India Acquires a Taste for Health and Wellness

Abstract

Health and wellness foods is an INR 10,352 crore market with a growth rate of about 10%. • Fortif ied foods with incremental nutrients gain favour with Indian consumers who are willing to spend more on healthy foods. • Men focus on fortif ication and nutrients, while women focus on making dietary choices that prevent health disorders. • Micro marketing, with its advantage of precision targeting will give manufacturers the edge in strategizing their go-to-market plans. Cultural factors and eating habits make Indians prone to weight issues, and with consumers now judging themselves on international body-image parameters, the general consensus is that a concerted effort on health and wellness is imperative.

Full text

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FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS Copyright © 2016 The Nielsen Company
1
FEATURED INSIGHTS
INDIA ACQUIRES A
TASTE FOR HEALTH
AND WELLNESS
UNDERSTANDING THE HEALTH CONSCIOUS
INDIAN AND THE POTENTIAL OF THE HEALTH
AND WELLNESS MARKET
• Health and wellness foods is an INR 10,352 crore market with a
growthrateofabout10%.
• Fortifiedfoodswithincrementalnutrients gainfavourwithIndian
consumerswhoarewillingtospendmoreonhealthyfoods.

• Men focus on fortif ication and nutrients, while women focus on
makingdietarychoicesthatpreventhealthdisorders.
• Micromarketing,withitsadvantageofprecisiontargetingwillgive
manufacturerstheedgeinstrategizingtheirgo-to-marketplans.
Cultural factors and eating habits make Indians prone to weight issues,
and with consumers now judging themselves on international body-
image parameters, the general consensus is that a concerted effort on
health and wellness is imperative.
DELIVERING CONSUMER CLARITY
THE HEALTH AND WELLNESS
CONSUMER
Indian consumers consider fortified foods with incremental nutrients
like protein, fibre, vitamins, calcium and minerals, an important
consideration while making a purchase. When asked what tips the
scales in favour of certain packaged foods over others, respondents of
our survey picked the promise of all-natural ingredients, high protein
and high fibre content as favourites. The message in this for brands is
to call out auxiliary health benefits rather than merely tagging products
as ‘healthy’.

2FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS
Source: Nielsen Global Health / Wellness Survey
Responses in the chart are an answer to the question ‘How important are the following health attributes in influencing you to purchase more
of a particular food/ food products? - Very Important’
Consumers clearly look at labels on packaged food and are willing
to pay more for products that make the cut. This is especially true of
products with added nutrients, rather than products with low fat or
gluten content.
HEALTH ATTRIBUTES PERCEIVED TO BE MOST IMPORTANT
LABELS THAT MAKE CONSUMERS LOOSEN THEIR PURSE STRINGS
0%
10%
20%
30%
40%
50%
60%
70%
Gluten free
Low/ No fat
Low/ No calories
Whole grain
No artificial flavors
No artificial colors
Genetically modified
organism (GMO) free
Organic
All natural
No high fructose corn
syrup
Portion control
Low / No carbohydrates
Local herbs/ ingredients
Ca eine free
High in protein
High in fiber
Low salt/ sodium
Natural flavors
Low sugar / Sugar free
Ingredients sourced
sustainably/ fair trade
Vitamin fortified
Calcium fortified
Minerals fortified
Micronutrient fortified
Rich in unsaturated fats
Made from vegetables/
fruits
Low / No cholesterol
CONSUMERS ARE LOOKING AT LABELS ON PACKAGED FOOD AND
ARE WILLING TO PAY MORE FOR PRODUCTS THAT MAKE THE CUT.
THIS IS ESPECIALLY TRUE OF PRODUCTS WITH ADDED NUTRIENTS,
RATHER THAN PRODUCTS WITH LOW FAT OR GLUTEN CONTENT.
1.30
ALL NATURAL
1.20
HIGH IN FIBER
1.20
NATURAL FLAVORS
1.06
MINERAL FORTIFIED
1.20
HIGH IN PROTEIN
Source: Nielsen Global Health / Wellness Survey
Responses in the above chart are an answer to the question ‘How willing are you to pay a premium for foods that contain health attributes?
- Very Willing’. Over-indexed attributes with 1.0 being the average.

