Time for foundational nutrition and lifestyle literacy

This article is authored by Pawan Agarwal, former CEO, FSSAI, and founder/CEO, Food Future Foundation and Santanu Mishra, co-founder, Smile Foundation.

Every September, Poshan Maah brings nutrition into national focus. It is also an opportunity to ask a larger question: Are we investing enough in preventing tomorrow’s health problems, or are we still largely preparing to treat them after they appear?

Nutrition (Pexel)

Today, India faces multiple nutrition and health challenges. Maternal and child nutrition and persistent undernutrition remain concerns. At the same time, obesity, diabetes, hypertension and other non-communicable diseases (NCDs) are rising. And as India grows older, healthy ageing will become an increasingly important public health priority.

These may appear to be separate challenges. In reality, they are connected across the life course.

India has rightly invested substantially in maternal and child nutrition and in combating undernutrition. But the growing burden of NCDs requires us to put prevention alongside treatment at the centre of our health strategy. ICMR-NIN’s Dietary Guidelines for Indians 2024 estimates that unhealthy diets account for 56.4% of India’s disease burden. What we eat and how we live therefore matter enormously.

Healthy ageing, too, does not begin at 60. Its foundations are laid much earlier. Food preferences, physical activity, sleep and other behaviours acquired during childhood can influence health decades later.

This is where schools can make a transformative difference.

India already has an extraordinary platform in its schools. Through PM POSHAN, millions of children receive cooked meals every school day. For children from vulnerable households, these meals provide an important nutritional safety net.

The next step is to think beyond calories alone. School meals should promote dietary diversity and help address micronutrient deficiencies, the hidden hunger that can persist even when calorie requirements are met. Menus can increasingly incorporate diverse grains, pulses, vegetables and other locally appropriate foods.

But what children eat in the school meal is only part of the story. What they bring in their tiffins, buy around school and eat at home matters just as much. Providing healthy food without enabling children to make healthy choices for themselves can take us only so far.

A child who receives a nutritious meal at school but regularly chooses foods high in salt, sugar and fat outside school has gained only part of the benefit. Equally, nutrition education that simply tells children what is healthy, without changing their habits and their everyday environment, is unlikely to work.

Schools, therefore, offer an opportunity to bring three things together: healthy and diverse food, a healthy school environment, and foundational nutrition and lifestyle literacy.

We have rightly made foundational literacy and numeracy a national educational priority because these capabilities are essential for learning throughout life. We now need similar thinking about health and wellbeing.

Foundational nutrition and lifestyle literacy can equip children with the basic capabilities to eat well, move well, sleep well and make informed choices throughout their lives.

This does not require another textbook, subject or examination. Children do not develop healthy habits by memorising the food pyramid or answering questions about vitamins. They learn through everyday practice: drinking water instead of sugary beverages, eating fruits and vegetables, washing hands, being physically active, sleeping adequately, eating without screens, understanding hunger and fullness, and making sensible food choices.

Japan recognised the importance of this more than two decades ago through Shokuiku, its approach to food education across schools, families and communities. India need not replicate another country’s model. But the underlying principle is powerful: healthy behaviour is learnt, and schools are among the best places to learn it.

A beginning has recently been made in 75 CM SHRI schools of the Delhi government through the Eat Well Live Well initiative. It seeks to translate foundational nutrition and lifestyle literacy into everyday school practice.

Children build habits around healthy routines, healthier food choices and mindful living, alongside social and planetary skills. Short classroom conversations are reinforced through the school environment and engagement with families. The objective is not to turn teachers into nutritionists or schools into clinics. It is to make healthy living part of the normal rhythm of school life.

The Delhi initiative should be treated as an opportunity to learn. Its impact on food choices, physical activity, everyday habits and school environments needs to be evaluated. What works can then be refined and considered for wider adoption.

India’s health care debate understandably focuses on hospitals, doctors, insurance, medicines and treatment capacity. All are necessary. But we cannot build a sustainable health care system merely by becoming better at treating diseases whose incidence continues to rise.

Some of our most consequential health interventions can happen years before someone enters a hospital. They happen when a child develops a taste for diverse foods, when physical activity becomes part of daily life, when healthy sleep and screen habits are formed, and when children learn to make informed choices for themselves.

Poshan Maah should, therefore, broaden our nutrition conversation, from preventing undernutrition to building lifelong wellbeing, and from individual interventions to a life-course approach to health.

India already has the architecture. PM POSHAN provides the food platform. Schools provide the learning environment. Families can carry these habits into everyday life.

If India wants to reduce the disease burden of the next generation, prevention cannot begin in the hospital. It must begin much earlier. Our schools may be the best place to start.

(The view expressed are personal)

This article is authored by Pawan Agarwal, former CEO, FSSAI, and founder/CEO, Food Future Foundation and Santanu Mishra, co-founder, Smile Foundation.