Tackling Adolescent Malnutrition in India

Syllabus: GS2/Issues Related To Health; Issues Relating to Hunger

Context

• Recent NFHS-6 (2023–24) findings highlighted rising obesity and lifestyle diseases in India, and signal an urgent need to address adolescent nutrition through school-based interventions.

Malnutrition among Adolescents in India

• India is facing a situation of double burden of malnutrition, where chronic undernutrition and rapid prevalence of overweight and obesity coexist.
• The period of adolescence ranges from age 10 to 19 years.

Key Facts and Evidence

• As per NFHS-6 (2023-24):
  • The percentage of obesity among women (age group 15-49 years) has risen from 24% to 30.7%.
  • The percentage of obesity among men has increased from 22.9% to 27.3%.
  • High blood sugar has increased from 15.6% to 20.9% among men and 13.5% to 17.8% among women.
• The Comprehensive National Nutrition Survey (CNNS, 2019) reported:
  • Nearly 27.4% of adolescents in India suffer from stunting.
  • Anemia continues to affect a large number of adolescent girls.
• India has been observing an increase in the ‘thin-fat’ phenomenon i.e. children appearing slim but carrying excess body fat which makes them vulnerable to diabetes and cardiovascular disorders.
• Nearly 21.8 crore men and 23.1 crore women in India may be overweight, with the sharpest rise among those aged 15–24 years by 2050 (2025, Lancet).

Key Causes of Malnutrition Among Adolescents in India

• Nutritional Transition and Imbalanced Diet: There is a trend of replacing traditional diets with high energy but deficient diets.
  • Heavy reliance on cereals leads to a deficiency of proteins, micronutrients and protective food.
  • The Dietary Guidelines for Indians 2024 suggests that half of the plate should contain fruits and vegetables; yet the intake is far below recommended levels.
  • Example: The studies conducted in schools indicate poor consumption of dairy products and fruits among adolescents.
• Increase in Consumption of Sugar and Ultra-processed Foods (UPFs): The availability of high fat, sugar and salt (HFSS) foods coupled with their aggressive marketing is changing the eating preferences of children.
  • A study by WHO showed that the consumption of UPFs has been rising in India at more than 13% per annum.
  • Sugar-rich beverages, packaged snacks and instant foods are taking the place of traditional diets.
  • Example: Regular intake of soft drinks by school students has led to increase in obesity and metabolic disorders.
• Physical Inactivity and Sedentary Lifestyle: Physical inactivity has emerged as one of the major risk factors for NCDs.
  • With the increase in screen time and online entertainment, energy expenditure has become much less.
  • The urban lifestyle habits are now spreading to rural areas too.
  • Example: It has been found through research that greater screen use has an inverse relationship with intake of fruits and vegetables, thereby increasing the risk.
• Poor Nutrition Literacy Skills: Many adolescents do not possess the skills for interpreting food labels, portion size calculation and recognizing misleading advertisements.
  • Nutrition education programs being carried out in schools remain theoretical rather than practical in nature.
  • Aggressive food marketing affects unhealthy dietary habits too.
• Socio-economic and Gender Issues: Poverty, food insecurity and gender inequality affect the nutrition status of adolescents.
  • Insufficient dietary intake of adolescent girls causes anaemia and inter-generational malnutrition.
  • Early marriage and pregnancy add up to malnutrition problems.

Related Initiatives in India

• PM POSHAN Scheme (Mid-Day Meal Scheme): It provides nutritious cooked meals to school children. It aims to achieve better enrolment, attendance and nutritional outcomes.
• POSHAN Abhiyaan (2018): It aims to reduce the prevalence of stunting, undernutrition, anaemia and low birth weight through convergence across various ministries.
• Anaemia Mukt Bharat (AMB): It aims at reducing anaemia amongst children, adolescents and women through iron folic acid supplementation and behavior change.
• School Health and Wellness Programme: It is part of Ayushman Bharat. It aims at promoting health awareness, nutrition education and healthy lifestyles among school-going students.
• Eat Right India Movement (FSSAI): It is an initiative for advocating safe, healthy and sustainable diets. It includes programs like Eat Right School and regulation of unhealthy food environments.
• ICMR-NIN’s ‘Let’s Fix Our Food (LFOF)’ initiative: It is a multi-stakeholder initiative for improving the food environment for adolescents.
  • It calls for regulation of HFSS food advertising, taxation on unhealthy beverages, food label literacy and model school nutrition curricula.

Way Forward

• Transform Schools into Health Promoting Institutes: Nutrition, health and physical activity need to become an integral part of school life rather than remaining supplementary to academics.
• Creating UPF Free School Zones: Regulation of HFSS foods and sugar-rich beverages need to be done strictly.
• Teaching Nutrition Skills: Adolescents need to learn about food label reading, portion sizing, basics of cooking and how food marketing works.
• Enhance School Meal Programmes: Diversification of the diet including proteins, fruits, vegetables and millets should be added to the current PM POSHAN.
• Ensuring Physical Activity Daily: Sports and physical education need to become an integral component of schooling.
• Promoting Behavioural Changes: School gardens, fruit breaks, nutrition clubs and peer campaigns can institutionalize healthy habits.

Conclusion

• Adolescent malnutrition is no more confined to undernutrition, but is increasingly becoming obesity, metabolic disorders and unhealthy behaviors.
• Since the majority of NCDs develop during adolescent period itself, there is a need for transforming schools into the front line public health institutions. Investment in healthier adolescents of today will help reduce the future disease burden and healthcare costs in the country.

Source: TH