As India's population grows older rapidly, projections show country's elderly count reaching 340 million by 2050.
Published Nov 22, 2025 | 6:08 PM ⚊ Updated Nov 22, 2025 | 6:08 PM
Representational image. credit: iStock
Synopsis: A study of 1,320 elderly residents in Hyderabad’s Addagutta states that nearly 50% suffer hypertension, one in four have diabetes, and half are overweight. Women face higher obesity rates (50.4%) due to menopause and cultural restrictions. Rice-heavy, protein-poor diets, low physical activity, insulin resistance, and rising multimorbidity drive major health crisis as India’s urban elderly population surges.
An elderly woman sits in her home in Addagutta, unaware that the rice-heavy meals she prepares three times a day contributes to a condition she shares with half the people her age in Hyderabad.
Her waistline has expanded over the years, her movement has slowed, and her doctor now prescribes pills for blood pressure. She represents a pattern that researchers from ICMR–National Institute of Nutrition(NIN) have documented across 1,320 households in the city.
Between March 2022 and January 2023, scientists walked through the streets of this neighbourhood, knocked on doors, and measured bodies. They recorded heights, weights, waist circumferences. They asked about meals, about medicines, about money. What emerged paints a picture of a population growing older while growing sicker.
The numbers tell a story that doctors have suspected but now confirm: 49.9 percent of people aged 60 and above in this part of Hyderabad live with hypertension. One in four has diabetes. Almost half carry excess weight that strains their hearts and overwhelms their insulin production.
The study reveals a gap that cuts across gender. Women show higher rates of obesity at 50.4 percent compared to 34.9 percent in men. Their waistlines measure larger. Their bodies store fat differently, particularly around the abdomen where it causes the most harm.
“We observed women had a higher prevalence of obesity than men, aligning with their higher waist circumference and waist-to-hip ratio, indicating a greater tendency toward central adiposity,” the researchers write in their findings.
This difference stems partly from biology. Menopause shifts how women’s bodies handle fat. Oestrogen levels drop, and fat that once distributed across hips and thighs migrates to the belly. This abdominal fat behaves differently from fat elsewhere. It releases chemicals that trigger inflammation and interfere with how cells respond to insulin.
“Endocrine changes, particularly declining oestrogen levels during menopause, shift fat distribution from peripheral to central areas, elevating the risk of cardiovascular diseases and type 2 diabetes,” the study authors explain.
But biology tells only part of the story. Women in Addagutta face constraints that men do not. They exercise less. Cultural practices restrict their movement outdoors. They prioritise feeding their families before themselves. Many lack the literacy and income that would give them better access to healthcare.
The study documents this inequality through measurements: 68.9 percent of elderly women show waist circumferences that place them at high risk, compared to 49.4 percent of men. When researchers calculated waist-to-hip ratios, 87.4 percent of all participants fell into the danger zone.
The research team examined what people eat, recording consumption patterns across eight food groups. The findings reveal diets heavy on cereals and vegetables but light on the proteins that muscles and immune systems need.
Only 41.2 percent of elderly participants consume meat, poultry, fish or eggs even once a week. Meanwhile, 74.4 percent eat vegetables regularly. Rice dominates plates. Oil flows freely in cooking. Pulses appear often enough, but the balance tips heavily toward carbohydrates.
“Our participants reported relatively high consumption of cereals, pulses, and vegetables. However, the lower intake of protein-rich foods, such as meat, poultry, and fish coupled with near-universal oil consumption, may contribute to the prevalence of obesity,” the authors note.
This pattern mirrors what researchers observe across South India, where elderly populations build meals around rice and green leafy vegetables while protein sources remain scarce. The study found that only 3.3 percent of participants consumed all eight essential food groups in a week.
The lack of protein matters. Ageing bodies lose muscle mass naturally, a process that protein intake helps counter. Protein also helps control blood sugar levels and supports weight management. Without adequate amounts, the rice-heavy diet creates a cycle: high carbohydrate intake drives blood sugar spikes, promotes fat storage, and accelerates the progression toward diabetes.
The study identifies obesity as the factor most connected to both hypertension and diabetes. Researchers used multiple ways to measure body composition, moving beyond simple weight calculations to examine where fat accumulates.
People classified as obese through body mass index showed 2.59 times higher odds of having hypertension compared to those with normal weight. For diabetes, the odds increased 1.81 times. Those with abnormal waist-to-hip ratios faced 1.66 times higher odds of hypertension, while large waist circumferences increased diabetes odds by 1.73 times.
“We found a significant association between obesity and the risk of hypertension. Obese individuals, as classified by higher BMI, showed a marked increase in the likelihood of developing hypertension,” the researchers state.
