Abstract

Background: India is undergoing a complex nutrition transition marked by the persistent burden of child undernutrition alongside a rapidly increasing prevalence of overweight and obesity across age groups. This coexistence, referred to as the double burden of malnutrition, poses major public health, policy, and economic challenges. Despite large-scale nutrition programs and economic growth, progress remains uneven with pronounced socioeconomic and regional disparities. Objectives: This study aimed to examine temporal trends in undernutrition and overnutrition in India, analyze socioeconomic and regional inequalities, assess the effectiveness of major government nutrition initiatives, and situate India’s nutrition trajectory within a global comparative framework. Methods: A descriptive secondary analysis was conducted using nationally representative data from NFHS-3, NFHS-4, NFHS-5, UNICEF–WHO–World Bank Joint Child Malnutrition Estimates, and relevant peer-reviewed literature published between 2000 and 2024. Key indicators including stunting, wasting, underweight, and overweight were analyzed across time, residence, socioeconomic strata, and selected countries. Results: Stunting and underweight declined; however, wasting remained persistently high. Overweight and obesity increased across age groups with diffusion into rural and lower-income populations. Inequalities persisted, and program impacts on acute malnutrition and overnutrition were limited. Conclusion: Integrated life-course, diet-quality–focused, and multisectoral strategies are essential to address India’s double burden and achieve equitable nutrition outcomes.

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