India’s food crisis is changing: How everyday eating habits are fueling diabetes and heart disease

It is time for India to ask less comfortable questions about whether there is enough food: what kind of food culture are we creating? The old public-health vocabulary of scarcity is no longer sufficient.

India still carries undernutrition and anaemia, but it is simultaneously living through a rapid expansion of diabetes, obesity, hypertension, fatty liver disease and cardiovascular risk. The country’s nutrition challenge is therefore not simply a calorie shortage. Increasingly, it is a surplus of the wrong calories, consumed in the wrong combinations, within lifestyles designed around sitting rather than movement.

The theme of World Food Day 2026 was “Innovate today. Nourish tomorrow”. In India, that should be read not only as an agricultural challenge but as a public-health one. A food system cannot be called successful merely because it produces and delivers more. It must also make the healthier choice affordable, attractive and easier to make.

From nourishment to convenience

Indian food culture is changing faster than our health institutions have adapted. Traditional diets were never uniformly healthy, but many centred on cereals or millets, pulses, vegetables, fermented foods, curd, seasonal produce, nuts, fish, or modest quantities of meat.

Urbanisation, longer commutes, delivery platforms, snacking and aggressive marketing have altered both what we eat and how often we eat it. Refined carbohydrates, sugar-sweetened beverages, fried foods and packaged products high in salt, sugar and fat move from occasional indulgence to daily routine.

The ICMR-National Institute of Nutrition’s 2024 Dietary Guidelines for Indians estimate that unhealthy diets account for 56.4 per cent of India’s total disease burden. It also warns that highly processed foods rich in fat, sugar, and salt have become increasingly accessible and affordable, while their marketing shapes dietary preferences, including among children.

UNICEF’s 2025 Child Nutrition Report found that obesity among children and adolescents aged 5–19 surpassed underweight globally for the first time, affecting 9.4 per cent against 9.2 per cent. In South Asia, the number of overweight children and adolescents has increased fivefold since 2000, reaching 70 million.

This is no longer merely an adult lifestyle problem. Food preferences shaped during childhood can establish patterns of consumption that persist for decades, making schools, advertising and household nutrition central to disease prevention. This matters because metabolic disease rarely arrives as a single diagnosis. It arrives as a cluster.

The metabolic warning lights are flashing

The 2025 International Diabetes Federation Atlas estimates that 89.8 million Indians aged 20–79 had diabetes in 2024, the world’s second-highest national burden; 43 per cent— 38.6 million — were undiagnosed, and the number is projected to reach 156.7 million by 2050. The WHO’s 2025 hypertension profile estimates 210.2 million Indians aged 30–79 have high blood pressure, yet only 17 per cent have it controlled.

It also records 49 per cent of adults as insufficiently physically active. India suffered about 2.8 million cardiovascular deaths in 2021, nearly half attributable to high systolic blood pressure. Fatty liver has become another marker of this metabolic crisis: Indian studies estimate it affects about 38.6 per cent of adults, rising above 50 per cent among high-risk groups with obesity or diabetes. Together, these figures reveal not separate epidemics, but an interconnected crisis of diet, inactivity and metabolic disease.

The economic consequences are equally serious. Diabetes and cardiovascular disease impose recurring costs through consultations, medicines, diagnostic tests, hospitalisation and lost working days. For households without adequate financial protection, managing a chronic illness can become a prolonged financial burden.

For the economy, preventable disease reduces productivity and increases pressure on health care resources. Prevention must therefore be understood not simply as a medical intervention, but as an investment in household financial security and India's productive capacity.

A healthy diet is simpler than the wellness industry suggests

The answer is not a fashionable 'detox', a miracle supplement or the elimination of entire food groups. The strongest evidence is strikingly ordinary.

WHO recommends at least 400 grams of fruits and vegetables a day for people over 10, salt below five grams daily, free sugars below 10 per cent of energy intake, preferably still lower, and carbohydrates primarily from whole grains, vegetables, fruits and pulses.

ICMR-NIN similarly emphasises variety and proportion. For an illustrative 2,000-kilocalorie diet, its food pyramid provides for roughly 400 grams of vegetables, 100 grams of fruit, 250 grams of cereals and nutri-cereals, 85 grams of pulses and legumes, 300 ml of milk or curd, 35 grams of nuts and seeds and about 27 grams of fats and oils. These are guides rather than prescriptions, but they expose how far many modern plates have drifted: too much refined starch, too few vegetables, too little fibre and invisible excesses of oil, salt and sugar.

Diet also cannot be separated from movement

Physical inactivity is compounding the problem. The latest WHO comparable estimate finds that 49.4 per cent of Indian adults were insufficiently active in 2022, including 57.2 per cent of women and 42 per cent of men — far above the 31 per cent global average reported in WHO’s 2024 assessment. Inactivity raises the risk of cardiovascular disease, type 2 diabetes and several cancers.

There is also a dangerous misconception that metabolic risk can be judged by appearance alone. Excess abdominal fat, elevated blood glucose, abnormal cholesterol and hypertension may develop without obvious symptoms.

A person need not appear visibly obese to face cardiometabolic risks. The nationally representative ICMR-INDIAB study, published in 2023, estimated that 351 million Indians had abdominal obesity in 2021, compared with 254 million with generalised obesity. The distinction strengthens the case for preventive screening, particularly among adults with family histories of metabolic disease.

Food policy must move beyond personal responsibility

It is easy to tell citizens to exercise restraint while surrounding them with environments engineered for overconsumption. Children encounter persuasive advertising; workers eat what is available near offices; families trade time for convenience; healthier products may require more preparation or money. The 'choice' to eat well is therefore shaped by income, time, labelling, marketing, school meals, urban design and the food industry itself.

India needs a nutrition policy that treats metabolic health as infrastructure. That means clearer nutrition information, stronger protection from the marketing of unhealthy foods, healthier school and workplace food standards, reformulation to reduce salt, sugar and harmful fats, and urban planning that makes walking and physical activity routine rather than recreational.

WHO itself identifies nutrition labelling, restrictions on marketing to children, healthy public procurement and fiscal measures among the tools to improve food environments.

India should also examine how taxation can reshape unhealthy consumption. In January 2026, WHO warned that sugary beverages remain inadequately taxed worldwide, with the median tax accounting for only about 2 per cent of the price of a common sugary soda. At least 116 countries tax sugar-sweetened beverages, but coverage remains uneven. India could consider more explicitly health-oriented, sugar-content-based taxation, alongside affordable drinking water and healthier alternatives. Revenue could support school nutrition and preventive health care. Such measures require careful design to protect lower-income households while discouraging excessive sugar circulation and consumption.

Public procurement can also support pulses, millets, vegetables, and diverse local foods instead of reducing nutrition policy to calorie delivery. Innovation need not mean replacing traditional food with laboratory-designed products. It can mean using science, markets and public policy to make diverse, minimally processed food easier to grow, distribute, afford and choose.

Occasions like the World Food Day should therefore broaden our definition of food security. A population is not truly food-secure if calories are plentiful but healthy diets remain difficult to afford; if children are simultaneously vulnerable to undernutrition and obesity; or if prosperity steadily converts into diabetes, fatty liver and heart disease.

India’s next nutrition revolution is not about eating less, but about eating better, moving more, and designing a food economy in which health is not the most difficult option on the menu.

(The author is a policy analyst, columnist and currently serves as The Statement Fellow at Students For Liberty)