India’s food consumption landscape is experiencing significant shifts, influenced by growing incomes, evolving dietary habits, and specific welfare programs. This analysis offers current insights into food group and micronutrient intakes within India, emphasizing variations based on geographic location, economic status, and seasonal changes. Data summarized in Tables 1 and 2 highlights both the extent and distribution of dietary changes over the last decade. Notably, the disparity in fruit consumption between the wealthiest and the poorest sections of society has reduced from 4.05 to 2.64, and seasonal variances in various food categories have similarly contracted, indicating modest progress towards dietary equity.
The observed decline in food expenditure as a share of total household spending—now below 50% in rural areas for the first time since India gained independence—reflects improved living conditions and economic growth. This trend aligns with patterns seen in other developing economies that have transitioned towards more varied and nutrient-rich diets [22].
A significant reduction in cereal spending, particularly among lower income groups, reflects a shift in demand as well as the effect of widespread food security initiatives like the Pradhan Mantri Garib Kalyan Anna Yojana (PMGKAY) [23] and the National Food Security Act (NFSA) [24]. These programs have effectively separated staple food access from household budgets, facilitating a shift towards increased consumption of fruits, dairy, and animal-derived foods. This trend is reflected in the rising intake of fresh fruits, milk, and meat among all economic strata, with the most significant improvements noted in lower-income households. Such changes signify the early success of targeted social safety measures and enhanced market integration in fostering broader dietary enhancements. Moreover, these shifts align with the notion of “saved expenditure” acting as a catalyst for dietary diversification [25].
Past research has made significant strides in documenting dietary patterns and nutritional outcomes in low- and middle-income countries [26, 27]. A systematic review conducted by Mayén et al. (2014) [28], which encompassed findings from 33 studies across 17 LMIC countries—primarily Brazil, China, and Iran—concluded that households with higher socioeconomic standing consumed more fruits and vegetables and maintained better dietary diversity. Our study corroborates these findings in the Indian context; however, the gap in the consumption of certain items, such as fresh fruits, dairy, and protein sources (like eggs, fish, and meats) between the top 20% and bottom 20% has narrowed significantly from 2011–12 to 2023–24. Simultaneously, the data from 2023–24 reveals distinct regional disparities: fruit intake is highest in the south, dairy in the north and west, meat products in the northeast and Kerala, vegetables in the east, cereals in the north and east, and pulses in central and southern states. Such heterogeneity mirrors cultural preferences, agricultural conditions, and market accessibility, underscoring the necessity of regionally tailored nutritional strategies [29].
While the positive trend towards greater dietary diversity is noteworthy, it still falls short of meeting recommended intake levels for many essential nutrients. There are significant micronutrient deficiencies across various income levels and regions, particularly concerning Iron, Zinc, B-Vitamins (Vitamins B1, B2, B3, and B6), and Calcium. These observations emphasize that mere diversification does not guarantee nutritional sufficiency; complementary strategies—such as targeted subsidies, focused interventions, and enhanced supply chains—are crucial to transforming these evolving consumption patterns into substantial health benefits.
Encouragingly, the most significant improvements in dietary diversity have been seen among the lowest income quintiles, contributing to a reduction in rural-urban and socioeconomic inequalities. National-level data from the Household Consumption Expenditure Survey 2023–24 indicates that overall rural-urban consumption gaps have narrowed from 84% to 70% over the past decade. Our findings reinforce this convergence through food group-specific trends: the most substantial proportional increases in fruit, dairy, and animal-source food consumption were recorded among lower-income households.
There has also been a notable decrease in seasonal variations in the intake of perishable foods—especially fruits and vegetables—since 2011–12, indicating enhancements in cold chain infrastructure, storage, and transport logistics. Such improvements have made nutrient-dense foods accessible year-round, even in remote areas. Remarkably, India’s horticultural production has significantly increased, with the gross value added from fruits, vegetables, and floriculture overtaking that of cereals for the first time, showcasing both a rise in production and changing consumption patterns [30]. The reduction of seasonal fluctuations serves as an important indicator of resilience within the food system, affecting dietary stability and micronutrient adequacy [31].
However, despite these advancements, substantial challenges persist in ensuring consistent accessibility and affordability of perishable foods across different regions and income groups. Issues such as inadequate last-mile connectivity, uneven market integration, and affordability limitations continue to hinder the nutritional impact of these supply-side improvements.
Even though cereals still play a primary role in providing Iron, Zinc, and B Vitamins, their limitations in delivering crucial micronutrients—particularly Vitamin C and Calcium—are evident. Micronutrient mapping based on HCES data and compositional analysis illustrates that fruits and vegetables contribute over 60% of Vitamin C intake, while dairy accounts for 70-75% of Calcium. Pulses and legumes, although consumed in lesser amounts, are vital sources of Zinc and Folate, especially in vegetarian households.
Nevertheless, our quantitative estimates of micronutrient intake reveal that nutritional gaps continue to exist despite modest improvements in dietary diversity. For instance, our analysis indicates that the average Iron intake among non-lactating adult women falls short of the Estimated Average Requirement (EAR) by nearly 4 mg/day, with approximately 70% of this demographic at risk of inadequate intake (Supplementary Fig. 1). Such high probabilities of inadequacy emphasize the limitations of current dietary patterns and the necessity for targeted strategies that address both the quantity and quality of nutrient intake. These insights also underscore the importance of incorporating nutrient requirement distributions into population-level dietary evaluations, facilitating more accurate identification of at-risk groups and more effective policy initiatives.
