What is the Most Common Nutritional Problem in India?

January 12, 2026 •

4 min read

According to a 2025 meta-analysis published in BMC Public Health, anemia is a severe public health problem in India, affecting the majority of toddlers and women. This widespread condition, predominantly driven by iron deficiency, is the most common nutritional problem in India, with high prevalence rates across multiple vulnerable population groups.

Quick Summary

Anemia, largely fueled by iron deficiency, is India's most widespread nutritional issue, impacting children, women of reproductive age, and pregnant women. Contributing factors include inadequate dietary iron intake, parasitic infections, and specific physiological needs. Addressing this requires multi-faceted strategies, including supplementation, food fortification, and public health campaigns.

Key Points

Prevalence of Anemia: A 2025 meta-analysis confirmed that anemia remains India's most common nutritional problem, with alarmingly high prevalence, particularly among toddlers (69%) and pregnant women (72%).
Iron Deficiency is the Leading Cause: While other deficiencies contribute, iron deficiency is the primary driver of anemia, affecting millions due to poor dietary intake and absorption.
Risk Factors: High-risk groups include women of reproductive age, infants, and young children. Other causes involve parasitic infections like hookworm and malaria.
Government Interventions: Initiatives like Anemia Mukt Bharat focus on prophylactic IFA supplementation, deworming, and food fortification to combat the problem.
The Double Burden: India faces the dual challenge of undernutrition (like anemia) and rising overnutrition (obesity), especially in urban areas, complicating effective public health strategies.

The Widespread Prevalence of Anemia in India

Iron deficiency anemia stands out as the single most prevalent nutritional disorder in India, with significant public health consequences. National surveys and recent meta-analyses confirm its alarming frequency across various age groups and demographics. While other issues like vitamin A and vitamin D deficiencies are also common, the sheer scale and impact of anemia, especially on vulnerable groups, make it the most pressing nutritional concern.

The National Family Health Survey-5 (2019-21) provides stark statistics, reporting that 67.1% of children aged 6-59 months, 57.0% of women of reproductive age (15-49 years), and 52.2% of pregnant women were anemic. Furthermore, a 2025 systematic review confirmed the persistent high prevalence, noting the highest rates among toddlers (69%) and pregnant women (72%). These figures highlight a crisis that goes beyond simple dietary intake, intertwined with socio-economic, environmental, and physiological factors.

Key Factors Contributing to Anemia

Dietary Deficiencies

Inadequate Iron Intake: Many Indian dietary patterns, particularly vegetarian ones, often lack sufficient bioavailable iron. While plant-based foods like leafy greens contain iron, its absorption is less efficient than the heme iron found in animal products.
Poor Micronutrient Absorption: Consumption of high quantities of tea, coffee, and phytic acid-rich cereals can inhibit iron absorption. A lack of Vitamin C, which enhances iron uptake, further exacerbates the problem.
Insufficient Variety: Diets heavily reliant on single staple foods like rice or wheat, without adequate diversification, result in a lack of essential micronutrients including iron, folate, and Vitamin B12.

Infections and Hygiene

Parasitic Infections: Soil-transmitted helminths, such as hookworms, are a common cause of chronic blood loss and anemia, especially in children. These parasites live in the intestines and feed on blood, leading to significant iron depletion.
Malaria: In endemic regions, malaria-induced red blood cell destruction is a major contributor to anemia.
Poor Sanitation: Unsafe waste disposal and inadequate hygiene practices facilitate the spread of parasitic infections, indirectly fueling the anemia crisis.

Physiological Vulnerabilities

Pregnancy and Menstruation: Women of reproductive age, particularly pregnant women and adolescent girls, are at high risk due to increased iron demands for fetal development and blood loss during menstruation, respectively.
Childhood Growth: Infants and young children experience rapid growth, which significantly increases their iron requirements. Inadequate complementary feeding practices and low maternal iron stores during pregnancy contribute to early childhood anemia.

Public Health Interventions and Strategies

The government of India has implemented several large-scale programs to combat anemia, with varying degrees of success. Key initiatives include the Anemia Mukt Bharat (AMB) strategy under the POSHAN Abhiyaan and the Rice Fortification Initiative.

