A few months ago, 35-year-old Zubin from Kochi went to the hospital with gastric issues. His food pattern was erratic and he led a sedentary lifestyle. “The patient was struggling with sleeplessness and other health ailments. Upon investigation, we found that his triglycerides, liver fat, and cholesterol levels were high. He was on the brink of developing diabetes and the gastric issues were the result of his routine,” said Dr Manju George, chief dietician at VPS Lakeshore, Kochi, adding that the condition was reversed in three to four months with significant lifestyle changes and diet modifications.
Skipping breakfast, consumption of sugary foods, eating dinner late and snacking at midnight, along with the lack of physical activity, made him overweight as well. “Fatty liver and acidity were treated with the assistance of medications. We suggested a low-carbohydrate, high-protein, and low-fat food pattern. He was asked to drink more water and cut down on sugar, and have his dinner no later than 8pm,” she added.
In the review after a month, it was noticed that he lost three kilos. He then started physical activity and also took acidity medications. After two months, there was a decrease of 7-8 kg in weight. The patient started to feel better with dietary changes.
According to Dr Manju, maintaining a consistent diet is necessary to reverse health conditions caused by poor diet, obesity, and overnutrition. “The term malnutrition is a double-edged sword now, as it denotes undernutrition and overnutrition. Earlier, we used to address the issue of underweight more. Now, with better accessibility and availability of food, and changing culture – the online delivery system and sedentary lifestyle – the number of people suffering from obesity and chronic diseases caused by overnutrition have been on the rise in India,” she said.
According to the study ‘Overnutrition among schoolchildren in India: a review and meta-analysis’ published in the Lancet Global Health in March 2018, one in nine schoolchildren suffered from overnutrition.
According to the World Health Organisation, malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilisation. The double burden of malnutrition includes undernutrition, overweight, and obesity, as well as diet-related non-communicable diseases.
According to Dr Sajana TM, a paediatrician at Aster Medcity, there has been a significant increase in the number of children and adolescents experiencing health issues related to overnutrition, particularly obesity. This trend poses serious health risks, including type-2 diabetes, hypertension, and cardiovascular diseases. The consumption of energy-dense, nutrient-poor foods, shift toward refined grains, which are often marketed directly to children through television, online platforms, and other media, have risen, influencing their food preferences and increasing the risk of obesity,” she said.
Dr Nivedita P, head of department of clinical nutrition at Amrita Hospital, Kochi, said the first indication (of overnutrition) is insulin resistance – a condition when the body becomes more resistant to insulin, a hormone that regulates blood sugar levels. “Insulin resistance is mostly caused by the consumption of excessive calories through processed foods. Overnutrition can also lead to fatty liver, PCOS, type-2 diabetes, and other conditions. Recently, type-2 diabetes is being diagnosed at an early age,” she said.
Obesity, which starts during childhood, is the most prevalent condition in children. “The incidence of childhood obesity is steadily rising in our population, paving the way for an alarming surge in lifestyle-related diseases such as type-2 diabetes, hypertension, and cardiovascular conditions at increasingly younger ages,” she said, adding that addressing childhood obesity requires a critical focus on promoting balanced, nutritious, and age-appropriate diets.
Hidden hunger
Another form of malnutrition is hidden hunger (micronutrient deficiency), which is experienced by people having deficiency of iron, vitamin D, and other nutrients. “In most cases, the individual may not understand it. The condition is caused by the lack of essential vitamins and minerals, or micronutrients, in their diet. When a person experiences craving, it could be an indication of hidden hunger. In such cases, they should consult a doctor. Consuming excess food to satisfy hidden hunger cravings can cause other health issues,” added Dr Manju.
When children with such impaired nutritional status enter adulthood, the situation turns ripe for lifestyle diseases considering today’s changing food habits and sedentary lifestyle. This paves the way for metabolic diseases at an early age, leading to increased medical costs and less productivity.
The factors
The study ‘Overnutrition: Current Scenario and Combat Strategies’, published in the Indian Journal of Medical Research, has found that in about two decades, a two to three-fold increase in the cumulative prevalence of overweight/obesity was reported from the national population surveys in India.
“The widespread availability and consumption of HFSS (High in Fat, Salt, and Sugar) foods — including processed snacks, ultra-processed foods, sugary beverages, and fast food are the main culprits. They contribute significantly to unhealthy weight gain and metabolic imbalances in children. These foods are often energy-dense yet nutrient-poor, displacing healthier dietary options and fostering long-term eating habits that increase the risk of chronic diseases,” said Dr Nivedita, adding that the number of food outlets has been increasing. Children these days are not able to control their temptation for junk foods and snacks.
Dr Sajana added that changes in family dynamics, such as reduced breastfeeding and increased reliance on processed foods, can influence children’s weight. “Additionally, children from lower socioeconomic backgrounds may have limited access to healthy foods and safe spaces for physical activity, further increasing their risk of obesity. Emotional stressors, such as maternal depression or family stress, can affect children’s eating behaviours and activity levels, potentially leading to obesity,” she pointed out.
According to the NOVA food classification system, ultra-processed foods with industrial formulations are made entirely or mostly from substances extracted from foods derived from food constituents, or synthesised in laboratories from food substrates or other organic sources. It includes fatty, sweet, savoury or salty packaged snacks, pre-prepared (packaged) meat, fish and vegetables, biscuits (cookies), pre-prepared pizza and pasta dishes, ice creams and frozen desserts, flavoured yogurts, energy and sports drinks, and other similar food items.
Along with a healthy diet and physical activity, good sleep hygiene can help, according to Dr Sajana. “Proper sleep boosts immune function, attention span, and overall growth and development. Lack of sleep is linked to obesity, poor academic performance, and mood disorders. Reducing screen time encourages physical activity, social interaction, and better sleep,” she added, emphasising that routine medical and dental visits allow for early detection of potential health issues.