By Neha Sethi, Nazia Jafri and Kinley Tshering

India is caught in a paradoxical situation of some sort, at least in this case. While the long running problem of malnutrition is still not solved, India is waking up to yet another rude fact- increasing urban, middle-class obesity.

According to the National Family Health Survey conducted in 2005-06, about 33.1 percent of India’s children below three years are undernourished. Health experts say that at the same time obesity is an emerging public health concern that is increasing especially among India’s affluent strata.

Doctor Atul Shardhana, a consultant pediatric surgeon at Kolmet hospital in New Delhi, says the extent of obesity among Indians living in urban areas has been calculated to be more than 30-33 percent. “What is alarming is the fact that there is an increase in obesity in children and adolescents,” he warns.

While obesity is caused due to improper diet, malnutrition is mainly caused due to insufficient food consumption. But both these diseases are ironically clubbed under the same group-malnourishment. Doctor Gitu, a Delhi based nutritionist, explains both malnutrition and obesity are cases of dietary deficiency. “What we mean by good food is the right kind of food in right quality and quantity.Taking a balanced diet is therefore very important either for an undernourished or an over nourished person,” says Dr Gitu Amarnani.

What many ignore is the eating habits. While the poor section do not have enough to eat, it seems the wealthier have not been eating well either. India has been traditionally a country of farmers where the problem of availability of food has existed for a long time.Now with the abundance of food available and influence of western culture on the food pattern, obesity among the people is on the rise,” says Dr Shardhana.

The repercussions of obesity and malnutrition are grave on the public health as both the diseases are known to be life threatening. Obesity leads to secondary problems which are now called metabolic syndrome that includes type 2 diabetes, hypertension, cardiovascular risks and cerebral risks to name a few.

While many attribute this parallel of under nutrition and obesity to India’s status as a ‘developing country’, there are economists who pin point the close relation of this parallel to the economy.

“One of the most important reasons for this is the inequality of income which exists in India। 70 percent of the Indian population is living under Rs 100 a day. Obviously people who cannot afford a proper meal will be malnourished,” says Professor Shahid Ashraf of the economics department in Jamia Millia Islamia.

Struck in this ironical situation, which disease should be given more priority as it concerns the health of two different section of the Indian population?“Malnutrition is the graver of the two। Obesity is a problem but it comes from a society who can contain the disease on their own. But malnutrition affects a huge number of people who has no access to improving their malnourishment,” adds Professor Ashraf.

In fact, India isn’t sure whether it will meet the Millennium Development Goal of reducing under nutrition by 2015. However, it will certainly have to face the growing problem of obesity.