Furthermore, we observe that in several large states, households primarily obtain Iron from cereals. For instance, in Rajasthan, cereals contribute about 79% of Iron intake, whereas in Uttar Pradesh, Haryana, Punjab, Bihar, Gujarat, Maharashtra, and Madhya Pradesh, this figure exceeds 60%. This raises concerns regarding the absorption of non-heme Iron, which is substantially lower (3-5%) compared to heme Iron sources. The Comprehensive National Nutrition Survey (CNNS, 2016–18) indicates that over 25-30% of adolescents experience Iron deficiency, illustrating that dependency on cereal-based sources alone is insufficient to fulfill physiological requirements [32].
These findings highlight the critical role of dietary diversity in combating micronutrient deficiencies and addressing the dual burden of malnutrition [8, 26, 33]. They emphasize the necessity for programmatic strategies aimed at enhancing access to nutrient-rich foods beyond the cereal sector, promoting fruits, vegetables, dairy, pulses, and animal-source foods—each making unique contributions to the micronutrient landscape.
Interpreting these results must take into account the population-level scope of HCES-based analysis. Household acquisition data do not reflect intra-household distribution or meals consumed outside the home, nor do they assess cooking losses—issues also highlighted in national dietary guidelines. Furthermore, the rise of ultra-processed and out-of-home foods is not included in nutrient estimations due to a lack of compositional coding in HCES, despite their increasing prevalence in diets. Dietary identity, such as vegetarianism, which influences animal food choices for cultural rather than purely economic reasons, is also overlooked in HCES. Therefore, trends in animal-source food consumption should be interpreted as changes among households that include such foods, not across all households.
In summary, these observations highlight HCES as a valuable complementary surveillance tool. While 24-hour recalls and biomarker assessments are crucial for evaluating individual nutrient adequacy and deficiencies, HCES uniquely facilitates regular, nationally representative monitoring of dietary sourcing and inequities that individual-level surveys cannot achieve. Policies aimed at enhancing nutrition security should thus rely on the combined evidence derived from food system surveillance (HCES) and individual nutrition assessment methods.
Policy Implications and Future Directions
The findings regarding dietary intake emphasize the necessity for a multi-faceted policy response that addresses both changing consumption behaviors and persistent nutritional deficiencies. First, initiatives should be adopted to actively support the production, distribution, and affordability of nutrient-rich foods, including fruits, vegetables, pulses, dairy products, and animal-source products [34].
Second, nutritional guidelines must be tailored to regional contexts, considering cultural preferences, agroecological diversity, and existing consumption disparities—especially in states where intake of essential food groups remains low. Third, targeted subsidies and market incentives for perishable, micronutrient-rich foods could improve access for vulnerable populations, building on existing equity gains. Lastly, ongoing investment in cold chain infrastructure and transport logistics is critical to ensure year-round availability and dampen seasonal variations in food intake [35].
Simultaneously, nutritional monitoring and reformulation standards for processed and packaged foods—which are increasingly consumed across all income groups—must ensure nutritional quality and mitigate risks associated with ultra-processed diets [36]. Updating nutrition coding would enhance surveillance systems’ abilities to better assess their impact on micronutrient adequacy and dietary risks. Future research should delve into the health effects of the changing food environment, the function of diversified food systems in preventing non-communicable diseases, and the effectiveness of integrated, regionally adapted interventions in maintaining equitable nutritional improvements. Regular 24-hour recalls, accompanied by biomarker surveys, are crucial for assessing nutritional adequacy and deficiencies. Combining these with HCES data can bolster the evidence base for nutrition strategies. Gathering more detailed dietary data broken down by state, region, physiological group, and gender is equally important for developing context-aware strategies that tackle persistent nutrient adequacy issues. Collectively, these policy recommendations serve as a framework for fostering nutritional equity and resilience in India’s evolving food system.
Limitations
Utilizing HCES for dietary monitoring and program design carries several advantages. The extensive sample size and regular implementations allow for analysis of trends over time and across various subnational units. It also facilitates connections between dietary patterns and socioeconomic and demographic variables, enabling more targeted interventions. Integrating nutrient intake estimates derived from HCES can prioritize investments in fortification, supplementation, and food system strategies that address undernutrition alongside emerging diet-related non-communicable diseases.
Nonetheless, several limitations need to be addressed. First, food consumption estimates are derived from household surveys, focusing on the household as the observational unit, which means that intra-household distributions are not captured. This is significant for nutrients like Iron, where standardizing intake to the Adult Food Equivalent may overestimate inadequacy prevalence [2, 37]. Second, the survey relies on 7-day and 30-day recalls, which can lead to biases if items are not remembered accurately. The analysis presumes that food acquired during the recall period is consumed same during that period; however, it does not account for household storage, waste, or sharing. Third, micronutrient estimates are based on raw food nutrition values from the IFCT 2017. There is a possibility that nutrient intake based on raw food consumption may be inaccurate, given that Indian cooking practices often result in significant nutrient losses. Additionally, our analysis does not account for the nutrient content of food eaten outside the home, beverages, or processed foods, due to the absence of standardized nutritional information for these items in HCES. Fourth, the HCES does not consider dietary identity, such as vegetarianism, which significantly affects choices related to animal-source foods in India. Moreover, the surveys likely under-represent households at the highest income levels, resulting in a likely underestimation of inequality among wealthier groups. Finally, the conclusions drawn should be interpreted as broader indicators of dietary patterns and potential micronutrient sufficiency. It’s also critical to note that for trusted assessments of micronutrient intake, one must factor in day-to-day variability, which typically requires data collection across several days. Consequently, such dietary and nutrition assessments should ideally leverage individual-level 24-hour recalls, or consider food diaries [7]. Therefore, while our results indicate general trends in dietary sourcing and associated micronutrient intake, they do not provide precise assessments of nutritional status. To achieve accurate and rigorous evaluations, comprehensive nutrition surveys representative of all states and their regions within larger states are needed.
