The statistics are stark, but they are a true reflection of the prevailing situation in the country. Over 53 per cent of young Indians (aged 18-35) find nutrition access challenging, while over 50 per cent feel that they eat a balanced diet, despite failing to identify nutritional food sources correctly. The Nutrition Awareness Index 2023, a state-wise index assessing awareness, affordability and accessibility of nutrition in India as perceived by end-consumers, provides key insights about nutritional access.
Punjab emerged the top state on nutritional access, while Bihar ranked at the bottom. Uttarakhand has the highest recognition of fats as a part of a balanced diet at 70 per cent, while Andhra Pradesh has the lowest recognition of pulses and legumes (29 per cent) as body-building foods. The recognition of protective foods like eggs (28 per cent), vegetables (60 per cent) and fruits (60 per cent) are among the lowest of all states in Rajasthan. Eighty-five per cent of Indians are unaware of vegetarian sources of protein, while more than 50 per cent are unaware of healthy fats.
The Nutrition Awareness Index, developed by YouGov, an internet-based market research and data analytics firm, is part of the Right To Protein campaign. It was prepared after a survey among more than 2,000 adult urban internet users, who can read and understand English. The survey was spread across 20 states with the highest GDP. The index is a dynamic, quantitative ranking model constructed from the average of the scores of all 20 states weighted by the relative share of each state as per population numbers from Census 2011. It presents interesting data points on state-wise awareness of and access to nutrition.
The survey shows that India really has no understanding of a balanced diet. The country is protein deficient and there is a large awareness gap as far as protein and nutrition sources are concerned. As health safety continues to be a major concern, the index was compiled to educate people about a balanced diet and also make them aware of sources of good proteins.
In 2012, Sumathi Swaminathan, a researcher from St. John's Research Institute in Bengaluru, published a report in the British Journal of Nutrition, pointing out that while the proportion of individuals at risk of deficient protein intake was high in rural and tribal adult populations, it happened against the backdrop of a high prevalence of low BMI. “This is a big burden in disadvantaged populations; it is not simply the burden of enhancing the quality of protein intake, but also the quality of the diet in general, and represents a severe challenge that needs to be met. It would also appear that the diet of Indian pregnant women do not meet their increased protein requirement.”
A decade later, nothing has changed. According to Shobha Suri of the Observer Research Foundation, proteins are not only lacking in Indian diet, but are overlooked. India’s protein consumption is much lower than the 48gm per day recommended by the Indian Council of Medical Research. The recommended dietary allowance of protein for an average Indian adult is 0.8gm to 1gm per kilogram of body weight. However, the average intake is only about 0.6gm per kilogram of body weight. “Globally, protein consumption is on the rise, averaging at 68gm per person per day. India has the lowest average protein consumption (at 47gm per person per day),” said Suri.
The Union government has various safety net programmes under the National Food Security Act, like the Integrated Child Development Services (ICDS) and the Mid Day Meal Scheme (MDM) for improving nutrition and food security. As Suri notes, “The ICDS provides 500 kilocalories, with 12-15gm of protein per day to children and up to 25gm of protein for adolescent girls. The school meal scheme provides for 300 kilocalories and 8-12gm of protein per day. Despite this, India is home to the world’s second largest undernourished population and high rates of malnutrition.”
According to experts, with the rise in non-communicable diseases, the inclusion of high-protein foods in diet has been strongly associated with improving insulin response and reducing diabetes. Said Dr Charu Dua, chief clinical nutritionist at Amrita Hospital in Faridabad, “While young Indians are consuming enough proteins, the intake reduces considerably for those in the elderly age bracket. To prevent deficiency, the RDA is 0.8gm per kilogram of body weight for an average sedentary adult. A vegetarian diet is easily able to meet this demand,” she said.
The latest ICMR guidelines, meanwhile, recommend consuming proteins as per EAR (estimated average requirement) and not RDA. As per EAR, the requirement is 0.66gm per kilogram of body weight. "What we need is two bowls of dal a day, lots of vegetables and milk on a daily basis,” said Dua. “A balanced diet with a cereals-pulses combination is crucial. One need not look for a non-vegetarian option to consume enough proteins.”
Deepa Bhatia, general manager, YouGov India, said it was important to work together towards building a healthier and more nourished India. “The Nutrition Awareness Index highlights the perceptions and understandings of nutrition across various states, allowing us to identify crucial areas that require immediate attention and investment,” she said. “Tailoring educational campaigns to state-specific nuances is crucial. Understanding regional variations allows us to design more targeted approaches to increase awareness.”
UNAWARE INDIA
States with the lowest nutrition index scores (% below national average)
Bihar: 10%
Lowest recognition of nuts and oil seeds as energy sources
Andhra Pradesh: 10%
Lowest recognition of pulses and legumes as body-building food
Rajasthan: 8%
Among the lowest recognition of benefits of eggs, vegetables and fruits
Tamil Nadu: 6%
Low acknowledgment of nuts and milk as body-building food
Gujarat: 6%
Particularly low awareness of body-building food like meat
Source: Nutrition Awareness Index 2023