Availability, healthiness, and price of packaged and unpackaged foods in India: A cross-sectional study

Elizabeth K. Dunford*, Clare Farrand, Mark D. Huffman, Thout Sudhir Raj, Maria Shahid, Cliona Ni Mhurchu, Bruce Neal, Claire Johnson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Vulnerable populations are the most prone to diet-related disease. The availability, healthiness, and price of foods have established associations with diet-related disease in communities. However, data describing this in India are sparse, particularly in urban slums and rural areas. Aim: To quantify and compare availability, healthiness, and price of packaged and unpackaged foods and beverages in India, and to identify opportunities to improve diets and health of vulnerable populations. Methods: Nutrition data and price were collected on foods and beverages available at 44 stores in urban, urban slum, and rural areas in four states in India between May and August 2018. Healthiness was assessed using the Australasian Health Star Rating system and product retail prices were examined. Comparisons in the findings were made across state, community area type, and adherence to current and draft Indian food labeling regulations. Results: Packaged foods and beverages (n = 1443, 89%) were more prevalent than unpackaged (n = 172, 11%). Unpackaged products were healthier than packaged (mean Health Star Rating = 3.5 vs 2.0; p < 0.001) and lower in price (median price per 100 g/ml: 13.42 Indian rupees vs 25.70 Indian rupees; p < 0.001), a pattern observed across most community area types and states. 96% of packaged products were compliant with current Indian labeling regulations but only 23% were compliant with proposed labeling regulations. Conclusions: Unpackaged products were on average much healthier and lower in price than packaged foods and beverages. Food policies that support greater availability, accessibility and consumption of unpackaged foods, while limiting consumption of packaged foods, have enormous potential for sustaining the health of the Indian population.

Original languageEnglish (US)
Pages (from-to)571-579
Number of pages9
JournalNutrition and Health
Issue number4
StatePublished - Dec 2022


  • Food system surveillance
  • India
  • healthiness
  • packaged food
  • price
  • unprocessed food

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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