmful ingredients, and shift away from misleading advertising.
7. Policy Interventions Are Essential
   – Front-of-pack labelling (FOPL), sugar and salt thresholds, taxation on harmful products, and incentives for healthier foods.
   – Public engagement and community education can shift consumer habits.

III. AUTHOR’S STANCE AND POSSIBLE BIASES

1. Strong Public Health Perspective
   – The article adopts a WHO-aligned viewpoint prioritising population health over industry competitiveness.
2. Critical of the Food Industry
   – It assumes food companies will not voluntarily reformulate without government pressure.
3. Limited Recognition of Consumer Agency
   – Emphasises structural constraints but underplays cultural preferences and consumer behaviour diversity.
4. Normative Emphasis on Regulation
   – Favors state intervention; provides less attention to market-based solutions or private-sector innovation.
5. Underexplores Agricultural Policy Linkages
   – While describing high cost of nutritious foods, it does not analyse MSP structures, supply chains, or crop diversification.

IV. PROS OF THE ARTICLE (Strengths)

1. Robust Use of Evidence and Data
– Uses National Sample Survey (NSS), ICMR research, and consumption analyses to substantiate claims.

2. Clear Explanation of Structural Food Environment Issues
– Highlights how economic and regulatory systems incentivise unhealthy foods.

3. Strong Grounding in Public Health Frameworks
– Links poor diets to rising NCD burden—accurate and timely.

4. Highlights Socio-Economic Inequality
– Makes a compelling case that poor nutrition is a symptom of poverty and food system failure.

5. Offers Practical Policy Interventions
– Advocates FOPL, fiscal measures, product reformulation, and public campaigns.

V. CONS OF THE ARTICLE (Critical Gaps & Limitations)

1. Insufficient Analysis of Agricultural Production and Food Supply
– Nutrient-dense foods are expensive partly due to skewed agricultural incentives favouring cereals over pulses, fruits, and vegetables.

2. Underplays Cultural and Regional Dietary Practices
– India’s food choices are shaped by caste, religion, climate, and culture, which the article does not sufficiently address.

3. Limited Engagement with Industry Realities
– Food companies operate within cost constraints and consumer demand patterns; reformulation is not always economically viable.

4. Overemphasis on Ultra-Processed Foods
– Rising obesity and NCDs are also linked to sedentary lifestyles, urbanisation, and stress, which are not discussed.

5. Little Discussion on Implementation Challenges
– Regulatory enforcement in India is patchy; FSSAI capacity and compliance issues need deeper discussion.

6. No Exploration of Global Comparative Models
– Other countries’ experiences (Chile, Mexico, UK) with taxation, labelling, or reformulation could provide valuable insights.

VI. POLICY IMPLICATIONS (UPSC GS-II & GS-III Relevance)

1. Nutrition and Public Health Policy (GS-II)
– Need for stronger regulation under FSSAI to ensure food safety and nutrition.
– Right to health debates increasingly include dietary rights.

2. Food Security and Agriculture (GS-III)
– Crop diversification, improved supply chains, and subsidies for nutritious foods are needed to correct affordability distortions.

3. NCD Control Strategy (GS-III)
– Dietary changes must be integrated into India’s National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).

4. Equity and Welfare
– Policies must ensure low-income groups have access to affordable, nutritious diets.

5. Fiscal Instruments
– Taxes on sugar-sweetened beverages, salt-dense snacks, and ultra-processed foods.
– Subsidies for pulses, fruits, vegetables, and protein-rich foods.

6. Behaviour Change Communications
– Public campaigns, school-based nutrition education, and labelling reforms.

VII. REAL-WORLD IMPACT ASSESSMENT

1. Rising NCD Burden
   – Poor dietary quality directly contributes to premature mortality and reduced productivity.
2. Economic Costs for Families
   – Low-income households spend disproportionately on food yet remain nutritionally deficient.
3. High Healthcare Expenditure
   – Treatment of diabetes, heart disease, and hypertension strains public health budgets.
4. Intergenerational Malnutrition
   – Dietary deficiencies in women and children perpetuate cycles of stunting and anaemia.
5. Food Industry Influence
   – Without regulatory pressure, companies are unlikely to shift away from unhealthy formulations.
6. Growing Urban–Rural Divide
   – Urban food environments are dominated by ultra-processed foods, while rural diets remain calorie-dense but nutrient-poor.

VIII. BALANCED CONCLUSION

The article offers a powerful and well-evidenced critique of India’s unhealthy food environment, exposing how affordability patterns and weak regulation make unhealthy diets the default choice for many Indians. It effectively connects dietary patterns to broader socioeconomic determinants and public health outcomes.

However, the analysis could be enriched with deeper examination of agricultural policies, cultural contexts, supply-chain factors, and private-sector constraints. While regulatory solutions are important, dietary transformation will require multi-sectoral, structural reforms spanning agriculture, health, education, taxation, and corporate accountability.

A healthy India cannot be built merely by awareness—it requires systemic change in how food is produced, priced, marketed, and consumed.

IX. FUTURE PERSPECTIVES (UPSC Mains-Ready Insights)

1. Develop a National Healthy Food Policy integrating agriculture, health, and education.
2. Implement mandatory front-of-pack labelling and regulate marketing to children.
3. Shift subsidies towards protein-rich and micronutrient-dense foods.
4. Expand horticulture, food processing of healthy items, and cold-chain infrastructure.
5. Introduce sin taxes on ultra-processed foods; promote healthy alternatives.
6. Strengthen the PDS to include millets, pulses, eggs, and fortified foods.
7. Implement nationwide behaviour change campaigns.
8. Foster industry partnerships for responsible reformulation.

The nutritional future of India hinges on reshaping its food systems to ensure health, affordability, and equity.