Authored by Dr. Rajesh Kapur, Former Additional Secretary, DBT, Govt. of India

India has made significant strides in reducing hunger and malnutrition over the past two decades. Expanded food security legislation, a well-established Public Distribution System, and targeted nutrition programmes have ensured that far more Indians have access to adequate calories than a few years ago. Yet, beneath this progress lies a quieter, but deeply consequential crisis, the crisis of hidden hunger.

Hidden hunger refers to deficiencies of essential micronutrients like Iron, Folate, Vitamin B12, Zinc, and Vitamin A, among others, in the body despite sufficient daily caloric intake. The impact of this is unmistakable; stunted cognitive development in children, compromised immunity, maternal anaemia, poor birth outcomes, and reduced workforce productivity. These are not merely health concerns but emerging as structural barriers to India’s human capital and long-term economic growth.

The Silent Burden of Micronutrient Deficiency

For younger and middle-aged Indians, these deficiencies can mean operating below their full cognitive potential. For the elderly, the stakes are even higher—elevated risks of strokes, dementia, and other serious neurological conditions. This is far from peripheral data; it reflects the lived reality for a significant proportion of India’s 1.4 billion people.

The numbers at the population level are equally sobering. The National Family Health Survey-5 (NFHS-5, 2019–21) recorded anaemia prevalence at 67.1 per cent among children aged 6–59 months, 59.1 per cent among adolescent girls aged 15–19 years, and 31.1 per cent among adolescent boys in the same age group. Among women aged 15–49 years, anaemia prevalence stands at 57.0 per cent .

Recent analysis of NFHS-5 data across four of India’s metropolitan cities found that at least seven out of ten children surveyed suffered from some form of micronutrient deficiency and that the economic cost of these deficiencies could amount to between 0.8 per cent and 2.5 per cent of GDP annually. That figure translates the human suffering of hidden hunger into terms that finance ministries, not just health departments, are obliged to reckon with.

Why Dietary Diversification Alone Cannot Bridge The Gap

The textbook answer to micronutrient deficiency is consuming a balanced diet that includes dietary diversification, supplementation. However, this prescription often overlooks the constraints faced by a large section of the population; it runs up against economic and behavioural realities.

For many households, food choices are shaped less by awareness and more by affordability, availability, accessibility and deeply ingrained dietary habits and patterns. Diets remain heavily dependent on staple grains that are calorie-dense and nutrient-poor. Under these conditions, relying on dietary transformation alone is neither realistic nor sufficient as a standalone strategy to close the gap at scale. This is where food fortification offers a practical, and safe solution. Food fortification has emerged as the most cost-effective and scalable public health strategy to address these deficiencies — a complement to dietary diversification, rather than a substitute for it.

Globally, fortification has proven effective across all age groups, helping reduce deficiencies by adding essential nutrients to daily staples and reaching populations that struggle most to meet nutritional needs. India already has an extensive delivery architecture to scale fortified foods, with programmes like the Public Distribution System and the PM POSHAN programme. Programmes targeting salt, flour, and oil over the past fifteen years have been associated with increased nutrient intake in at-risk populations. This is no more a theoretical possibility, but a demonstrated strategy.

Policy, Industry, and Public Awareness: A Shared Responsibility

Addressing hidden hunger through fortification requires more than government action alone. Fortification’s full potential is constrained by gaps in awareness, implementation, monitoring, and public engagement. This remains particularly true for India, where the regulatory framework exists but implementation remains uneven across states and supply-chain actors.

Industry has a critical role to play in adopting fortification at scale, supported by independent monitoring. Building consumer awareness will require sustained efforts through schools, frontline workers, and mass communication.

Addressing hidden hunger is often viewed as a welfare measure. It is, in fact, far more than that. It is an investment in India’s future workforce and its long-term economic resilience. The tools are in place, the evidence is clear, and the support system exists. What is required now is the coordinated action across policy, industry, and community to ensure that India’s fight against hidden hunger and malnutrition moves beyond calories toward quality nutrition.