Opinion 2024 Dietary Guidelines: What Indians should eat — and don’t

Dietary guidelines in any country aim to improve food security, safety, nutrition and health. They are used to shape the food environment by setting norms for foods offered in public settings (schools, workplaces and restaurants); and by guiding the food industry to improve the nutritional quality of food products (for example, reducing sodium, fat and sugar content) or by regulating the marketing and sale of products of low nutritional value and/or high in fat, sugar, salt (HFSS) and additives — particularly those directed at children. They include advice on foods, food groups and dietary patterns.

The 2024 Guidelines address various dietary aspects including grains, fruits, vegetables, and the reduction of HFSS foods, while also touching on concerns like ultra-processed foods, protein powders, food safety and food labelling as well as physical activity and exercise. However, the guidelines fall short of addressing micronutrient deficiencies. Our study at ICRIER shows that one in five Indians are Vitamin D deficient, similar is the prevalence of other deficiencies like anaemia. Food fortification, which should be an important area for policy intervention, to make micronutrients like vitamin D, iron, and iodine available to consumers is dealt with briefly, perhaps because the ICMR-NIN nationwide survey, ‘Diet and Biomarkers Survey (DABS-I)’ to identify micronutrient deficiency is yet to be released. Further, contemporary issues of gut health, sustainable diets and the impact of climate change on food production and consumption patterns should have been given due importance.

India has experienced significant changes over the past decade, including economic growth, increased female workforce participation, and sedentary lifestyles. The food industry has grown by leaps and bounds. Correspondingly, the prevalence of noncommunicable diseases is rapidly rising. Besides dietary diversification and supplementation, India needs fortified salt, oil, milk, and cereals, given that the Indian diet is mostly cereal-based but there is regional variation in the type of cereal taken. However, cereals fail to offer the requisite protein, which pulses have. The 2024 Guidelines recommend an intake of 85g of pulses, eggs and flesh foods along with 300 ml of milk products to meet the protein requirements. However, with the escalating prices of pulses and animal foods, these recommendations are beyond the reach of many in the country. These guidelines should at least be followed up in public procurement programmes.

Some states like Tamil Nadu and Odisha are already including eggs in their mid-day meals. Other states should also look at options to use public procurement programmes to address diseases like Vitamin D deficiency. Nutritionists and experts pointed out that the average cost of adhering to these guidelines is Rs 62 per person/day, totalling nearly Rs 250 for a family of four. Strong policy, multi-stakeholder partnerships and programmatic impetus are needed to make a nutritious and healthy diet within the reach of the common man. In this context, the government can think of measures like linking fiscal incentives to fortified food, developing a model guideline for PDS so that the right kind of food is distributed through the PDS, building public awareness through the FSSAI’s Eat Right Campaign or front-of-pack-labelling.

There is an urgent need to align all government policies — financial, regulatory, health, agriculture, public distribution — towards the same objective of promoting good nutrition among Indians. FAO/WHO recommends that dietary guidelines be developed by interdisciplinary teams from agriculture, health, education, nutrition, food science, and other sectors, and be open for public comment. Although the first Dietary Guidelines for Indians in 1998 followed this process, the 2024 version appears to have bypassed detailed stakeholder consultations. While several industry bodies and professional associations are coming forth with their suggestions, it is still not too late to have detailed deliberations with multiple stakeholders to incorporate their inputs and translate the guidelines to be practical, actionable and adoptable.

Puri Professor (Retd) at the Department of Food and Nutrition, Institute of Home Economics, University of Delhi and Mukherjee is Professor at ICRIER