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

India's experience presents a puzzle at odds with a basic fact of household economics: amidst unprecedented economic growth, average daily calorie consumption has declined in recent decades. Does an improving disease environment explain 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 (one-fifth or more) of India's calorie decline.