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FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS Copyright © 2016 The Nielsen Company
CONSUMER WILLING TO SPEND MORE
FOR HEALTHY VARIANTS
Apart from specific ingredients that pique consumer interest, certain
variants of foods too command a much higher rate of premium on the
back of their health and wellness attributes. Healthy variants of noodles
and tea top the list with premium rates of above 70%.
Source: Nielsen
AVG PRICE PER KG/L PREMIUM CHARGED(%)
PACKAGED ATTA
CATEGORIES
33 48 44
22
72
82
24
106 127
301 518
150 273
106 131
BASE H&W
REFINED OIL
TEA
NOODLES
BISCUITS
PORTRAIT OF A FORTIFICATION
SEEKER
Consumers driving the move to fortified foods are conscious about
brands and labels on packaged foods. Four distinct traits characterise
this consumer.
• They are loyaltotrustedbrands and go as far as to buy only from
producers they trust.
• They read labels for nutrition content, b elieve health claims and
follow portion guidance.
• They are willingtopayapremium for foods that meet their approval.
• They monitorfoodintakeanddiet, and are willing to sacrifice taste
for health.
Statistically, one of every two consumers consider themselves either
overweight or underweight. Two of every five are currently trying to lose
weight and physical exercise is the top action taken by consumers in
India who are trying to stay in shape.

4FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS
HOW INDIAN MEN AND WOMEN
APPROACH THIS WEIGHTY ISSUE
The Indian male leans towards fortification and nutrients in his food
and therefore buys organic, natural and fortified foods. On the other
hand, women who also seek organic and natural foods stress more on
making dietary choices to prevent health disorders and are willing to
forgo taste in the bargain.
ARE YOU CURRENTLY TRYING TO LOSE WEIGHT?
WHICH OF THE FOLLOWING ACTIONS ARE YOU
TAKING TO LOSE WEIGHT?
YES 43%
NO 57%
VERY
OVERWEIGHT
SOMEWHAT
OVERWEIGHT
ABOUT THE
RIGHT WEIGHT
A LITTLE
OVERWEIGHT
UNDERWEIGHT
2% 8% 27%
51%
79%
12%
BATTLE OF THE BULGE
65% 11% 10% 5%
Source: Nielsen Global Health/ Wellness Survey
DOING
PHYSICAL
EXERCISE
CHANGING
MY DIET
TAKING DIET
PILLS/BARS/
SHAKES
TAKING
MEDICINE
PRESCRIBED
BY MY DOCTOR
OTHER

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FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS Copyright © 2016 The Nielsen Company
46% 40%
All these insights from the Nielsen Global Health and Wellness
Survey point to the abundant market opportunities that lie ahead for
the segment. What will define success for food brands is a measured
approach that drives effectiveness, and is cognisant of consumer
aspirations.
WHAT MEN WANT: FORTIFICATION
WHICH OF THE FOLLOWING ACTIONS ARE YOU
TAKING TO LOSE WEIGHT?
ORGANIC
60% 53%
HIGH IN FIBER
59% 54%
HIGH IN PROTEIN
59% 47%
ALL NATURAL
51% 43%
VITAMIN FORTIFIED
48% 43%
MINERAL FORTIFIED
MALE FEMALE
Source: Nielsen Global Health/Wellness Survey
Responses in the chart above are an answer to the question ‘How important are the following health
attributes in influencing you to purchase more of a particular food/food products? - Very Important’
WHAT WOMEN WANT: MONITORING DIET
I AM WILLING TO
SACRIFICE TASTE FOR A
HEALTHIER OPTION
30% 38%
I CHOOSE LOCAL, NATURAL
AND ORGANIC ALTERNATIVES
WHENEVER POSSIBLE
40%
34%
I ACTIVELY MAKE DIETARY CHOICES
TO HELP PREVENT CERTAIN HEALTH
CONDITIONS SUCH AS, OBESITY,
DIABETES, HIGH CHOLESTEROL,
HYPERTENSION
35% 42%
I MOSTLY SHOP FOR FOODS
AT SPECIALTY RETAILERS THAT
SELL A WIDE VARIETY OF
HEALTHY FOODS
36% 42%
HEALTHY HYDRATION IS A
PART OF MY LIFESTYLE
36% 42% MALE FEMALE
Source: Nielsen Global Health/Wellness Survey

6FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS
HEALTH & WELLNESS FOODS: SIZE OF
THE OPPORTUNITY
Health and wellness foods is an INR 10,352 crore market. With a growth
rate of about 10%, it is a promising segment for manufacturers to
tap into. Categories that are in vogue like oats noodles and green tea
promise to drive growth.
HEALTH AND WELLNESS FOODS IS AN INR 10,352
CRORE MARKET. WITH A VALUE GROWTH RATE
OF ABOUT 10%, IT IS A PROMISING SEGMENT FOR
MANUFACTURERS TO TAP INTO.
CATEGORIES DRIVING GROWTH IN HEALTH AND WELLNESS FOODS
The fast growth of milk food drinks and cereals demonstrate that the
most important meal of the day may well provide the next impetus to
growth. Consumers are moving away from traditional breakfast options
like ‘parathas’ to a wider and healthier assortment of cereals, oats and
fortified milk food drinks.
SNACKS
PACKAGED
GROCERY
HEALTHY
BISCUITS
MULTIGRAIN
ATTA
MILK FOOD
BEVERAGES
SALES GROWTH
HEALTHY
OILS
GREEN
TEA
SUGAR
SUBSTITUTE
1155 Cr.
1,205 Cr.
5,180 Cr.
1,250 Cr.
165 Cr.
258 Cr.
COOKING
AND OTHERS
WHEAT AND
OATS NOODLES
187 Cr. 951 Cr.
BREAKFAST
CEREALS
Source: Nielsen
5%
7%
11%
9% 4%
14%
52%
10%
BEVERAGES
ATTA

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FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS Copyright © 2016 The Nielsen Company
THE MOST HEALTH CONSCIOUS OF
THEM ALL
A granular view of the geographies that are driving the shift towards
health and wellness foods, shows that the south India is the earliest
to adopt the trend, followed by the east. The west and north will need
some encouragement from manufacturers to follow suit.
HEALTH AND WELLNESS FOODS: REGIONAL PREFERENCES
Source: Nielsen
25%
25%
17%
13%
17%
30%
21%
28%
17%
41%
31%
36%
HEALTHY BISCUITS
GREEN TEA
HEALTHY OILS
HEALTH & WELLNESS
12% 14% 8% 7%
1% 16% 8% 12%
54% 73% 59% 43%
11% 35% 25% 28%
13% 13% 5% -7%
NORTH EAST WEST SOUTH

8FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS
THE CHANNEL OF CHOICE?
Indian shoppers mostly turn to traditional trade stores for their
provisions, with health and wellness foods being no exception. While
this holds true across most categories, instant noodles and cereals
buck the trend with healthy sales in modern trade outlets.
While insights on categories, consumer aspirations and regional usage
patterns help strategise sales and marketing efforts, an important piece
of the puzzle is identifying opportunity areas through micro-marketing.
Sweeping generalisations run the risk of over-simplifying the market
opportunity, and savvy marketers have begun to realise that precision
targeting may be the key differentiator in clinching market share.
MT
TT
Source: Nielsen
FMCG 93% 7%
93% 7%H&W
TRADE CHANNEL SPLIT GENERAL TRADE MODERN TRADE
H&W
7%I93% 29%I71%
HEALTHY
OILS
11%I89%
MFD
HEALTHY
BISCUITS
15%I85%
GREEN
TEA
44%I56%
BREAKFAST
CEREALS
44%I56%
OATS AND ATTA
NOODLES
13%I87%

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FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS Copyright © 2016 The Nielsen Company
REACHING THE HEALTH CONSCIOUS
INDIAN
THE MICRO MARKETING OPPORTUNITY
When compared to developed nations, and even other BRIC countries,
India allocates a smaller proportion of the national Gross Domestic
Product (GDP) to health. However, private expenditure is above most of
the developed countries. Clearly, there is a scope to work on efficiencies
and work towards a healthier community by identifying locations that
need intervention by multiple stakeholders to boost investment on
health, and thereby improving the residents’ living standards.
In India, about 65% of operational beds are in the private sector, and
more than 85% of healthcare spends are by the same sector.
WHEN COMPARED TO DEVELOPED NATIONS, AND EVEN OTHER BRIC
COUNTRIES, INDIA ALLOCATES A SMALLER PROPORTION OF THE NATIONAL
GROSS DOMESTIC PRODUCT (GDP) TO HEALTH. HOWEVER, PRIVATE
EXPENDITURE IS ABOVE MOST OF THE DEVELOPED COUNTRIES.
HEALTH EXPENDITURE: INDIA VERSUS OTHER BRIC NATIONS
COUNTRIES
BRAZIL
CHINA
INDIA
RUSSIAN
FEDERATION
OUT-OF-POCKET
HEALTH EXPENDITURE
(PERCENTAGE OF
PRIVATE EXPENDITURE)
HEALTH
EXPENDITURE AS
PERCENTAGE OF
GDP
57.76
76.65
85.88
92.42
9.67
5.57
3.97
6.55
Note: Out-of-pocket expenditure is any direct outlay by households, including gratuities and in-kind payments, to health practitioners and
suppliers of pharmaceuticals, therapeutic appliances, and other goods and services whose primary intent is to contribute to the restoration or
enhancement of the health status of individuals or population groups. It is a part of private health expenditure.
Source: World Bank, 2013

