Half of IndiaÂs adolescents (10 to 19 years)  almost 63 million girls and 81 million boys  are not healthy. They are either short, thin, overweight or obese. Almost all adolescents in India have unhealthy or poor diets. This is the main cause for all forms of malnutrition.

These are the findings of a report on adolescents released by NITI Aayog and UNICEF India. Over 80 percent of adolescents also suffer from Âhidden hunger which means deficiency of one or more micronutrients such as iron, folate, zinc, vitamin A, vitamin B12 and vitamin D, according to the report ÂAdolescents, Diets and Nutrition: Growing Well in a Changing WorldÂ, based on the recently released Comprehensive National Nutrition Survey (CNNS).

The CNNS data set provides new insights into all types of macronutrient and micronutrient malnutrition, dietary habits, life skill behaviours, access to services (school, health and nutrition) and physical activity throughout adolescence (10-19 years) for both girls and boys. This is the first thematic analysis of the wealth of CNNS data that provides important insights on the lives of IndiaÂs adolescents.

According to the report, fruits and eggs are consumed daily by less than 10 per cent of boys and girls while over 25 percent of adolescents reported no consumption of green leafy vegetables even once a week. Milk products are consumed by 50 percent of adolescents daily.

Growing incomes and increased spending on food has translated to greater consumption of fried foods, junk foods, sweets and aerated drinks. Today, 10 to 19-year-olds in every Indian state face an increased risk of diabetes and heart disease.

Adolescent girls especially suffer multiple nutritional deprivations. The report finds more girls suffer from shortness than boys. Anaemia affects 40 percent of adolescent girls, compared to 18 per cent of boys, and worsens as they get older.

The report suggests focusing on adolescent girls, before they become mothers, is critical to break IndiaÂs intergenerational cycle of malnutrition. One of the goals of POSHAN Abhiyaan (National Nutrition Mission) is to reduce anaemia among adolescent girls by 3 per cent per year. Ensuring that school and community-based interventions reach all is essential to achieve this goal.

CNNS gives important programme insights on strengthening school-based services. Schools are a cross-sectoral platform to address good nutrition  diets, services and behaviours. This is especially important for the early adolescent age-range (10-14 years), as 85 per cent of this age-group is enrolled in school. 

The findings reveal that nearly 25 percent of girls and boys do not receive any of the four school-based services (mid-day meal, biannual health check-ups, biannual deworming and weekly iron folic acid supplementation). Addressing this gap will be critical to addressing early adolescent nutrition issues.

The report also recognizes the how important it is that meals and snacks at home be nutritious. Campaigns on healthy food choices should be centred around the promotion of a variety of items in appropriate proportions at home.

Risks for non-communicable diseases are established in childhood and adolescence. For example, diabetes, cardiovascular diseases and hypertension among adolescents is increasing. The second decade of life (10 to 19 years), is therefore critical to intervene in early adolescence to prevent such diseases.

All girls and boys are unable to meet the 60 minutes per day recommended outdoor sports and exercise time. On an average, girls in late adolescence spend only 10 minutes per day on such activities. Boys do relatively better, with exercise time of 40 to 50 minutes per day.

The report recommends that adolescents themselves be supported as mobilizers and co-implementers at schools and other platforms they access, to spread the right nutrition messages to aid IndiaÂs Jan Andolan to end malnutrition.

With the POSHAN Abhiyaan now in its second year, the timing is right to strengthen nutrition interventions for Âwould be mothers and fathers to prevent the intergenerational cycle of malnutrition, the report says.