Double burden of malnutrition among school-going adolescent girls in North India: A cross-sectional study

Abstract

Context:Double burden of malnutrition comprising both undernutrition and overnutrition is nowadays emerging as a major public health concern among adolescent girls in India.Aim:The present study was conducted to determine the prevalence of underweight, overweight, and obesity among school-going adolescent girls along with dietary and physical activity-related factors associated with them.Settings and Design:The present cross-sectional survey was conducted among 2400 school-going adolescent girls (10–19 years) in Barabanki district of Uttar Pradesh.Subjects and Methods:Multistage sampling technique was used for enrolment of the study subjects. Data were collected on sociodemographic profile, physical activity, dietary intake, and anthropometry. WHO body mass index (BMI)-for-age cutoff classification of girls was used for assessment of underweight, overweight, and obesity.Statistical Analysis Used:Statistical analysis was done with the Epi Info software. Multinomial logistic regression analysis was used to ascertain various predictors of underweight, overweight, and obesity among adolescent females (P < 0.05 was considered as significant).Results:The proportion of underweight, overweight, and obese students were 47.0%, 5.9%, and 2.7%, respectively. The girls in mid and late adolescent age group were significantly less susceptible for being underweight for age (odds ratio [OR] 0.28; 95% confidence interval [CI] 0.22–0.36; P = 0.00). The girls belonging to middle and upper socioeconomic strata were about 35 times more susceptible toward obesity (OR 35.12; 95% CI 13.33–92.49; P = 0.00) and 12 times more susceptible toward being overweight (OR 12.46; 95% CI 13.33–92.49; P = 0.00) as compared to those in lower income groups. The probability of overweight and obesity were about 3 times (OR 3.13; 95% CI 1.76–5.55; P = 0.00) and 10 times (OR 9.66; 95% CI 4.00–23.35; P = 0.00) higher among adolescent girls who reside in urban areas as compared to rural one. Apart from these, non-Hindu religion, nuclear type of family, parent's education profile of middle school and above, and engagement in physical activities more than 2 h a day were other factors found to be directly associated with increased chances of overweight/obesity (OR > 1; P < 0.05).Conclusions:The high prevalence of the double burden of malnutrition revealed the need of the hour to modify and strengthen the existing adolescent health programs of India so as to deal with both the facets of nutrition spectrum substantially.

Spatial patterns and determinants of undernutrition among late-adolescent girls in Ethiopia by using Ethiopian demographic and health surveys, 2000, 2005, 2011 and 2016: a spatial and multilevel analysis

“…On the other hand, adolescent girls after 18 years may be engaged in marriage and may be better access to eating patterns in economically limited families. In contrast with the above, a study from India [ 30 ] showed that late-adolescents were less likely for undernutrition compared with early-adolescents.…”

Underweight and Associated Factors Among Teenage Adolescent Girls in Resource-poor Settings: A Cross-sectional Study

“…Adolescents (10)(11)(12)(13)(14)(15)(16)(17)(18)(19) years old) comprise one quarter of the world's population. 8,9 This time of life is critically important because it is during this period that rapid growth and development occurs, and thus, adolescents require higher nutrient intakes.…”

“…More importantly, adolescent girls need good quality nutritive foods in sufficient quantity to cope with the added nutritional requirements associated with onset of maturity, menstruation, participation in various physical activities, 14,15 and to reduce health risks and break the intergenerational cycle of malnutrition. 16,17 Researchers in recent studies overlooked several important predictors of underweight adolescent girls such as sociodemographic and socioeconomic factors, 18,19 parental education,- 18,20 occupation, 20 dietary habits 5,18 and food insecurity. 21,22 It is well known that being underweight is one of the major public health concerns in teenage adolescent, especially school-aged children in South East Asian countries as it impacts health, cognition, and educational achievements.…”

Cross-Sectional Analysis of Nutritional Status, Knowledge and Uptake of Nutritional Services Among Adolescent Girls in Western India

“…8,9 Malnutrition -either nutrition deficiency (underweight) or excess nutrition (over-weight or obesity) -leads to physical as well mental health problems in adolescents. 10,12 For example, adolescents with nutrition deficiencies are likely to face short physique, cognitive impairment, mental functioning and reduced immunity whereas overweight and obese adolescents often experience low self-esteem, distorted body image and are at higher risk for developing noncommunicable diseases including mental disorders. 7,[10][11][12] Malnutrition has even more devastating effects on adolescent girls.…”

“…10,12 For example, adolescents with nutrition deficiencies are likely to face short physique, cognitive impairment, mental functioning and reduced immunity whereas overweight and obese adolescents often experience low self-esteem, distorted body image and are at higher risk for developing noncommunicable diseases including mental disorders. 7,[10][11][12] Malnutrition has even more devastating effects on adolescent girls. In addition to common health risks, adolescent girls are more susceptible to infections, face difficulties in recovering from illnesses and surviving child birth in future or more likely to deliver low birthweight babies creating a vicious cycle.…”