10 FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS
In order to understand and then activate a healthier community, a good
place to start would be to develop a method to identify locations with
different levels of performance in health. By analysing at the micro
level, Nielsen attempted to identify districts on the basis of health
performance measures. This was done in two steps.
A.Amulti-dimensionalindexwascreatedbyaggregatingthe 
followingparameters:
• HealthCareServices
o Deliveries attended by skilled personnel
o Children Fully Immunized (12-23 months)
o Woman with >3 Antenatal Care
• HealthInfrastructure
o No. of hospitals per person
o No. of registered doctors per person
• OutcomeMeasures
o Inverse of infant mortality rate
o Inverse of under 5 mortality rate
o Inverse of malnourished children
The index is derived in the following way: First, we standardised each
of the variables so that all the variables were in same scale, i.e., 0 to 1.
Second, to ensure objectivity, equal weights were assigned and hence
an arithmetic mean was used to calculate composite index.
B.OnthebasisofthederivedHealthIndexvalues,Districtswere
clusteredintofourquartiles;‘Leaders’,‘Progressive’,‘Aspirers’and
‘NeedImprovement’
From an analysis of these quartiles or clusters, it emerges that the
proportion of ailing people is lower in the leading cluster and people
there are consequently spending less on treatment. Moreover, there are
fewer children with malnutrition in leading clusters and understandably,
these consumers spend more on prevention.

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FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS Copyright © 2016 The Nielsen Company
Source: Estimates using NSSO-71st Round, 2013-14
Leaders: Districts leading in health performance
Source: NSSO, Nielsen Micro Marketing and Economics
Source: Estimates using Indian Development
Landscape, MME-Nielsen
PROPORTION OF AILING
PERSON LOWER IN THE
LEADING CLUSTER VIS-À-
VIS OTHERS: SPENDING
LESS ON TREATMENT
PROPORTION OF AILING
PERSON (PER ‘000)
MALNUTRITION OF CHILDREN
(LESS THAN 5 YEARS)
MAL-NUTRITIOUS CHILDREN
LOWER IN LEADING CLUSTER
VIS-À-VIS OTHERS:
SPENDING MORE ON
PREVENTION
79
101
124
127
LEADERS
PROGRESSIVE
ASPIRERS
NEED
IMPROVEMENT
16.1
28.9
44.1
47.6
PREVENTIVE MEASURES ARE NOT A
PRIORITY
Consumers spend on medical treatment because they have to, whether
they can afford it or not. However, spending on prevention is perceived
as expendable. Only when consumers feel comfortable with disposable
income, do they consider spending on prevention. What is heartening
is that though the ability to spend is highest in the leading cluster, the
income of people across all four of our district clusters are increasing.

12 FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS
Despite increasing incomes, only the leading cluster spends a
substantial proportion of the household expenditure on health and
preventive measures.
AFFLUENCE LEVEL:
PERCENTAGE OF
HOUSEHOLDS EARNING
MORE THAN RS. 10 LAKH
ANNUALLY
POVERTY LEVEL:
PERCENTAGE OF
HOUSEHOLDS EARNING
LESS THAN RS. 75,000
ANNUALLY
2004 2009 2014
Source: Nielsen Micro Marketing and Economics
Source: Nielsen Micro Marketing and Economics
PERCENTAGE OF HOUSEHOLD EXPENDITURE ON HEALTH
TO TOTAL EXPENDITURE
6.0%
4.3%
3.2%
3.3%
LEADING DISTRICTS
PROGRESSIVE DISTRICTS
ASPIRERS
NEED IMPROVEMENT
61%
46%
28%
59%
44%
28%
63%
50%
32%
67%
53%
34%
LEADING
DISTRICTS
PROGRESSIVE
DISTRICTS
ASPIRERS
NEED
IMPROVEMENT
5%
9%
18%
4%
8%
16%
3%
6%
12%
2%
4%
10%

