Popkin and Ng (2022) proposed a stage wise nutrition transition (Figure 1) to offer an explanation to changing health environments in India and world over. It describes five stages through which societies tend to navigate: collecting food, facing famine, receding famine, nutrition-related chronic diseases, and finally behavioural change to hit the reset mode on poor health situations. In the earliest stage, diets depend on hunting and gathering, with high physical activity and low life expectancy. The famine stage reflects unstable food supply and widespread undernutrition as receding famine stage is met with improved food security and diet diversity. Rapid urbanisation and economic growth trigger a shift towards ultra-processed foods, and non-communicable diseases. The final stage represents growing awareness and efforts to improve diet and lifestyle and reduce dependence on foods out of a package.

The optimism of this positive stage of nutritional transition is that they are a modifiable determinant of population health. The way forward will be through understanding UPFs and nutritional influences in India with large-scale cohort studies while resetting the dynamic food environment back to India’s rich traditional landscape. The article re-emphasises the need for stricter policy changes, focused educational initiatives, and stringent market regulations to promote healthier eating habits while reducing the dependence on UPFs and incidence of diet-related NCDs.