The Food and Agriculture Organization (2024) estimates that the hidden cost of the conventional global food system is US$ 12.7 trillion. In India, this hidden cost amounts to $1.3 trillion, with 73 per cent of it attributed to health-related issues. Globally, the double burden of malnutrition — co-existence of under-nutrition with obesity, is evident across all age groups (FAO et al., 2024).
Studies highlight serious concerns in Indian diets. The typical Indian food plate is dominated by carbohydrate-rich foods, which constitute 70-75 per cent of intake, with insufficient protein, fibre, and vitamins consumption (Kumar et al., 2025). Poor nutrition education, unhealthy dietary habits, inaccessibility of nutrient rich food are the major causes of malnutrition and hidden hunger in the country. This problem is further linked to the predominance of cereal-based food through the public distribution system (Kumar et al., 2025). The micronutrients in Indian staple crops such as rice and wheat have sharply declined, however, the toxins in food have increased severely in the past 40 years (Debnath et al., 2023).
The findings of State of Food Security and Nutrition in the World report (SOFI, 2025) highlight the significant nutrition deficiencies and related challenges India is facing.
In 2024, India had the highest global prevalence of wasting (low
weight relative to height) among children under five years of age, at 18.7 per cent, affecting more than 21 million children.
Around 37 million children under the age of five in India are stunted, highlighting ongoing issues of chronic undernutrition.
More than half of Indian women aged 15-49 experience anaemia, with a prevalence of 53.7 per cent in 2023, impacting approximately 203 million women.
Although there has been some improvement, 12 per cent of the Indian population remained undernourished in 2024, and 42.9 per cent cannot afford a healthy diet.
From 2012 to 2024, overweight children under five rose from 2.7 million to 4.2 million, while the number of obese adults more than doubled over a decade, climbing from 33.6 million to 71.4 million.
Current trends show that Indian households are consuming processed and calorie-dense food. The budget of household on outside paid food has been doubled between 2015 and 2019 (Shagun 2024 c, November 9). The study also indicates that the fast food is relatively cheaper than nutrient rich food items.
The National Sample Survey Office (NSSO) report (2022-23) highlighted trends in food consumptions. With rising income, the percentage of spending on food consumption has declined 13 per cent among rural consumers and 8 per cent among urban consumers. The survey also noted that the share of milk and vegetables is gradually replacing cereals in India’s overall food consumption (Shagun, 2024 b, February 26).
Additionally, a small section of consumers, particularly the urban elite, is becoming more health conscious and demanding organic food options. This shift is reflected in the recent increase in demand for organic products. In India, the organic food trade will be increasing at a compound annual growth rate of 20.5 per cent over the next five years (Dhar & Roy, 2022).
There are several food policies and schemes in India; however, due to inherent gaps and implementation challenges, they are often ineffective in tackling health-and-nutrition related problems.
Integrated Child Development Services (ICDS)
Launched in 1975, the ICDS scheme targets children below six years of age, as well as pregnant and lactating mothers. It provides six services: supplementary nutrition, immunisation, health check-up, referral services, pre-school education, and nutrition & health education (Ministry of Women and Child Development, n.d.). Anganwadi workers are responsible for nutrition and education related tasks, whereas immunisation and health checks are conducted in government established primate health care centres. Researchers raised concerns about the effectiveness of the scheme in terms of quality of services and overall impact (Dixit et al., 2018).
Mid-Day Meal Scheme (MDMS)
India’s Mid-Day Meal Scheme (MDMS) is regarded as the largest school meal programme globally, providing fresh, cooked meals to children from disadvantaged backgrounds. The programme has improved children’s health and nutrition status, provided a safety net and has also increased school enrolments (Singh et al., 2014). However, it faces implementation challenges including issues with quality and quality of food, shortage of fund, and infrastructure (Singh and Bhue, 2022).
POSHAN Abhiyaan (National Nutrition Mission)
Launched in 2017, Poshan Abhiyan focuses on technology-based monitoring, community mobilisation, institutional capacity building, and convergence among various government schemes to reduce malnutrition (Kapur & Suri, 2020). However, it faces challenges such as limited digital literacy among frontline workers, inconsistent data reporting, inadequate inter-departmental coordination, and delays in fund disbursement, which eventually hinders its effectiveness to a large extent.