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FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS Copyright © 2016 The Nielsen Company
1Improved drinking water facility as defined by WHO include-household connection, public standpipe, borehole, protected
drug well, protected spring, rainwater collection.
2Improved sanitation facility as defined by WHO include-Connection to a public sewer, connection to a septic system,
pour-flush latrine, simple pit latrine, ventilated improved pit latrine.
A HEALTHIER COMMUNITY THROUGH MICRO
MARKETING
A granular look at each cluster helps understand where each locality stands on health and
what their priorities are. All the stakeholders in the health and wellness market can derive their
distinct lessons from the four district clusters.
LEADERS:DISTRICTSWITHHIGHEXPENDITUREONHEALTHANDAHIGHHEALTHINDEX
Consumers in leading districts can afford to take measures for the upkeep of their health. They
also display a low level of ailments and spend more on preventive measures. This segment can
be approached with the knowledge that they can spend on expensive health items.
PROGRESSIVE:DISTRICTSWITH MODERATELYHIGHEXPENDITUREONHEALTHANDA
PROGRESSINGHEALTHINDEX
Consumers in this cluster are low on ailments with gradually improving health statistics. They
are warming up to spending on preventive measures. Brands looking at this segment can focus
on educative content to drive demand.
ASPIRERS:DISTRICTSWITHLOWEXPENDITUREONHEALTHANDANIMPROVEMENTIN
SOMEMEASURESOFTHEHEALTHINDEX
These consumers can afford little but have a high prevalence of ailments. It is safe to assume that
they will spend more on treatment. Since it will be largely non-profitable, and since treatment
requirements are comparatively high, there needs to be government or NGO intervention to
improve the health situation.
NEED IMPROVEMENT: DISTRICTSWITH LOW EXPENDITURE ON HEALTH AND A LOW
HEALTHINDEX
Consumers in this segment have very low incomes and require government intervention first to
make a significant improvement.
Micro marketing works to improve efficiency through precision targeting. To illustrate, the city
of Lucknow can be mapped to mark out the four clusters. Health Index at the neighbourhood
level as defined earlier, is an aggregation of (A) health care services, (B) health infrastructure (C)
outcome measures. The parameters used to measure each of the categories is redefined based
on the information available at the neighbourhood level:
• Health care services- medical services, pharmaceuticals.
• Health infrastructure- hospitals, registered doctors.
• Outcome measures- factors that influence outcome directly.
• Improved drinking water 1facility, improved sanitation facility2.
Neighbourhoods within the city can be classified by their Health Index and their household
expenditure on health.

14 FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS
The focus of brands and manufacturers in this instance would be on the
encircled clusters of ‘Leaders’ and ‘Progressive’.
Whether ‘Leaders’, ‘Progressive’, ‘Aspirers’ or ‘Need Improvement’,
consumers across segments are increasingly waking up to the difference
health can make to their lives. Statistics, trends and micro marketing
strategies are tools that marketers can use to optimise the massive
opportunity that promises to grow despite any residual economic
uncertainty in the country.
MICRO MARKET IDENTIFICATION FOR ACTIVATION:
ILLUSTRATION OF LUCKNOW MICRO MARKET
ASPIRERS-
IMPROVING
IN HEALTH
INDEX HIGH
IN HEALTH
EXPENDITURE
20000
18000
16000
14000
12000
10000
8000
6000
4000
2000
0
00.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9
-0.1
NEED
IMPROVEMENT
PROGRESSIVE-
MODERATELY HIGH
IN HEALTH INDEX-
LOW IN HEALTH
EXPENDITURE
LEADERS-HIGH IN
HEALTH INDEX-
HIGH IN HEALTH
EXPENDITURE
PER HOUSEHOLD EXPENDITURE ON HEALTH
Source: Nielsen Micro Marketing and Economics
Rajiv Gandhi Ward
1st NCL
Maha kavi Jai
Shankar Prasad
NCL
HEALTH INDEX

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FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS Copyright © 2016 The Nielsen Company
MANOJ KULKARNI
DIRECTOR
NIELSEN INDIA
MINAKSHI CHAKRABORTY
SENIOR MANAGER
NIELSEN INDIA
NEHA AHUJA
SENIOR MANAGER
NIELSEN INDIA
ABOUT THE AUTHORS
ABOUT NIELSEN
Nielsen Holdings plc (NYSE: NLSN) is a global performance management
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For more information, visit www.nielsen.com.
Copyright © 2016 The Nielsen Company. All rights reserved. Nielsen and
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registered trademarks of their respective companies.
Mani Goyal from the Nielsen Industrial Market Research team contributed to
this issue of Featured Insights.

16 FEATURED INSIGHTS | INDIA ACQUIRES A TASTE FOR HEALTH AND WELLNESS