Context

• While historically battling undernutrition and infectious diseases, India is now facing a silent but severe epidemic, noncommunicable diseases (NCDs) driven by lifestyle-related factors.
• Recent data from Hyderabad’s IT sector, where 84% of employees were found to have Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD), underscores the rapid and alarming rise of NCDs, particularly among urban working populations.
• Therefore, it is important to explore the multifaceted dimensions of India’s nutrition-related health crisis, its socioeconomic and occupational drivers, and the urgent need for comprehensive regulatory reform.

The Paradox of Malnutrition in India

• India is experiencing a paradoxical nutritional landscape, where undernutrition and overnutrition coexist.
• While significant parts of the country still battle hunger and nutrient deficiencies, urban centres are witnessing a surge in obesity and related metabolic disorders.
• According to the World Health Organisation, NCDs accounted for 74% of global deaths in 2019, with a disproportionate burden falling on low- and middle-income countries like India.
• In 2021, India ranked second globally in obesity prevalence, reflecting a troubling shift in public health trends.
• This dual burden is starkly evident in the Global Hunger Index, where India’s low ranking reveals that economic growth has not translated into equitable nutritional outcomes.
• Particularly in technology-driven metropolitan areas such as Hyderabad and Bengaluru, professionals are increasingly tethered to sedentary routines, high-stress environments, and diets dominated by ultra-processed, nutritionally poor foods.

Multifaceted Dimensions of India’s Nutrition-Related Health Crisis

• Urbanisation, Occupational Hazards, and Lifestyle Shifts
  • The transformation of urban India into a global technological hub has come with unintended health consequences.
  • The IT industry, emblematic of India’s economic rise, exemplifies this shift.
  • Employees are often subject to irregular work hours, insufficient sleep, and easy access to calorie-rich, nutrient-poor food in office kiosks, contributing to the high prevalence of obesity and metabolic disorders.
  • This occupational hazard is not limited to IT professionals. National-level surveys indicate that the prevalence of overweight and obesity increases with both age and income.
  • Among men aged 40 to 49, the obesity rate rises to 32%, and among the wealthiest quintile, to 37%.
  • These trends extend across gender and urban-rural divides, with higher NCD prevalence reported in urban areas, particularly among those aged 18 to 59, the most economically productive age group.
• Public Health Indicators and the Failure of Preventive Care
  • Despite some improvements in healthcare access and diagnosis, preventive and treatment outcomes for NCDs remain dismal.
  • The STEPS Survey (2023–24) from Tamil Nadu, one of India’s more developed states, paints a grim picture.
  • While workplace interventions like the Makkalai Thedi Maruthuvam programme have screened hundreds of thousands, actual disease control remains poor.
  • Among hypertensive individuals, only 16% have controlled blood pressure; among young diabetics, fewer than 10% achieve glycaemic control.
  • Poor dietary habits and physical inactivity are widespread.
  • Over 94% of Tamil Nadu respondents reported inadequate fruit and vegetable intake, while nearly one-fourth lacked sufficient physical activity.
  • The availability of unhealthy food options and the proliferation of fast-food outlets in cities further exacerbate these trends.
• Regulatory Shortfalls and Consumer Awareness
  • Although consumer awareness around nutrition is growing, it remains insufficient to combat an obesogenic environment shaped by aggressive marketing and inadequate food regulation.
  • The Eat Right India movement, spearheaded by the Food Safety and Standards Authority of India (FSSAI), has made strides through certification programmes, hygiene ratings, and public awareness campaigns like Aaj Se Thoda Kam.
  • However, these efforts lack enforcement strength and fail to reshape the food landscape meaningfully.
  • Efforts to introduce tools such as the Health Star Rating (HSR) for packaged foods have met with criticism from medical and nutrition experts who question their effectiveness and scientific basis.
  • Further complicating reform is the resistance from powerful food industry lobbies, which continue to prioritize profit over public health.

The Way Forward

• Global Lessons: The Saudi Arabian Model
  • India can learn from international best practices in tackling NCDs. Saudi Arabia’s Vision 2030 initiative provides a compelling model.
  • By integrating regulatory reform with civic engagement, the kingdom has implemented strong measures such as calorie labelling in restaurants, excise taxes on sugary beverages and energy drinks, and sodium limits in processed foods.
  • These policies have earned Saudi Arabia WHO recognition for best practices in sodium reduction and the elimination of trans fats.
  • The success lies in coherent, cross-sectoral coordination, something India has yet to achieve.
• Need for Structural Reform
  • The solution to India’s NCD crisis lies not in fragmented awareness campaigns, but in systemic regulatory transformation.
  • First, taxation on foods high in sugar, salt, and unhealthy fats, akin to sin taxes on tobacco and alcohol, should be implemented.
  • These taxes can disincentivise unhealthy food production and generate revenue for health promotion.
  • Second, food labelling norms must be made mandatory, standardised, and easily understandable.
  • Clearer front-of-pack labelling and public education campaigns should go hand in hand.
• Promotion of Healthier Lifestyles
  • Urban planning and workplace policies must promote healthier lifestyles, encouraging walking, physical activity, and better access to nutritious food.
  • Lastly, India's regulatory bodies must work in tandem with health ministries, urban development authorities, and the private sector to design environments that make healthy choices easier.

Conclusion

• India’s urban health crisis, driven by poor nutrition, sedentary lifestyles, and weak regulatory oversight, is a ticking time bomb.
• The data emerging from the IT corridors of Hyderabad and beyond is not merely alarming, it is a call to action.
• With projections estimating up to 450 million overweight or obese Indians by 2050 and childhood obesity growing at an unprecedented rate, the time for half-measures is over.
• India must embrace a multisectoral, prevention-focused strategy, rooted in robust regulation, health equity, and economic foresight.