The World Bank has said malnutrition affects huge numbers of people in India, especially women and children, despite decades of often effective government action.
Its report "Wasting Away - The Crisis of Malnutrition in India" blames poverty and low status of women for some of its most shocking statistics - half of all children under four are malnourished, it says, and 60% of women are anaemic.
Mothers and sisters often forego food in poor families to give husbands and sons more than their share, the report says.
One of the authors of the report, Mira Chatterjee, says malnutrition on such scale means money invested in education is not used effectively as hungry children cannot study.
Economic cost
The report estimates that malnourished workers mean an annual loss of $10 bn in lost productivity.
It praises India's effort to feed its people through agricultural innovation and poverty alleviation schemes, but says population growth, high prices and unemployment often offset well intentioned government programmes.
The country's huge force of migrant labour suffers acutely from malnutrition according to the report.
It recommends putting an end to malnutrition as a major policy objective of the government.
India has been justifiably proud of its self sufficiency in food since the so-called green revolution in agriculture in the 1960s and 70s.
But this report will add to growing feelings of unease that a new attempt to end hunger once and for all is an urgent need as the country enters the next millennium.