Diets, Nutrition, and Poverty - The Oxford Topic of Food, Politics, and Society - page 326

Thus, dietary transition was characterized by a substitution of traditional staples by
primary food products that are more prevalent in western diets. These shifts are reflected
in higher consumption of proteins, sugars, fats, and vegetables.
Some of the underlying factors behind this dietary transition are expansion of the mid-
dle class, higher female participation in labor markets, emergence of nuclear two-income
families, a sharp age divide in food preferences (with younger age groups more sus-
ceptible to new foods advertised in the media), and rapid growth of supermarkets and
fast-food outlets.4
The health implications of the dietary transition are unclear. A more varied and
nutritionally balanced diet and higher levels of food hygiene are associated with better
health. But there is a trade-off as more energy-dense foods are linked to higher inci-
dence of diet-related noncommunicable diseases (NCDs) such as diabetes, coronary
heart disease, and certain types of cancer. Although India lags behind other develop-
ing countries in the epidemiological transition—decline in infectious disease mortality
compensated for increasingly by higher mortality from chronic degenerative NCDs—
there is some evidence of this transition taking place. Estimated deaths from NCDs are
projected to rise from 3.78 million in 1990 (40.46% of all deaths) to 7.63 million in 2020
(66.70% of all deaths)
The scheme of this chapter is as follows: The second and third sections review the
evidence on nutrient intake and dietary changes, focusing particularly on the down-
ward shift in calorie, protein, and other nutrient intakes over the period 1993-2004. In
the fourth section, recent evidence on eating out as an aspect of dietary transition in
India is reviewed. The fifth section undertakes a demand-theory based explanation of
the factors driving the downward shifts. In the sixth section, we use a different mea-
sure of undernutrition, based on the calorie share of staples. The seventh, eighth, and
ninth sections, respectively, focus on poverty nutrition traps, an assessment of whether
child undernutrition is underestimated; and the links among aging, obesity, affluence,
expansion of the middle class, urbanization, and noncommunicable diseases (NCDs).
The tenth section examines the (potential) contribution of National Rural Employment
Guarantee Scheme (NREG) and Public Distribution System (PDS) toward mitigating
the extent and severity of undernutrition (including micronutrient deficiency). As cur-
rent debates on food security have veered toward a right to food, a new perspective is
delineated in the eleventh section, to suggest that food security involves a right to poli-
cies (or a “right to a right”) designed to ensure fulfillment of food entitlements. The final
section makes some concluding observations from a broad policy perspective.
Nutrient Intake
Various sources—including detailed household consumption expenditure surveys con-
ducted by the National Sample Survey Organisation (NSSO) every five years in India
(the so-called thick samples)—point to a puzzle. Despite rising incomes, there has been