Although poor nutritional outcomes among the Indian population are a well-known problem, there is insufficient discussion in policy circles about what Indians eat.
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Food security has long been reduced to satisfying physical hunger. However, the quality of the food people consume or the drivers of people’s diets have not received enough attention in research or policy. With high levels of anemia on the one hand and the increasing burden of noncommunicable diseases on the other, the need to focus policy attention on dietary diversity is urgent.>
Even in the case of addressing child malnutrition, along with other factors such as sanitation, childcare centres and improved child feeding practices, the quality of children’s diet is a problem. According to the NFHS-5, only 11.3% of children aged six months to two years receive a ‘minimum acceptable diet’ as defined by the World Health Organization (WHO). This includes feeding frequency and minimum dietary diversity.
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India too lacks such dietary studies as are conducted in many parts of the world, so there is not much data on the diversity of diets among the population.
The National Nutrition Monitoring Bureau (NNMB) of the National Institute of Nutrition (NIN) used to conduct nutrition surveys, but this was discontinued about 10 years ago. Even when the NNMB surveys were conducted, they did not cover all states in the country and had small sample sizes. However, there are reports that a national diet survey is currently underway.
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The National Family Health Survey (NFHS) does include some questions on food consumption, but these are not sufficient to give us complete information on the diversity of the diet. Although we get an idea of which food groups people regularly consume, this survey does not include data on the amounts consumed. Therefore, even a spoonful of milk added to a cup of tea each day can be counted as milk consumed daily.>
According to the most recent data from the NFHS, 56.2% of men and 49.6% of women eat fruit at least once a week, and 57.8% of men and 45.1% of women eat eggs at least once a week.
The National Sample Survey Office’s Consumption Expenditure Survey (CES) also provides some information on food consumption. The recent Household CES (2022-23) data is yet to be analysed to estimate calorie or protein consumption; the data from the report shows that per capita consumption of cereals has declined over the years from 12.72 kg per capita per month in 1999-2000 to 9.61 kg per capita per month in 2022-23.>
Although there are problems with comparability between different waves of the survey, this trend of decreasing the amount of cereal consumption is a long-term trend. About 10% of the food budget is spent on cereals in rural and urban areas and about 18% on milk. Vegetables, fruits, ‘eggs, fish and meat’ make up a similar share of total food expenditure in rural and urban areas (about 9% to 11%).
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Illustration: Pariplab Chakraborty>
Interestingly, almost 21% of the food budget in rural areas and 27% in urban areas is spent on beverages, refreshments and processed foods. This needs to be carefully understood given the harmful effects of consumption, especially of ultra-processed foods.>
Analysis of the unit data can provide more insight into dietary patterns, but this is not the same as a nutrition survey. The survey essentially asks questions about expenditure on food, which are then used to derive household-level dietary information. For example, if rice was used as an ingredient to make kheer at home, it would be shown as ‘rice’ rather than ‘kheer’. Information on distribution within households is also not available in this survey.>
What we do know for sure is that there is much room for improvement in dietary diversity. There is also some information available on the causes of poor dietary diversity, although much more detailed research is needed.
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For example, the report on State of Food Security and Nutrition in the World, 2024 put forward by a group of UN agencies estimates that 55.6% of the Indian population cannot afford a healthy diet. Affordability is determined by both income levels and prices. While we know that a large part of the Indian population earns a very low income, food prices have been more volatile.>
In a recent article in Economic and political weeklyResearchers Sudha Narayanan, Kalyani Raghunathan and Anita Cristopher of the International Food Policy Research Institute (IFPRI) argue that the cost of healthy diets (COHD) should be calculated in conjunction with consumer price indexes for food (CPI-F).>
They show that while these two are correlated, they do not always move in the same direction. The COHD estimates the cost of buying the daily recommended amounts of various foods as recommended by the Indian Council of Medical Research (ICMR), from the cheapest source. This would obviously be a better measure of what people need to meet their health and nutrition needs compared to the CPIs. They could form the basis for calculating minimum wages, poverty lines and so on.
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In addition to accurate measurements, food and nutrition security policies must also broaden their emphasis from grain security to healthy diets. Traditionally, agricultural food security policies have focused only on grains, particularly rice and wheat.>
Although some mention is now being made of millets, interventions on pulses and oils are far from adequate. The Public Distribution System (PDS) also mainly distributes only rice and wheat, although some states have included millets, pulses and/or edible oils.>
Even the meals given to children in schools and Anganwadis do not have much diversity in protein and micronutrient sources. It is mostly rice and dal in one form or another that children across the country are given, with little addition of vegetables, fruits or animal proteins such as eggs, milk or meat.
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At the other end of the spectrum, issues related to the regulation of marketing and sales of processed foods are also important. A shift in focus to improving dietary diversity for all may also be a good transition to a comprehensive food and nutrition policy based on a ‘food systems’ approach.>
Dipa Sinha is a development economist.>