NEW DELHI: To tackle growing obesity among children, India needs to introduce skill-based nutrition education within the school timetable for Grades 1-12, prohibit all direct and indirect marketing of high fat, sugar and salt (HFSS) foods to children under the age of 18 and make existing initiatives such as sugar boards, oil boards and other nutrition literacy activities across all schools mandatory, said a latest ICMR-UNICEF report.
The report, jointly prepared by Indian Council of Medical Research-National Institution of Nutrition (ICMR-NIN), UNICEF, India, and The Public Health Foundation of India (PHFI), also recommends that the government should mandate the development and annual implementation of a standardized health and nutrition report card for all students to assess and monitor key indicators related to nutritional status, dietary practices, physical activity, fitness, growth and overall health.
The ‘Nutrition Environment Assessment Toolkit for Schools’ (NEAT-S) and its report, ‘Strengthening Evidence on school nutrition environments in India: insights from feasibility assessment of the adapted NEAT-S Tool,' which was released this week by The Let's Fix Our Food (LFOF) Consortium, led by ICMR-NIN, suggest that all schools should ensure a minimum of 60 minutes of daily structured physical activity for students, including those in Grades 11–12, through mandatory integration within the school schedule.
It specifically suggested that specific measures should be instituted to promote equitable participation of girls, as it was found that they spend less time in vigorous exercise (from 25 minutes in the 10–14 years age group) to just 10 minutes (in the 15–19 years age group), compared with 40 and 50 minutes respectively among boys.
The report, which is available with this paper, also suggests that schools should implement structured parent and family engagement programmes through parent-teacher meetings (PTMs).
These engagements should include at least two family nutrition sessions per year, to strengthen home and school food environments by promoting healthy lunchbox practices, nutritious home diets, adherence to iron and folic acid (IFA) supplementation and deworming, and awareness of the risks associated with HFSS foods and children’s exposure to digital food marketing.
It also suggested that school canteens should undergo comprehensive reform, replacing fried and packaged food options with alternatives such as fresh fruits, traditional snacks, sprouts, nuts, buttermilk, millets and whole grains. "Pricing mechanisms should be structured to ensure that nutritious choices are consistently more affordable than unhealthy ones, encouraging students to opt for healthier options," it said.
“Schools should further introduce dedicated healthy meal days or a designated healthy snack corner to normalise healthy eating. All canteen service providers should hold a valid FSSAI licence and be required to undergo annual food safety training to uphold hygiene, quality and accountability standards,” the report added.
Recommending that the Union Education Ministry and Health and Family Welfare Ministry should issue a joint directive to institutionalise structured, skill-based nutrition education within the school timetable for Grades 1–12, the report said, a minimum of 45–60 minutes per week should be allotted to this.
The curriculum – across all school boards – should be aligned with the Dietary Guidelines for Indians, 2024 and the National Education Policy (NEP) 2020, and should include age-appropriate, skill-based learning on healthy diets, food label interpretation, food systems awareness and informed food choices, complemented by practical school-based initiatives such as sugar, oil and salt Boards and other nutrition literacy activities.
It also pushed for a standardised regulatory definition of HFSS to be developed and formally adopted by the Food Safety and Standards Authority of India (FSSAI) to ensure clarity, uniformity, and consistency in the implementation, monitoring, and advertising restrictions related to unhealthy foods.
The report also recommended to the government to notify and immediately operationalize pending provisions and sub-regulations under the FSSAI Food Safety and Standards (Safe Food and Balanced Diets for Children in School) Regulations, 2020, particularly Regulation 3(5), which mandates that school authorities ensure no person sells or permits the sale of foods high in saturated fat, trans-fat, added sugar or sodium within school premises or campuses, and Regulation 5(1), which prohibits the advertisement, marketing, sale, or offering for sale of such food products within school campuses and within a 50-metre radius of school gates.
Among the other key recommendations are periodic assessment of school food environments as a routine state-level monitoring mechanism – conducted at least annually – to evaluate exposure to HFSS foods, menu quality, food safety and hygiene standards, and gaps in the implementation of nutrition-related services within schools.
On issuing health and nutrition report cards for all students, the experts said it should serve as a systematic mechanism for the early identification of health and nutrition risks, monitoring of student well-being by both school authorities and parents, strengthening of school health services, and promotion of accountability for healthy school environments.
The need to introduce these measures at an early age was felt as 246 million children are enrolled across 1.47 million schools where they spend over 12,000 hours across 10–12 years – making it a critical window during which dietary behaviours are formed, and long-term health outcomes are established.
In India, 561 million children aged 5–19 years constitute nearly one-third (28.5 per cent) of the total population. Nearly 41 million children aged 5–19 years are living with overweight or obesity in 2025, and India is projected to account for more than 11 per cent of the global childhood obesity burden by 2030 if current trends continue.
India is facing a rapidly growing burden of diet-related non-communicable diseases (NCDs), including obesity, diabetes, hypertension, cardiovascular diseases and certain cancers.
The Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) study highlights the widespread burden of metabolic risk factors across the country, estimating that more than 101 million adults are living with diabetes, approximately 315 million with hypertension and 254 million with generalised obesity.