Nutrition transition in india: secular trends in dietary intake and their relationship to diet-related non-communicable diseases.

J Diabetes. 2011 Jun 7. doi: 10.1111/j.1753-0407.2011.00139.x. [Epub ahead of print] India is facing an ‘epidemic’ of diet-related non-communicable diseases (DR-NCDs), along with widely prevalent undernutrition resulting in substantial socio-economic burden. The aim of this paper is to review secular trends in food groups and nutrient intake and implications for DR-NCDs in India so as to understand optimal choices for healthy diets for prevention of DR-NCDs. The literature search was carried out in PubMed (National Library of Medicine, Bethesda, MD) and Google Scholar search engines upto July, 2010. Manual search for all other references, national and medical databases was also carried out. Nutrition transition over the past 30 years (1973-2004), has resulted in 7% decrease in energy derived from carbohydrate and 6% increase in energy derived from fats. Decreasing intake of coarse cereals, pulses, fruits and vegetables, increasing intake of meat products and salt, coupled with declining levels of physical activity due to rapid urbanization have resulted in escalating levels of obesity, atherogenic dyslipidemia, subclinical inflammation, the metabolic syndrome, type 2 diabetes and coronary heart disease in Indians. Studies also suggest that adverse perinatal events due to maternal nutritional deprivation may cause low birth weight, which coupled with early childhood ‘catch-up growth’ leads to obesity in early childhood, thus predisposing to NCDs later in life. In view of rapidly increasing imbalanced diets, multi-sectoral preventive approach is needed to provide balanced diets to pregnant women, children and adults, and to maintain normal body weight from childhood onwards, to prevent escalation of DR-NCDs in India.