Prosperity and malnutrition

As Pakistan modernises, a silent crisis is unfolding on our dining tables, reflecting our aspirations and vulnerabilities.

Given rising incomes and changing lifestyles, millions of Pakistanis are transforming their food consumption habits. Meat has increasingly replaced vegetables and pulses in our diets. Fast food, sugary drinks, and processed snacks are now ubiquitous. While these choices symbolise progress and growing prosperity, they also have a dangerous side effect: deteriorating health.

More than half of Pakistan’s adult population is now either overweight or obese, according to nationally representative data from 2018. This rise in non-communicable diseases–linked to excessive consumption of meat, sugar, salt, and processed foods–is becoming a new epidemic.

The NCD crisis in Pakistan is deepening rapidly. Diseases such as diabetes, hypertension, cardiovascular illnesses and certain cancers – once considered ‘diseases of affluence’ – are now affecting urban and rural populations alike. According to the World Health Organization, over 58 per cent of all deaths in Pakistan are now attributed to NCDs.

The figures are sobering: over 33 million Pakistanis are living with hypertension, while more than nineteen million are affected by diabetes. Four in 10 adults are overweight or obese, and physical inactivity is alarmingly high, particularly among urban women. Tobacco use, another key driver of NCDs, affects nearly one in five adults. These conditions are not isolated health issues; they drain household savings, overburden healthcare systems and slash national productivity.

This crisis is not confined to hospitals or clinics but in households, workplaces, and schools. Poor dietary choices, sedentary lifestyles, lack of awareness, and limited preventive care have created a perfect storm. If left unaddressed, the NCD burden will strain an already fragile healthcare system and erode economic resilience.

But the story does not end there.

Ironically, Pakistan also suffers one of the highest rates of stunting and malnutrition among children in the world. A significant portion of pregnant women are iron- and zinc-deficient. At the same time, we are a nation struggling with both overnutrition and undernutrition, a dual burden that threatens our collective well-being.

The issue extends beyond what is on our plates. Unsafe water and unhygienic food practices have resulted in widespread illness. A recent Gallup Pakistan survey found that nearly half the population reported suffering from diarrhoea, skin diseases or other waterborne infections. For daily wage earners and low-income workers, these health issues are not just a personal setback but an economic catastrophe. A sick worker loses income. A sick child keeps a parent at home. A nation riddled with disease loses productivity.

Add to this the cultural and economic importance of food: Agriculture, food processing and marketing account for more than half of Pakistan’s GDP. Food is not just sustenance; it is identity, livelihood, and a reflection of our values. The challenge is creating a food system that honours cultural roots, boosts economic growth and ensures public health.

This requires a shift in our thinking. We must concentrate on three things. First, move towards locally grounded solutions rather than adopting global templates that may not suit our context. Second, balance administrative regulations with behavioural change, embedding food safety into social norms. Passing more regulations and laws, arbitrary implementations on businesses through fines and challans, as many of the food authorities have been doing, are only going to provide temporary respite. The real change will come when we reduce the demand for unhealthy food or unhealthy amounts of food.

Third, promote a framework that respects our cultural food practices while urgently addressing the health crisis brewing under the surface. Any regulations or norm-changing campaigns that do not respect the local culture will only fail, as have many other administrative measures for other policy-relevant issues.

Food safety, nutrition and the prevention of non-communicable diseases are not niche concerns; they are central to our national well-being. Pakistan’s future depends on how well we nourish our bodies as well as on our collective understanding of what it means to live well.

The writer is executive director of Gallup Pakistan and holds a Masters degree from the School of Oriental and African Studies (SOAS), London.