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, revealed a paradox that should concern policymakers. While the survey highlights notable gains in maternal and child healthcare, nutrition, immunisation coverage, it simultaneously records an alarming rise in non-communicable diseases (NCDs) – signalling that India is undergoing a silent but profound epidemiological transition. The findings expose a worrisome gap in India’s public health strategy: Despite significant investments in disease detection and treatment, insufficient attention has been paid to preventing the behavioural and lifestyle factors that drive the growing NCD burden. Addressing this challenge requires the integration of lifestyle medicine as a central pillar of India’s health policy.
The World Health Organization (WHO) defines non-communicable diseases including cardiovascular diseases, diabetes, hypertension, cancers and respiratory illness – as chronic conditions of long duration that were responsible for approximately 43 million reported deaths in 2021, where one-third of the deaths were associated with low and middle income countries, such as India. Although NCDs arise from a complex interaction of genetic, environmental and other socio-economic factors; four modifiable behavioural risks remain at the centre of this crisis: Unhealthy diets, lack of physical activity, tobacco use and harmful alcohol consumption.
India has launched several initiatives over the past decade to address this growing burden. Among the most significant is the National Programme for Prevention and Control of Non Communicable Disease launched in 2010, which focuses on the population based screening for individuals over 30, early detection and clinical management of major NCDs. Additionally, programmes such as the Indian Hypertension Control Initiative seek to improve the management and control of high blood pressure at the primary health care level.
While these measures have remained crucial and undoubtedly improved early detection and treatment, the NFHS-6 data underscores 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 risen from 18.9% to 22.9% and further to 27.3% during the same period. Diabetes and hypertension have also registered substantial increases across adult populations. These trends are not isolated health indicators; they are warning signals of a deeper structural problem. Today, NCDs account for nearly 63-65% of all deaths in the country and contribute to more than half of India’s Disability-Adjusted Life Years (DALYs) – up dramatically from three decades ago. If current trend persists, nearly three-fourths of all deaths in India could be attributable to NCDs by 2030, resulting in millions of premature and preventable deaths.
These findings expose a fundamental policy blind spot. Despite more than a decade of policy interventions, NCDs continue to rise across populations. This suggests that while India has strengthened its ability to detect and manage disease, it has been far less successful in addressing the behavioural and lifestyle factors that cause disease in the first place. In essence, the country’s NCD strategy remains disproportionately focused on treatment rather than prevention.
It is at this crucial 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 behavioural interventions. It combines structured approaches to dietary modifications, physical activity, stress management, sleep optimisation, tobacco cessation and behavioural counselling. Rather than treating symptoms alone, it seeks to modify the everyday behaviours that drive many chronic diseases.
Several studies have pointed out the effectiveness of this strategy that can significantly reduce the incidence and progression of NCDs while lowering long-term health care costs. Recognising this potential, health care systems across the world have increasingly begun incorporating lifestyle medicine into primary care. Countries such as Australia, and China, through its Healthy China 2030 action plan, have integrated it into primary care as a frontline strategy for preventing and managing NCDs, similarly, projects such as Europe Union’s CARE4DIABETES Joint Action have initiated efforts to incorporate lifestyle-focused interventions into health care delivery and professional training.
In India, however, the integration of lifestyle medicine remains fragmented rather limited–as existing public health frameworks continue to prioritise screening and detention, 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 their underlying causes.
India, therefore, requires a decisive shift from its current predominantly curative-health model towards a lifestyle-centred approach to healthcare. The creation of a National Lifestyle Medicine Framework and its integration into the existing NCD frameworks should become the policy priority.
The principles of lifestyle medicines, and routine lifestyle-risk assessment must become integral components of healthcare delivery. Strengthening capacity-building programmes for medical professionals, nursing staff, ASHA workers, and other community health workers must extend beyond disease identification to include guidance on healthy behavioural change. Primary-care providers should be equipped to function as lifestyle coaches capable of supporting long-term behavioural modifications within community settings. Medical education must also evolve by incorporating lifestyle medicine modules as a standard component of professional training.
Additionally, digital tools can further strengthen these efforts by enabling behaviour tracking, monitoring clinical parameters, and disseminating evidence-based lifestyle guidance at scale. India’s expanding digital health infrastructure and health data systems offer a valuable foundation for integrating lifestyle-based interventions into routine health care delivery.
Most importantly, policymakers need to recognise that the battle against NCDs cannot be won in hospitals and clinical settings alone. The latest NFHS finding should serve as a wake-up call for India. While the country has made commendable progress in expanding disease screening programmes, strengthening disease management, the continued rise of NCDs highlights the limitations of a predominantly treatment-focused approach. Addressing this growing challenge requires integrating lifestyle medicine into public health policy and placing prevention at the centre of India’s health care strategy.
It is important to note that the NCDs’ implication extends far beyond public health. Escalating NCD prevalence reduces workforce productivity, leads to premature retirement, decreases work capacity, and increases absenteeism. Research suggests that every 10% increase in the NCD mortality rate can reduce country’s GDP growth by around 0.5% yearly. Moreover, at the household level, the NCDs burden significantly increases health expenditures and deepen financial vulnerability. Studies reveal that NCD-affected households spend ₹35,512 on health care on average higher than the non-NCD household which is nearly ₹21,214.
Thus, the future of India’s health system will depend not only on how effectively it treats disease, but on how successfully it prevents it. The challenge now is not simply to diagnose and manage disease more efficiently, but to prevent it from occurring in the first place. India’s next generation of health reforms must, therefore. place lifestyle medicine at the heart of a holistic, preventive, and multisectoral strategy to combat the country’s rapidly growing burden of non-communicable diseases.
(The views expressed are personal)
This article is authored by Mahesh Ganguly, teaching assistant and research fellow, IIT Bombay.
