The latest National Family Health Survey (NFHS-6) released by the Ministry of Health and Family Affairs in collaboration with the Indian Institute of Population Sciences has revealed a paradox that should concern policy makers. While the survey highlights notable gains in maternal and child health care, nutrition, immunization coverage, it also records an alarming rise in non-communicable diseases (NCDs) – indicating that India is undergoing a silent but profound epidemiological transition. The findings highlight a worrying gap in India’s public health strategy: despite significant investments in disease detection and treatment, insufficient attention has been paid to curbing the behavioral and lifestyle factors that drive the rising NCD burden. Tackling this challenge requires integration of lifestyle medicine as a central pillar of India’s health policy.
The World Health Organization (WHO) defines non-communicable diseases as long-term chronic conditions including cardiovascular diseases, diabetes, hypertension, cancer and respiratory diseases that were responsible for about 43 million deaths in 2021, where a third of the deaths were linked to low- and middle-income countries like India. Although NCDs arise from a complex interaction of genetic, environmental and other socio-economic factors; Four modifiable behavioral risks remain at the center of this crisis: unhealthy diet, lack of physical activity, tobacco use, and harmful alcohol consumption.
India has launched several initiatives over the past decade to address this growing burden. One of the most important is the National Program for Prevention and Control of Noncommunicable Diseases, launched in 2010, which focuses on population-based screening, early detection and clinical management of major NCDs for persons above 30 years of age. Additionally, programs such as the Indian Hypertension Control Initiative seek to improve the management and control of hypertension at the primary health care level.
While these measures remain important and have undoubtedly improved early detection and treatment, the NFHS-6 data underscore their limitations. Obesity among women aged 15-49 has increased from 20.7% in NFHS-4 to 24% in NFHS-5 and 30% in NFHS-6, while among men it has increased from 18.9% to 22.9% and further to 27.3% during the same period. Substantial increases in diabetes and hypertension have also been reported in the adult population. These trends are not isolated health indicators; They are warning signs of a deeper structural problem. Today, NCDs account for about 63-65% of all deaths in the country and contribute to more than half of India’s disability-adjusted life years (DALYs) – dramatically higher than three decades ago. If the current trend continues, Nearly three-quarters of all deaths in India by 2030 could be due to NCDs, resulting in millions of premature and preventable deaths.
These findings expose a fundamental policy blindness. Despite more than a decade of policy interventions, NCDs continue to increase among the population. This suggests that although India has strengthened its capacity to detect and manage the disease, it has been less successful in addressing the behavioral and lifestyle factors that cause the disease. In short, the country’s NCD strategy focuses disproportionately on treatment rather than prevention.
It is at this critical juncture that lifestyle medicine must become a central pillar of India’s strategy against NCDs. Lifestyle medicine is an evidence-based medical discipline that focuses on preventing, managing, and, in some cases, reversing chronic diseases through sustained behavioral interventions. It combines a structured approach to dietary modification, physical activity, stress management, sleep optimization, tobacco cessation, and behavioral counseling. Rather than treating symptoms alone, it attempts to modify the everyday behaviors that lead to many chronic diseases.
Several studies have pointed to the effectiveness of this strategy that can significantly reduce the incidence and progression of NCDs while reducing long-term health care costs. Recognizing this potential, health care systems around the world have begun to incorporate lifestyle medicine into primary care. Countries such as Australia and China, through their Healthy China 2030 action plan, have integrated it into primary care as a leading strategy to prevent and manage NCDs. Similarly, projects such as the Europe Union’s CARE4DIABETES joint action have initiated efforts to incorporate lifestyle-focused interventions into health care delivery and professional training.
However, in India, the integration of lifestyle medicine is fragmented and rather limited – as the existing public health framework continues to prioritize screening and containment, with relatively little emphasis on sustained lifestyle interventions. As a result, the health care system often treats the consequences of unhealthy lifestyles without adequately addressing the underlying causes.
Therefore, India needs a decisive shift from its current predominantly curative-health model to a lifestyle-centric approach to health care. The creation of a national lifestyle medicine framework and its integration into the existing NCD framework should become a policy priority.
The principles of lifestyle medicine and routine lifestyle-risk assessment should become integral parts of health care delivery. Strengthening capacity-building programs for medical professionals, nursing staff, ASHA workers and other community health workers should go beyond disease identification to include guidance on healthy behavior change. Primary care providers should be equipped to act as lifestyle coaches capable of supporting long-term behavior modifications within community settings. Medical education should also be developed by including lifestyle medicine modules as a standard component of professional training.
Additionally, digital tools can further strengthen these efforts by enabling behavior tracking, monitoring clinical parameters, and disseminating evidence-based lifestyle guidance on a large scale. India’s expanding digital health infrastructure and health data systems provide a valuable foundation for integrating lifestyle-based interventions into routine health care delivery.
Most importantly, policymakers need to understand that the fight against NCDs cannot be won in hospitals and clinical settings alone. The latest NFHS findings should serve as a warning to India. While the country has made commendable progress in expanding disease screening programmes, strengthening disease management, the continued growth of NCDs highlights the limitations of a predominantly treatment-centric approach. To address this growing challenge, there is a need to integrate lifestyle medicine into public health policy and place prevention at the center of India’s health care strategy.
It is important to note that the implications of NCDs extend far beyond public health. Increasing prevalence of NCDs leads to reduced workforce productivity, premature retirement, reduced work capacity and increased absenteeism. Research shows that every 10% increase in NCD mortality rate can lead to an annual reduction of about 0.5% in a country’s GDP growth. Furthermore, at the household level, the burden of NCDs significantly increases health expenditure and deepens financial vulnerability. Studies show that NCD affected families spend ₹The average expenditure on health care is Rs 35,512 more than that of a non-NCD family, which is approximately ₹21,214.
Thus, the future of India’s health system will depend not only on how effectively it treats disease, but also on how successfully it prevents it. The challenge now is not only to diagnose and manage the disease more efficiently, but also to prevent it from occurring in the first place. Therefore, India’s next generation health reforms are essential. Place lifestyle medicine at the center of a holistic, preventive and multi-sectoral strategy to tackle the rapidly increasing burden of non-communicable diseases in the country.
(Views expressed are personal)
This article is written by Mahesh Ganguly, teaching assistant and research fellow, IIT Bombay.
