Diets, Nutrition and Poverty: Lessons from India

This chapter addresses a persistent tension in current debates over food security, with illustrative data from India. The case allows us to disaggregate concepts in food policy that are often lumped together, so as to better understand what is at stake in rapidly changing economies more generally. Despite rising incomes, there has been sustained decline in per capita nutrient intake in India in recent years. The assertion by Deaton and Dreze (2009) that poverty and undernutrition are unrelated is critically examined. A demand-based model in which food prices and expenditure played significant roles proved robust, while allowing for lower calorie “requirements” due to less strenuous activity patterns, life-style changes, and improvements in the epidemiological environment. This analysis provides reasons for not delinking nutrition and poverty; it confirms the existence of poverty-nutrition traps in which undernutrition perpetuates poverty. A new measure of child undernutrition that allows for multiple anthropometric failures (e.g., wasting, underweight, and stunting) points to much higher levels of undernutrition than conventional ones. Dietary changes over time, and their nutritional implications, have welfare implications at both ends of the income and social-status pyramids. Since poverty is multidimensional, money-metric indicators such as minimum income or expenditure are not reliable, because these cannot adequately capture all the dimensions. The emergent shift of the disease burden toward predominately food-related noncommunicable diseases (NCDs) poses an additional challenge. Finally, the complexity of normative issues in food policy is explored. Current approaches to food security have veered toward a “right-to-food” approach. There are, however, considerable problems with creating appropriate mechanisms for effectuating that right; these are explored briefly. Cash transfers touted to avoid administrative costs and corruption involved in rural employment guarantee and targeted food-distribution programs are likely to be much less effective if the objective is to enable large segments of the rural population to break out of nutrition-poverty traps. The chapter ends by exploring an alternative model, based on the same normative principle: a “right to policies,” or a “right to a right.”