How does the shift from underweight to obesity as the main form of malnutrition affect India’s public health strategies?

India has traditionally focused its public health efforts on combating undernutrition, especially among children and women. However, recent reports, including from UNICEF, indicate a growing prevalence of obesity, making it a significant form of malnutrition alongside underweight. This shift requires a reorientation of public health strategies to address both extremes of the nutrition spectrum.

• Dual Burden Approach: Policies must now tackle both undernutrition and overnutrition. Programmes should be designed to identify and manage both underweight and overweight individuals, especially in urban and transitioning rural areas.
• Dietary Guidelines and Food Environment: There is a need to promote balanced diets, reduce consumption of processed and high-calorie foods, and encourage healthy eating habits through public campaigns and school curricula.
• Focus on Lifestyle Diseases: Obesity increases the risk of non-communicable diseases (NCDs) like diabetes and hypertension. Public health strategies should integrate screening and prevention of NCDs at the primary healthcare level.
• Urban Planning and Physical Activity: Policies should encourage physical activity by creating more public spaces, parks, and pedestrian-friendly infrastructure to combat sedentary lifestyles, particularly in urban areas.
• Regulation and Taxation: Introducing taxes on sugary drinks and junk foods, and regulating advertising of unhealthy foods, especially to children, can help curb the obesity trend.
• Targeted Interventions: Vulnerable groups, such as schoolchildren and adolescents, should be targeted through specific interventions like regular health check-ups, nutrition education, and physical activity programmes.
• Monitoring and Data Collection: Strengthening surveillance systems to monitor trends in both undernutrition and obesity will help in timely policy adjustments and resource allocation.