Obesity Surge Needs Multi-pronged Action

A conducive environment needs to be created for healthy behaviour to become natural, easy to adopt and an affordable choice

- K Srinath Reddy

For decades, India's health policy and programmes viewed malnutrition through the lens of undernutrition, aiming to prevent stunting, wasting and underweight among young children, anaemia in children and women and iodine deficiency at all ages. Poverty was measured by economists in terms of individual calorie consumption, rather than nutrients available through diverse diets. Food policy focused on ensuring availability of carbohydrate-rich staples (rice and wheat) as well as calorie-dense edible oils.

While programmes to prevent and correct undernutrition must continue with unwavering commitment, recent decades have witnessed the rapid rise of another form of malnutrition, manifest as overweight and obesity. It was labelled inappropriately by nutritionists as over-nutrition, placing the blame on overconsumption of calories by individuals. They overlooked the fact that fibre-poor, calorie-dense diets of those who became obese were also deficient in essential nutrients. Undernutrition in pregnancy and childhood can lead to rebound adiposity in later life when the diet became comparatively calorie-rich even if it was deficient in other major nutrients. For the poor, the choice of healthy but expensive foods was an unaffordable luxury while obesity-causing foods were being mass-produced at lower cost.