A new survey by the Development Intelligence Unit shows that obesity is a rapidly evolving problem, especially in rural India, and needs to be addressed through policies and awareness campaigns
Thirty years ago, obesity was not considered a public health issue. Even as late as the 1990s, obesity was only seen as a western concern, whereas undernutrition or malnutrition was more of a problem for developing nations such as India.
But the fact of the matter is obesity and excess weight is rising globally as people all over the world struggle with being overweight or obese.
According to Dr. Mira Shekar, Global Lead for Nutrition at The World Bank, in the last few decades, obesity has gone up by at least three times.
Today 44% of adults across the world are either overweight or obese and for kids under five years, almost 80% who are obese or overweight live in the lower and middle-income economies of the world, which includes India.
The problem is closer to home than one thinks or cares to admit.
As per the findings of the fifth National Family Health Survey (NFHS), 33 states have reported an increase in obesity since the fourth NFHS results among children aged 0-5 years [2.1% in NFHS 4 has increased to 3.4% in NFHS 5].
The problem is even more acute among adults.
Traditionally, the prevalent sedentary lifestyle means there is higher obesity in urban India than in rural India.
As more women are working, there is less time for meals to be cooked from scratch.
Nevertheless, obesity among rural women aged 15-49 years has increased to 19.7% in NFHS 5 from 15% in NFHS 4, and to 19.3% among rural men in NFHS 5 from 14.3% in NFHS 4.
Shekar further states that there are several reasons responsible for this rising problem – but mostly lifestyle changes are making it harder for people to access healthy food systems.
Lower and middle-income countries need to improve their food systems. Policy planners need to recognise the fact that more and more women are now going out to work, which in itself is a good thing.
But this also means there is less time for meals to be cooked from scratch at home.
This leads to healthy foods being replaced by unhealthy foods or snacks, especially in the diets of children and adolescents, who usually do not cook for themselves.
To dig deeper the newly established Development Intelligence Unit (DIU) has conducted a pan-India (rural) telephone-based survey covering 4,174 adolescent boys and girls aged 10-19 years (coverage of 2,117 aged 10-14 years and 2,057aged 15-19 years).
DIU is a collaboration between the Sambodhi Panels and the Transforming Rural India Foundation under its Rural ThinkInsights series. The survey specifically looked at the frequency of consumption of unhealthy (junk) food by rural adolescents, the source of procurement and location of consumption.
The most consumed fast food item among adolescents is India’s new namkeen – “chips” – from potato or corn chips to “puffcorn” snacks made up of rice, lentil and corn, like Kurkure or Mad Angles.
The overwhelming majority – 87% of those surveyed – said they had consumed this kind of snack three times in the past 7 days.
This is followed by biscuits (usually flour-based), which were consumed by every three in four adolescents around 3.5 times in the last 7 days.
Contrary to popular perceptions, carbonated and non-carbonated (local) soft drinks were also consumed by nearly 30% of adolescents, around twice a week.
While sliced bread (commonly flour-based) is yet to make major inroads in a rural diet, surprisingly, over 40% of adolescents do consume instant noodles, which seems to have made heavy inroads as an alternative snacking option in rural India. This was consumed around two times in the last 7 days.
Sugar-based sweet items – be it traditional sweets, chocolates, hard-boiled candy or ice cream – were being consumed by one in two adolescents around 2-3 times in the past 7 days as well.
Contrary to popular perceptions, carbonated and non-carbonated (local) soft drinks were also consumed by nearly 30% of adolescents, around twice a week.
Apart from the quantum of consumption, it is also important to present the source of procurement and consumption.
The survey found that for all these fast foods, home is the primary source of procurement – where the adolescent had been given the item.
Biscuits, instant noodles, sliced bread, namkeens like chips, candy and ice cream were also bought from a local store, or bought from the thelawala (local hawker or vendor) in a combination ranging between 10-45%.
Soft drinks and sweets, to a lesser extent, are offered at the homes of friends or families and consumed there as well.
Given that home is a principal point of consumption, a concentrated awareness campaign targeting parents is the likely way forward.
Regarding the place of consumption, overwhelmingly for 4 out of the 7 fast food items, the major share of the consumption took place at home.
Namkeens are consumed both inside and outside of school or home. Similar trends were reported for both sweetened soft drinks as well as chocolates/candy/ice cream.
Given that home is a principal point of consumption, a concentrated awareness campaign targeting parents is the likely way forward.
The obesity problem is not just a personal problem – it can have a huge effect on the local and global economy.
Obesity can lead to non-communicable diseases, like cardiovascular cancers and diabetes.
It also means higher healthcare costs, higher absenteeism from work, and lower productivity.
The World Bank has been prescribing several means to address this problem, including taxation on unhealthy foods, namely sugar-sweetened items like soft drinks and high-fat foods, and mandatory front-of-package labelling on processed foods.
Perhaps it is time for India to sit up and listen.
The lead image at the top shows a variety of sweets at a local sweet shop (Photo by Pavlovakhrushev, Canva)
Sandeep Ghosh is the Team Lead for the Data Intelligence Unit. He has been part of the research consulting industry for over 30 years. Before DIU, he was the Head of Research at BBC Media Action (India) Limited.
