The factors which affect nutrition levels are food, inheritability, genetic predisposition, clean water, sanitation, disease conditions, geography and human development etc. According to the economist Arvind Panagaria, the processes of nutritional outcomes are shaped more by food intake, inheritability of poor nutrition across generation and genetic predisposition towards a shorter stature. However, the economist Sonalde Desai while accepting that the first one is a function of household income and food prices and so amenable to being addressed through public policy states that the other two are beyond the reach of public policy. Desai shows from an analysis of nutrition data that the difference in nutrition begins at six months of age where children start supplemental food. The quality or the quantity of the supplemental food is not sufficient to overcome the effect of gastrointestinal diseases which affect these children the moment they begin taking anything else other than mother’s milk. Research in many countries has found that gastrointestinal disease in associated with inadequate access to water and sanitation systems. These have to be addressed to reduce malnutrition among children. Thus, it is important to look at the role of disease conditions shaped by water and sanitation. The poor quality of water and sanitation leads to a high prevalence of diseases like diarrhoea, which stop food absorption and affect nutritional outcomes. The disease environment is also one of the prime reasons for the nutritional outcomes. The disease environment affects both the rich and the poor but there is difference between communities. Many of the households do not have access to basic amenities. The spill over effects of the disease environment spread through contamination and flies so even well to do households living in unsanitary neighbourhoods are affected. The situation of people who live in different geographic areas like urban and rural is different. This reflects in most indicators of health care systems. Regional inequalities remain in different levels; an educated person from a rural area and an uneducated person from an urban area do not get the same facilities. So there is a need for holistic understanding of nutrition level among children in India, and also a need for multidimensional inputs to assess nutrition levels of food intake, disease conditions, right policy emphasis and genetic predisposition as well as to create a right parameter for the Indian population for nutrition level. According to National Family Health Survey data when a child is born there is no change in nutritional outcomes across income groups for the first 6 months but when they start taking food, then growth is affected because of the differential food intake and diseases. Thus inter generational inheritability and genetic predisposition have a marginal effect. The income to nutrition data also shows that the improvement in nutrition over the period 1992-93 to 2006 is far greater for richer households. So upper income groups have better nutrition out comes. Earlier more than half of the Indian population had no access to toilets and sanitation but now there is a substantial improvement and around 36% households have access to water closets and more than half have access to toilets of one kind or other. There is not much of a gap between geographic areas as this has been overcome with time. Therefore the most important factor at present to influence nutritional outcomes is food intake which is related to income. Thus, there is a need to improve the incomes and food availability of poor households while continuing the thrust towards ensuring greater sanitation.