From undernutrition to obesity, Lancet study unveils India’s double whammy

NEW DELHI: India is grappling with a profound nutritional shift, as highlighted by the latest Lancet study, with nutritionists attributing this "double whammy" of undernutrition and obesity to a dual challenge: inadequate consumption of quality foods and easy access to cheap, unhealthy alternatives.

The Lancet study, published on Thursday, found that in India, nearly 44 million women and 26 million men were obese in 2022, respectively.

"These numbers are up from 2.4 million and 1.1 million in 1990 for women and men, respectively, while for children, the baseline number was about 0.4 million," said study co-author Guha Pradeepa, from Madras Diabetes Research Foundation (MDRF), Chennai, told PTI.

The analysis by the NCD Risk Factor Collaboration (NCD-RisC) — a global network of scientists — and the World Health Organization (WHO) also found that about 12.5 million children aged between five and 19 were overweight in 2022.

Reacting to the study findings, nutritionist Sudha Vasudevan, who was not involved in the study, noted that while good quality foods are nutrient-dense like fruits and vegetables, unhealthy foods are usually processed, containing high-fat, sugar, salt, and refined carbohydrates.

"We had not yet won the war against undernutrition-related health problems, but now we are additionally burdened by those coming from overnutrition or obesity, and resembling the developed nations in that sense," Vasudevan, Senior Scientist and Head of the Department of Foods & Nutrition Research, MDRF, told PTI.

The findings suggest trends of an "epidemiological and nutrition transition" of India, Vasudevan said.

“While the developed countries might be economically equipped to deal with obesity and related healthcare burden, India is not and therefore, we are struggling,” she said.

The Lancet study looked at body mass index (BMI) to understand how obesity and underweight have changed worldwide from 1990 to 2022. It analysed the weights and heights of over 220 million people aged five years or older, from across more than 190 countries.

The findings also highlighted a major shift in lifestyle over the past decades, including lack of exercise and healthy food, said Pradeepa.

The study found that the adult obesity rate in India increased from 1.2 per cent in 1990 to 9.8 per cent in 2022 for women, while for men, it rose from 0.5 per cent to 5.4 per cent.

Pradeepa attributed the spike in obesity rate to a combination of biological and social factors.

"Biological factors involve constant, cyclical hormonal activity with pregnancy-specific weight gain, following which taking care of the child takes precedence.

"On the other hand, social factors compel them to prioritise their children's and family's health over their own. These factors present as barriers to doing exercise for women and taking care of themselves," she explained.

The findings revealed the need for innovative interventions in terms of introducing more physical activity and movement in a day, especially for women, said Pradeepa.

She referred to Thandav, which is one such intervention, developed by Dr. R. M. Anjana, President of MDRF.

Thandav is a ten-minute routine that combines the physical exercise aspect of high-intensity interval training (HIIT) with enjoyable dance movements.

The routine thus makes the act of performing physical exercise more entertaining and recreational, and also more socially acceptable as girls and women can perform this easily at their homes, explained Pradeepa.

Anjana along with colleagues at MDRF, have scientifically investigated the impact of Thandav on the physical fitness of Indian girls and women and published papers in journals such as Diabetes Technology & Therapeutics.