Health and Hunger: Disease, Energy Needs, and the Indian Calorie Consumption Puzzle

Josephine Duh, Brattle Group
Dean Spears, Delhi School of Economics

India’s experience presents a puzzle at odds with basic facts of household economics: amidst unprecedented economic growth, average per capita daily calorie consumption has declined in recent decades. Could an improving disease environment explain part of the calorie decline? A diminished burden of infectious disease could lower energy needs by increasing absorption and effective use of calories. We document a robust effect of disease exposure – measured as infant mortality and as poor sanitation – on calorie consumption. Similar effects are found using multiple datasets and empirical strategies. Disease can account for an important fraction of India’s calorie decline.