Processed foods, socio-economic status, and peri-urban obesity in India

Abstract

The ‘State of Food Security and Nutrition in the World 2020′ report states that switching to healthy diets will both prevent backsliding into hunger and help countries meet their sustainability goals. In 2019–2020, 17 percent of India’s adult population was undernourished. At the same time, however, 23 percent of all adults were obese. The increasing prevalence of obesity implies that improving diets and reducing risks for obesity and non-communicable diseases (NCDs) is a major food security challenge for India in the coming years. Overconsumption of calories from processed foods is known to increase the risk of obesity. To gain insights into the dietary transition and its relationship with obesity, we use cross-sectional data from a primary socio-economic survey conducted in the rural-urban interface of Bangalore, a mega-city in India that is characterized by high economic development. We show that for women in lower-middle socio-economic status (SES) groups, higher share of calories from semi-processed foods (SPF) is associated with a higher prevalence of obesity, while excess consumption of calories from ultra-processed foods (UPF) is associated with a higher obesity prevalence among women in higher SES groups. Older women and women who consume above the recommended daily allowance (RDA) of calories are more vulnerable to excess calories from SPF consumption than younger women and women who consume less than the RDA of calories. Furthermore, a lower prevalence of obesity is observed among women who consume excess calories from SPF but engage in labor-intensive occupational activity. These results speak to the need for interventions that incentivize weight loss and increased physical activity. The result that SPF consumption is associated with an increased prevalence of obesity especially among lower-middle SES group calls for interventions that increase access to and affordability of healthy diets. Policy instruments such as diversifying the public distribution system (PDS) are important to improve accessibility and affordability of healthy diets. In addition, increasing sugar and processed food taxes and incentivizing companies to invest in culturally sensitive food labeling should be considered to shift consumer demand towards healthier diet choices.