India has largely solved one problem that once defined its development trajectory: the fear of mass hunger. Grain stocks are robust, procurement systems are entrenched and food-based welfare schemes reach millions of households every day. But India continues to rank poorly on nutrition indicators that matter for health, learning and productivity. The paradox is striking. The country is food-secure, but not nutrition-secure.
This contradiction lies at the heart of India’s current nutrition challenge. Hunger today is no longer only about empty stomachs. It is about diets that fill bellies but fail bodies. Micronutrient deficiencies, often described as “hidden hunger”, now coexist with undernutrition and rising obesity, creating what public-health experts call a triple burden of malnutrition.
Addressing this crisis requires moving beyond ideological debates and simplistic solutions. It demands an approach that recognises the value of scientific interventions such as food fortification, while simultaneously rebuilding local food diversity and dietary practices that have sustained Indian communities for generations. The future of India’s health lies not in choosing between the laboratory and the kitchen, but in learning how to use both wisely.
The scale of the India’s nutrition crisis
The data is unequivocal. According to NFHS-5, more than half of women of reproductive age in India are anaemic, as are nearly two-thirds of children under five. These deficiencies have long-term consequences: impaired cognitive development, lower educational attainment, reduced economic productivity and higher maternal and child mortality.
What makes this crisis particularly insidious is that it persists despite widespread calorie availability. Public programmes such as the Public Distribution System and the Mid-Day Meal Scheme have been effective in preventing starvation. But they were never designed to deliver dietary diversity at scale. Cereals dominate plates, while fruits, vegetables, pulses and animal-source foods remain limited, especially among low-income households.
This is not a failure of intent. It is a structural limitation of systems built to address hunger, not nutrition.
Food fortification as a public-health tool
In this context, food fortification has emerged as a pragmatic response. By adding essential micronutrients such as iron, folic acid, iodine and vitamin A to staple foods, fortification seeks to improve nutritional intake without requiring behavioural change.
From a public-health perspective, its appeal is clear. Fortification is scalable, cost-effective and capable of reaching populations that may otherwise be excluded from targeted interventions. International evidence suggests that fortification can significantly reduce anaemia, neural tube defects and iodine deficiency disorders when implemented correctly.
In India, fortified rice, wheat flour, edible oil and salt are increasingly integrated into welfare schemes. For populations with acute deficiencies, fortification acts as a nutritional safety net—one that can be deployed quickly and at scale.
But fortification has limits.
It can correct specific deficiencies, not replace the complex nutritional profile of a diverse diet. It cannot provide dietary fibre, phytochemicals or the full range of micronutrients found in whole foods. Nor can it address the social and behavioural dimensions of eating.
The case for local food diversity
India’s traditional diets evolved over centuries to reflect geography, climate and culture. Millets in semi-arid regions, leafy greens in riverine belts, fermented foods in the Northeast—these were not lifestyle choices but adaptive strategies for survival and health.
The erosion of these food systems has been gradual but profound. Market consolidation, agricultural monocropping, urbanisation and aggressive marketing of ultra-processed foods have narrowed dietary diversity. The result is a nutrition transition that has left low-income communities vulnerable to both deficiency and excess.
Local food diversity is not nostalgia. It is a sustainability strategy. Diets built around seasonal vegetables, pulses, millets and indigenous greens are more resilient to climate shocks, less dependent on global supply chains and nutritionally richer than cereal-heavy or processed diets.
Rebuilding this diversity requires institutional support through schools, Anganwadi centres and community systems that reconnects people with locally available foods and the knowledge to use them.
A false binary in India’s nutrition policy
Public debate often frames fortification and local diets as competing approaches. This is a false binary.
Fortification is most effective as a protective measure—a baseline intervention to prevent severe deficiency. Dietary diversity is the long-term solution for sustainable health. One addresses urgency; the other builds resilience.
The problem arises when fortification is treated as a substitute for food system reform, rather than as a complement. Over-reliance on fortified staples, especially when paired with ultra-processed foods, risks entrenching monotonous diets and undermining local agriculture.
The challenge for policymakers is not to choose sides, but to design nutrition strategies that integrate both approaches without allowing one to crowd out the other.
Lessons from field-based implementation
This balance is best observed at the community level, where civil society organisations working across nutrition, health and education often see that behaviour change, access and trust are as important as nutrient composition.
Smile Foundation’s health and education programmes offer one such example. Operating across multiple states, the Foundation sustains efforts to promote local food consumption through kitchen gardens, nutrition education and community engagement.
In districts where anaemia rates were high, fortified foods provided immediate relief. But long-term improvement was observed only when families began incorporating locally grown vegetables, greens and iron-rich foods into daily meals. Schools that established nutrition gardens not only diversified diets but also improved food literacy among children and caregivers.
The insight here is not about scale, but design. Nutrition interventions work best when they are layered, combining scientific inputs with local food systems and information with access.
The new challenge: ultra-processed diets
Even as undernutrition persists, India faces a growing problem of over-nutrition. Ultra-processed foods, often fortified but high in sugar, salt and unhealthy fats, are increasingly common in urban and semi-urban diets.
This creates a perverse situation where a child can be both overweight and micronutrient-deficient. Fortification alone cannot resolve this contradiction. Without parallel efforts to promote whole foods and regulate unhealthy diets, nutrition policy risks addressing symptoms while deepening causes.
From food security to nutrition security
India’s next nutrition transition must therefore move beyond food security to nutrition security. This means rethinking how welfare schemes, agriculture, education and health systems interact.
Fortify where necessary. Diversify wherever possible. Protect vulnerable populations today, while rebuilding food systems for tomorrow.
A more grounded way forward
As climate change, urbanisation and economic inequality reshape India’s food landscape, the choices made today will determine whether the country improves health outcomes or locks itself into a cycle of nutritional inadequacy.
The path forward lies in recognising diversity as strength—not inefficiency—and science as ally, not replacement. Nutrition policy must resist one-size-fits-all solutions and instead build layered strategies that respond to both urgency and sustainability.
India does not need to choose between fortified rice and backyard greens. It needs both. The task is to ensure that neither becomes an excuse for neglecting the other.
Only then can the country move from feeding its population to nourishing it.