National Iron Plus Initiative (NIPI)
National Iron Plus Initiative (NIPI), started in 2011, is a revised version of the National Nutritional Anaemia Prophylaxis Programme in 1970, by the Union Ministry of Health & Family Welfare (MoHFW). The programme aims to prevent and treat iron deficiency, anaemia, across different age groups, particularly women and children. However, the high prevalence of anaemia in the country is often attributed to poor programme coverage, limited capacities of health functionaries, and inadequate and irregular supplies (Kapil et al., 2019).
Public Distribution System (PDS)
Public distribution programme in India provides food security to a large section of population. However, concerns have been raised regarding the quality of food grains, proper targeting of poor households, and the need to increase diversity of food items supplied through PDS (Panda et al., 2020). Operational inefficiencies, including leakage in adequate coverage and delays in distribution, have further limited its effectiveness in enhancing food security and reducing child mortality (George and Mckay, 2019).
Food Safety and Standards (Packaging and Labelling) Regulations, 2011 (FSSAI)
FSSAI sets science-based food safety and quality standard and is involved in their monitoring and enforcement to ensure the production and supply of safe food for human consumption (Bera et al., 2023). However, several issues persist, including gaps in food safety compliance, inadequate infrastructure for testing and surveillance, and low consumer awareness regarding safe and nutritious food.
These issues need to be handled urgently. Strengthening policy execution, along with active consumer participation, is essential to address the grand challenge of double burden of malnutrition and expediate progress towards a sustainable and equitable food system.
To address the malnutrition challenge, following measures can be undertaken to strengthen implementation of government schemes and programmes, improve stakeholder participation, and ensure sustainable outcomes.
Enhancing soil health
Nutrient-rich food production begins with healthy soils. In this regard, soil testing should be encouraged, while the excessive use of fertilisers and pesticides needs to be curbed. Government programmes, including the National Mission on Natural Farming, can play a crucial role in scaling up natural farming practices focused on soil regeneration and nutrient-rich food production.
Common language for sustainability
A shared common understanding of sustainability is largely lacking among consumers. Given the complexity of the food systems and sustainability issues, it is crucial to develop a common language for consumers and work collectively to address the food systems challenge (Amman et al., 2023).
Nutrition literacy
Experts recommend integrating nutrition literacy into public health initiatives and school programs, along with conducting sensitisation campaigns targeting women, children, and youth (Kumar et al., 2025). Additionally, mass media can be an effective tool to promote healthy and sustainable food choices among people.
Nutrient mapping of grains
Before commercialisation of seeds, there is a need to assess nutrient density in cultivars. During the breeding process, state agricultural universities and seed research centres should ensure that genes responsible for nutrient retention in grains are preserved. The use of AI technology can speed up the assessments multi-folds.
Strengthen food labelling and transparency
Mandatory eco-labelling and nutritional scoring should be enforced for all packaged food items. Stringent penalties should be imposed on food companies that mis-represent products or deceptive labels. The FSSAI should implement clear Front-of-Pack Labelling (FoPL) that transparently displays nutrient content, along with salt, saturated fat, and sugar levels, in simple and easily understandable language.
Use of digital tools
Policy framework needs to support digital tools and systems that ensures full traceability and origin disclosure of food items. This can include the use of QR codes, blockchain-based tracking, and mobile applications that provide details on production practices, nutritional value, and sustainability credentials. It will enable consumers to make informed choices with complete product information.
Fiscal incentives for nutrient rich products
Government interventions are needed to make healthy food more affordable and stimulate market demand for nutritious products. The government should revise GST policies to encourage shop keepers and food retail outlets to sell nutrition rich products and discourage sales of unhealthy products.
Public procurement reforms
The public procurement system should be reformed to include separate quota for sustainably, and locally produced products. Greater emphasis should be given on sourcing millets, pulses, and oilseeds, thereby supporting local farmers to grow nutrient dense crops. It will enhance dietary diversity for consumers and strengthen local food system.
Consumers are the largest stakeholder in the food systems. Dietary shifts at the consumer level not only improve public health but also deliver significant environmental benefits, including reduction in CHG emissions, biodiversity loss, land-use changes and nutrient runoff (FAO, 2024; Brocard & Wunder, 2025). By making informed choices, consumers can drive transformative changes in the food system. Strategic government actions, particularly through demand side food policies, can influence consumer behaviour and promote sustainable consumption, thereby catalysing food system transformation.
Deepak Chamola is a development professional and researcher
Views expressed are the author’s own and don’t necessarily reflect those of his organisation or Down To Earth