Protein deficiency statistics in India

In India, protein deficiency is mostly counted as part of undernutrition, which national surveys track through height and weight. The latest figures, from the fifth National Family Health Survey (NFHS-5, 2019-21), show 35.5% of children under five as stunted, 19.3% as wasted and 32.1% as underweight.1 Among adults, guidelines from the Indian Council of Medical Research's National Institute of Nutrition (ICMR-NIN) report chronic energy deficiency in 16.2% of men and 18.7% of women.2

What the surveys measure

The survey, run by the Ministry of Health and Family Welfare, measures children's height and weight.1 Stunting is low height for a child's age, wasting is low weight for height, and underweight is low weight for age.3

For adults, the measure is body mass index (BMI). ICMR-NIN recommends a BMI of 18.5 to 23 for Asians, and the adult figures above count people whose BMI falls below that range.2 The guidelines call this chronic energy deficiency, or undernutrition among adults.

These measures pick up a shortfall of food in general, including energy, protein and micronutrients (vitamins and minerals). They show how many people are undernourished, but they cannot separate protein from the rest of the diet.

Child undernutrition in NFHS-5

The Ministry of Women and Child Development summarised the change between the last two surveys in December 2023.1

All three measures improved between the surveys. Even so, about a third of young children were still stunted or underweight when NFHS-5 was carried out.

Undernutrition among Indian adults

The guidelines include a table drawn from NFHS data for adults aged 18 to 69. It shows chronic energy deficiency falling from 23.8% to 16.2% among men, and from 23.0% to 18.7% among women, between 2016 and 2021.2 Women's rate fell less, and it remains higher than men's.

The same table shows a second problem. In 2021, overweight and obesity affected 22.9% of men and 24.0% of women. ICMR-NIN describes this as a dual burden of malnutrition, with undernutrition and overweight found in the same communities and even the same households.2

Where Indian diets fall short on protein

ICMR-NIN's guidelines point to the make-up of the diet. Cereals supply 50 to 70% of daily energy for many Indians, while pulses, meat, poultry and fish together supply only 6 to 9%. The recommended share for that group is 14%.2

In fact, ICMR-NIN estimates that a typical adult diet already reaches 60 to 70 g daily, above what most people require. The weak point is quality, since diets built mostly on cereals can miss some essential amino acids.2 That is why the guidelines ask people to combine cereals with pulses at meals. They also note that cereals are widely available, while the supply of pulses per person stays low. Pulses and meat also cost more, so many households rely heavily on cereals.2

Protein deficiency disorders and where they stand

Kwashiorkor is a disease caused by deficiency of protein, often with a shortfall of some micronutrients too.4 Cleveland Clinic describes kwashiorkor and marasmus as the two main types of severe protein-energy undernutrition, the group also known as protein-calorie malnutrition diseases.4 ICMR-NIN notes that both have largely disappeared in India, while milder undernutrition, often without clear signs, and anaemia remain public health issues.2 The short protein deficiency diseases chart below sets the two side by side.

Signs of protein deficiency in an individual need a doctor's assessment. A diagnosis cannot be made from survey numbers or from a list of symptoms found online.

What an adult can take from these numbers

For an adult, the practical step is to check your own intake against ICMR-NIN's figure of 0.83 g per kg. Keep cereals and pulses in balance at meals, add a pulse at lunch and dinner, and keep milk or curd in the day.

Horlicks Protein is meant for adults, 18 years and older, and not for children. On days when an adult's meals fall short, one sachet in 200 ml of cold water or milk adds 24 g of protein. The brand suggests using it once a day.

Conclusion

India's statistics on protein deficiency come from undernutrition measures. NFHS-5 found 35.5% of children under five stunted, 19.3% wasted and 32.1% underweight, all lower than in NFHS-4, while 16.2% of men and 18.7% of women had chronic energy deficiency. ICMR-NIN's guidelines trace much of the problem to diets heavy in cereals and light in pulses and other protein foods, with protein quality the bigger gap. Severe forms such as kwashiorkor and marasmus have largely disappeared, and for adults the answer starts with balanced meals that meet 0.83 g per kg.

Sources

1. Press Information Bureau, Government of India. Steady improvement in indicators for malnutrition, 20 December 2023. https://www.pib.gov.in/PressReleaseIframePage.aspx?PRID=1988614

2. ICMR-National Institute of Nutrition. Dietary Guidelines for Indians, 2024. https://nin.res.in/dietaryguidelines/pdfjs/locale/DGI_2024.pdf

3. World Health Organization. Malnutrition, fact sheet. https://www.who.int/news-room/fact-sheets/detail/malnutrition

4. Cleveland Clinic. Kwashiorkor. https://my.clevelandclinic.org/health/diseases/23099-kwashiorkor