Supplementation: Regular provision of Iron and Folic Acid (IFA) supplements to targeted beneficiaries, including children, adolescent girls, and pregnant women, is a cornerstone of the AMB strategy.
Deworming: The National Deworming Day program administers Albendazole tablets biannually to children and adolescents to control intestinal parasites that cause blood loss.
Fortification: The fortification of essential food items, such as rice and milk, with iron and other micronutrients is a key long-term strategy to improve the nutritional status of the general population.
Behavioral Change Communication: Campaigns and awareness programs aim to educate communities on healthy dietary practices, proper hygiene, and the importance of compliance with supplementation.

Comparison of Anemia Prevention Strategies


Intervention	Mechanism	Target Population	Effectiveness	Challenges
IFA Supplementation	Direct delivery of iron and folic acid to at-risk groups.	Children, adolescents, pregnant women.	Proven to be effective in directly increasing hemoglobin levels.	Low compliance rates, supply chain issues, side effects like constipation.
Food Fortification	Incorporating iron into widely consumed staples like rice.	General population.	Offers broad coverage and passive intake without requiring conscious behavior change.	Initial investment costs, quality control of fortified products, public acceptance.
Deworming	Reduces parasitic infections that cause chronic blood loss.	Children and adolescents.	Highly effective against a specific cause of anemia.	Requires consistent implementation and can be limited to specific endemic regions.
Dietary Diversity	Education and promotion of iron and Vitamin C-rich foods.	General population.	Sustainable, natural approach to address micronutrient deficiencies.	Dependent on socio-economic status, cultural food habits, and agricultural practices.

The Double Burden of Malnutrition

While undernutrition in the form of anemia and other micronutrient deficiencies remains a significant problem, India is also grappling with the rising burden of overnutrition, particularly obesity, in urban areas. This phenomenon, known as the 'double burden of malnutrition,' results from increased consumption of energy-dense but nutrient-poor processed foods. Studies have even shown an association between obesity and anemia in Indian schoolchildren, highlighting the complexity of modern nutritional challenges. Addressing India's most common nutritional problem, therefore, requires a comprehensive approach that tackles both deficiencies and overconsumption of unhealthy foods.

Conclusion

Anemia, stemming primarily from iron deficiency, is unequivocally the most common nutritional problem in India. Its pervasiveness, particularly among women and children, poses a serious and persistent threat to public health and national development. The issue is driven by a combination of inadequate dietary intake, poor absorption, high infectious disease burden, and physiological factors. Despite government efforts through supplementation, fortification, and deworming, the prevalence rates remain high, indicating the need for stronger, multi-pronged interventions. Tackling this challenge effectively requires sustained public health action that addresses the interconnected issues of micronutrient deficiencies, hygiene, and changing dietary habits across all segments of the population.

Frequently Asked Questions

Iron deficiency is the leading cause of anemia in India, resulting from inadequate dietary intake and poor absorption of iron, compounded by factors like parasitic infections.

Women of reproductive age, particularly pregnant women and adolescent girls, along with toddlers and young children, are the most affected groups due to high physiological iron requirements and increased risk of deficiency.

The Indian government has launched the 'Anemia Mukt Bharat' (AMB) strategy, which involves iron and folic acid (IFA) supplementation, periodic deworming, food fortification, and promoting behavioral change for better nutrition.

Dietary factors include low intake of iron and Vitamin C-rich foods, high consumption of iron-inhibiting substances like tea, and reliance on staple foods without sufficient diversity.

The 'double burden' refers to the coexistence of undernutrition, like anemia, and overnutrition, like obesity, within the same population. This arises from diets high in calories but low in essential nutrients.

Yes, infections can cause anemia. In India, parasitic infections like hookworms and infectious diseases like malaria are significant contributors to anemia by causing chronic blood loss or destroying red blood cells.

Vitamin C is an 'iron enhancer,' meaning it helps the body absorb non-heme iron from plant-based foods more efficiently. Consuming Vitamin C-rich foods like Indian gooseberry (amla) or citrus fruits alongside iron sources can improve iron status.