Epidemiol Health.  2019;41:e2019050. 10.4178/epih.e2019050.

The double burden of malnutrition among adults in India: evidence from the National Family Health Survey-4 (2015-16)

Affiliations
  • 1International Institute for Population Sciences (IIPS), Mumbai, India.
  • 2Department of Development Studies, International Institute for Population Sciences (IIPS), Mumbai, India. selvinsw@gmail.com
  • 3Department of Humanities and Social Sciences, Indian Institute of Technology Roorkee, Roorkee, India.
  • 4Tata Institute of Social Sciences, Mumbai, India.

Abstract


OBJECTIVES
India still faces the burden of undernutrition and communicable diseases, and the prevalence of overweight/obesity is steadily increasing. The discourse regarding the dual burden of underweight and overweight/obesity has not yet been widely explored in both men and women. The present study assessed the determinants of underweight and overweight/obesity in India among adult men and women aged 15-49.
METHODS
Population-based cross-sectional and nationally representative data from the National Family Health Survey-4 (2015-16), consisting of a sample of men and women, were analyzed. Stratified 2-stage sampling was used in the NFHS-4 study protocol. In the present study, bivariate and adjusted multinomial logistic regression analyses were performed to determine the correlates of underweight and overweight/obesity.
RESULTS
The results suggested a persistently high prevalence of underweight coexisting with an increased prevalence of overweight/obesity in India. The risk of underweight was highest in the central and western regions and was also relatively high among those who used either smoking or smokeless tobacco. Overweight/obesity was more prevalent in urban areas, in the southern region, and among adults aged 35-49. Furthermore, level of education and wealth index were positively associated with overweight/obesity. More educated and wealthier adults were less likely to be underweight.
CONCLUSIONS
In India, underweight has been prevalent, and the prevalence of overweight/obesity is increasing rapidly, particularly among men. The dual burden of underweight and overweight/obesity is alarming and needs to be considered; public health measures to address this situation must also be adopted through policy initiatives.

Keyword

Thinness; Overweight; Obesity; Nutritional status; Socioeconomic factors; India

MeSH Terms

Adult*
Communicable Diseases
Education
Family Health*
Female
Humans
India*
Logistic Models
Male
Malnutrition*
Nutritional Status
Obesity
Overweight
Prevalence
Public Health
Smoke
Smoking
Socioeconomic Factors
Thinness
Tobacco, Smokeless
Smoke
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