In India, each State is practically equivalent to a country with its specific socio-economic level, different ethnic groups, food habits, health infrastructures and communication facilities. Thus, the nutritional status of the population shows significant variation between states since it results from a varying combination of factors.
For children 1-5 years of age, the prevalence of underweight ranged from 13% in the State Meghalaya to 77% in Gujarat. The prevalence of stunting ranged from 20% in Goa to 83% in Gujarat. The distribution of stunting coincides almost exactly with that of underweight, i.e. the highest prevalence of stunting were observed in the same States as those of underweight. As for underweight and stunting, wasting is a serious public health problem in most States. The distribution of wasting does not coincide with that of stunting and underweight except for the States of Madhya Pradesh and Arunachal Pradesh which show the worst nutritional situation of all States in India.
The States of Karnataka, Gujarat, Madhya Pradesh and Orissa are highly affected by adult malnutrition with more than half of the adults having a BMI under 18.5 kg/m2. Patterns of child and adult malnutrition overlap in that both show extremely poor nutritional status in the states of Gujarat, Orissa, Arunachal Pradesh, Karnataka, Maharashtra, Madhya Pradesh and Andhra Pradesh.
In the last 20 years, there has been an improvement in the nutritional status of the Indian population. This improvement results from not only changes in food intake but also socio-economic factors, increased availability of potable water, lower morbidity and improvement of health facilities.
In children under five years of age, the marked improvement in nutritional status is shown by the a reduction of the prevalence of underweight from 63%, in the 1975-79 period to 53% in the 1988-90 period. The under-five mortality rate (U5MR), an important indicator of the socio-economic development, and health and nutritional status of a society, declined from 282% in 1962 to 115‰ in 1994. However, a multitude of infectious diseases such as respiratory and intestinal infections as well as malaria remain the main cause of death in children under five, with malnutrition being an aggravating factor. Measles, tetanus, typhoid and hepatitis are also frequent causes of death during infancy and childhood.
In adults, average BMI values were similar for both males and females. About 50% of the adult population had a BMI below 18.5 kg/m2 while only a negligible proportion were overweight or obese. In a few States such as Arunachal Pradesh, obesity and correlated diseases are becoming a public health problem. In the last 20 years, a clear shift to the right is seen in the distribution of BMI values, suggesting an improvement in adults’ nutritional status over this period. Moreover, according to FAO the proportion of the population whose energy requirements were satisfied was 21% in 1990-92 against 36% in 1969-71, thus indicating an improvement of the food supply situation.
In the last 20 years, there have been no significant changes in patterns of dietary intake. Cereals remain the staple food in India providing most of the energy intake. Since the seventies the consumption of foods like pulses, roots and tubers has fallen , while that of other foods like sugar, "jaggery" (unrefined brown sugar), fats and oils and green leafy vegetables have slightly increased. The average Indian diet remains largely deficient in green leafy vegetables, meat, fish, milk and milk products. Moreover, it also remains deficient in some micronutrients such as vitamin A, iodine and iron.