The double burden of malnutrition in India: Trends and inequalities (2006–2016)

Abstract

Rapid urban expansion has important health implications. This study examines trends and inequalities in undernutrition and overnutrition by gender, residence (rural, urban slum, urban non-slum), and wealth among children and adults in India. We used National Family Health Survey data from 2006 and 2016 (n = 311,182 children 0-5y and 972,192 adults 15-54y in total). We calculated differences, slope index of inequality (SII) and concentration index to examine changes over time and inequalities in outcomes by gender, residence, and wealth quintile. Between 2006 and 2016, child stunting prevalence dropped from 48% to 38%, with no gender differences in trends, whereas child overweight/obesity remained at ~7–8%. In both years, stunting prevalence was higher in rural and urban slum households compared to urban non-slum households. Within-residence, wealth inequalities were large for stunting (SII: -33 to -19 percentage points, pp) and declined over time only in urban non-slum households. Among adults, underweight prevalence decreased by ~13 pp but overweight/obesity doubled (10% to 21%) between 2006 and 2016. Rises in overweight/obesity among women were greater in rural and urban slum than urban non-slum households. Within-residence, wealth inequalities were large for both underweight (SII -35 to -12pp) and overweight/obesity (+16 to +29pp) for adults, with the former being more concentrated among poorer households and the latter among wealthier households. In conclusion, India experienced a rapid decline in child and adult undernutrition between 2006 and 2016 across genders and areas of residence. Of great concern, however, is the doubling of adult overweight/obesity in all areas during this period and the rise in wealth inequalities in both rural and urban slum households. With the second largest urban population globally, India needs to aggressively tackle the multiple burdens of malnutrition, especially among rural and urban slum households and develop actions to maintain trends in undernutrition reduction without exacerbating the rapidly rising problems of overweight/obesity.

Influence of gender and parental migration on IYCF practices in 6–23-month-old tribal children in Banswara district, India: findings from the cross-sectional PANChSHEEEL study

“…Recently the Government of India also launched the National Nutrition Strategy (in 2017) and the National Nutrition Mission (in 2018). The National Nutrition Mission provides an updated strategic framework for action to improve nutritional outcomes by holistically addressing the multiple determinants of malnutrition, through cross-sectoral convergence and contextualized planning at each level of the implementation process [ 11 ].…”

Influence of Iron Addition (Alone or with Calcium) to Elements Biofortification and Antioxidants in Pholiota nameko

“…An imbalance between the macro and micronutrients required for metabolism reactions leads to malnutrition. One of its forms is undernutrition resulting from nutrient deficiencies (these terms are often incorrectly used interchangeably) [1]. Unfortunately, elemental deficiencies are still a relevant health issue in developing and underdeveloped countries [2].…”

Reducing “Screen-Time” and Promoting Self Care Activities among Overweight and Obese Pre-Adolescents: A Randomized Controlled Trial

“…It has also been reported that obesity is identified as an independent risk factor for COVID-19 disease severity and obese children may experience a more severe COVID-19 trajectory which might include the need for respiratory support. 7 The overall obesity of 53.01% was high as compared to pre-covid era estimations of 19.3% 8 and ~7-8%, 9 respectively.…”