Subjective social status and health of Saudi medical students: a cross-sectional study on the role of peer comparisons.

India is home to one of the world’s largest populations of young adults, with a substantial proportion of individuals in the 18–25-year age group transitioning into higher education. This demographic group is increasingly exposed to rapid dietary and lifestyle changes associated with urbanization, academic pressures, and evolving food environments. The proportion of India’s working age population has increased, with United Nations predictions indicating it was approximately 58% in 2000 and may rise to 64% by 2035. Moreover, demographic estimates indicate that India’s median age was merely 29 in 2020, in contrast to over 40 in other industrialized countries such as the USA, Europe, and Japan. India is currently experiencing a complex nutritional landscape characterized by the coexistence of undernutrition, overweight, and obesity. National evidence (NFHS-5) indicates that while undernutrition remains a concern, particularly micronutrient deficiencies, the prevalence of overweight and obesity is increasing among university students and young adults (increased to 24% in women and 23%) in men due to rapid dietary and lifestyle transitions. This positions India as one of the world’s ‘largest youthful nations.’ When this demographic advantage is combined with conducive policy conditions that promote health, education, skill development, and viable employment opportunities, it can accelerate India’s economic growth. Previous research has shown that healthier dietary patterns, including greater consumption of plant-based foods, are associated with improved health outcomes as Springmann et al. estimated that shifts toward healthier diets could substantially reduce diet-related health risks at the population level. While India has made notable progress in food availability and overall health indicators, the country continues to face a dual burden of undernutrition and overweight, reflecting shifts in dietary practices and lifestyle behaviors. These changes are particularly relevant among university students, for whom emerging adulthood represents a critical period in the formation of long-term eating behaviors that can influence body mass index (BMI). Shifting to healthy diets that include sustainability considerations can contribute to reducing health and climate change costs by 2030 because the hidden costs of these diets are lower compared with those of current consumption patterns. FAO Estimated that $12.7 trillion/year in hidden costs are embedded in global food systems $8 trillion from unhealthy diets and undernutrition, and $3.1 trillion from environmental damage. In the past decade, India has achieved significant gains in health and nutrition. Although India has achieved notable progress in reducing infant mortality and improving food production capacity, these advances have not uniformly translated into optimal nutritional outcomes across all age groups. Young adulthood, particularly the university years, represents a critical period during which eating behaviours are shaped by increased independence, academic pressures, and changing food environments. The persistence of unhealthy eating practices during this stage may contribute to both undernutrition and excess weight, highlighting the need to better understand eating behaviours and their psychosocial correlates among university students. Despite substantial improvements in food availability and the implementation of multiple national nutrition initiatives, India continues to face a dual burden of undernutrition and diet-related non-communicable diseases. Several researches have shown that prevalence of overweight, obesity and associated risk factors including dietary habits among Indian university students have resulted high levels of malnutrition highlighting the growing public health burden in young populations in India. Recent national and global assessments indicate limited progress in addressing nutrition-related health risks, including overweight, obesity, and diabetes among adults. These challenges coexist with persistent dietary inadequacies and unhealthy eating patterns, reflecting broader shifts in food consumption and lifestyle behaviors. Such trends are increasingly evident among young people, highlighting the importance of understanding eating behaviors and nutritional health during early adulthood. Among young adults, irregular eating patterns, meal skipping, unhealthy food choices and body image concerns were found to have key influences on BMI; both underweight and overweight prevalence in Indian context. Springmann et al. highlighted that diet costs across 150 countries, showing that healthy diets aligned with sustainability goals are more affordable than current consumption patterns in many regions, particularly high-income countries. Beyond dietary intake alone, psychological and social factors exert a substantial influence on eating behaviours among young adults. Emotional states such as stress, anxiety, boredom, and loneliness have be