India is a vast and varied subcontinent. Covering 2.4 percent of the global landmass, it supports more than one-sixth of the world’s population. In 200 1, India’s population had reached 1 028 million people, living in 220 million households in 35 states and union territories (Map). As a developing country with high population density, ever since Indian independence, planners in India have recognized the importance of planned growth of the economy emphasis on human resource development. Policy-makers recognize that optimal nutrition and health are prerequisites for human development. Article 47 of the Constitution of India states that "the State shall regard raising the level of nutrition and standard of living of its people and improvement in public health among its primary duties". Over the last five decades, successive five-year plans have lain down policies and multisectoral strategies to combat nutrition-related public health problems and improve the nutritional and health status of the population.
Currently, the country is undergoing a rapid socio-economic, demographic, nutritional and health transition. Although India has not yet overcome the problems of poverty, undernutrition and communicable diseases, it is increasingly facing additional challenges related to the affluence that results from industrialization, urbanization and economic betterment. Over the last two decades, overnutrition and obesity have emerged as public health problems; there have been increases in the prevalence of diabetes and cardiovascular disease (CVD), especially in urban areas. The magnitude of these problems varies among states and socio-economic strata and between urban and rural areas, and it is a matter of concern that these diseases occur a decade earlier in India than elsewhere and that they affect poor segments of the population and those in rural areas. Case fatality rates are reported to be higher in poor and rural populations, probably because of poor access to health care and consequent delayed diagnosis and treatment. This case study reviews the impact of ongoing socio-economic, demographic and life style transitions on nutritional status, and the health implications of the ongoing nutrition transition.