This connection between belly fat and disease operates through biological mechanisms that scientists now understand. Visceral fat, the type that wraps around internal organs, functions almost like an organ itself. It produces hormones and inflammatory molecules that disrupt normal metabolism.
“These adipocytes function as an endocrine organ, producing adipokines that are associated with insulin resistance, type 2 diabetes, and metabolic syndrome,” the study explains.
The pattern becomes self-reinforcing. Inflammation makes cells resistant to insulin. The pancreas works harder to produce more insulin. Eventually, it cannot keep up, and blood sugar rises. Meanwhile, the same inflammatory processes damage blood vessels and raise blood pressure.
Urban life accelerates these processes. People in Hyderabad walk less than their rural counterparts in Telangana. They sit more. High-calorie foods sit within easy reach. Physical activity drops among older adults who face mobility limitations and lack safe spaces to exercise.
The study documents how diseases cluster. Among the 1,320 participants, 34.9 percent live with at least one chronic condition. Another 26.6 percent manage multiple diseases simultaneously, typically hypertension combined with diabetes.
This multimorbidity, as doctors call it, complicates treatment. Pills prescribed for one condition interact with medicines for another. Doctor visits multiply. The risk of hospitalisation increases. Managing daily life becomes harder when multiple diseases demand attention.
The researchers examined stroke, bronchial asthma, and thyroid disorders as well, finding prevalence rates of 4.4 percent, 3.5 percent, and 3.1 percent respectively. Other conditions appeared in less than 1 percent of participants.
The study focused on one neighbourhood but captured diversity within it. Of the 1,320 participants, 44.1 percent were men and 55.9 percent were women. Ages ranged from 60 upward, with an average of 67.9 years. The largest group, 37.4 percent, fell between 60 and 64 years old.
Religion varied: 81.9 percent identified as Hindu, 12.1 percent as Muslim, and 5.8 percent as Christian. Just over half lived in nuclear families, while 36 percent resided in overcrowded homes. Despite this crowding, 93.5 percent had toilets in their homes, indicating access to basic amenities.
Education levels remained low. The study found that 71.4 percent of participants could not read or write. This illiteracy limits health literacy, making it harder to understand medical advice, read prescription labels, or navigate the healthcare system.
Wealth varied among participants. Researchers noted that those from higher wealth index groups showed 1.80 times higher odds of having hypertension compared to those with less money, suggesting that prosperity in urban India does not automatically translate to better health outcomes.
The context extends beyond Hyderabad. India’s population grows older rapidly. Projections show the elderly population reaching 340 million by 2050, up from current levels. This demographic shift means millions more people will face the health challenges that this study documents.
“India’s ageing population, expected to reach 340 million by 2050, faces a growing burden of noncommunicable diseases like hypertension, diabetes, and obesity,” the researchers write in their background notes.
Earlier data from the Longitudinal Ageing Study in India showed diabetes prevalence of 14.9 percent among those aged 60-74 and 11.5 percent among those 75 and older. Urban areas showed higher rates at 26.1 percent. The Hyderabad study’s finding of 25.8 percent aligns with these patterns.
Global trends mirror what happens in India. A 2019 study found that 19.3 percent of people aged 65 and older worldwide lived with diabetes, with prevalence ranging from 18 percent to 33 percent across different studies. About 30 percent of older adults showed impaired glucose regulation, placing them at risk for developing diabetes.
The researchers call for action on multiple fronts. Their findings point toward interventions focused on diet, weight management, and gender-specific programmes.
“Our study can be viewed under certain limitations. Self-reported disease status, though useful for capturing individual experiences, may involve some recall inaccuracies,” the authors acknowledge, noting that including physical activity data and body fat distribution measures could have strengthened their analysis.
The study’s design, which captured data at a single point in time, limits conclusions about causation. What happens first—does obesity cause hypertension, or do shared factors produce both? The cross-sectional approach cannot answer these questions definitively, though the associations remain clear.
The authors emphasise that their findings, drawn from urban Hyderabad, may not represent rural elderly populations where diets, activity levels, and disease patterns differ. Yet the study provides what they call crucial insights for addressing health challenges in urban India.
“Our findings highlight a significant burden of hypertension, diabetes, and obesity among the urban elderly. This higher prevalence of noncommunicable diseases among elderly population in Hyderabad reflects a complex interplay of biological, sociodemographic, and dietary factors,” the researchers conclude.
They call for programmes that account for the specific challenges women face, that promote balanced nutrition including adequate protein, that address obesity through practical interventions, and that recognise how biological factors interact with social and economic conditions.
(Edited by Amit Vasudev)
