Malnutrition contributes both to underweight and overweight, and both conditions contribute to a variety of disease risks. Approximately 40% of the underweight women in the world reside in India, a country that also has the highest number of underweight girls (1 in 5). In addition, India ranks third in the world for the number of obese women (5.3% of global numbers). It is unclear what the key determinants for both underweight and obesity might be within this country and how they have changed over time. Young and colleagues conducted a study to ascertain the types of factors contributing to these conditions among women and adolescents at the state and national level. They report the results of their work in the February 2020 issue of The Journal of Nutrition.

Data for the study were derived from the National Family Health Surveys conducted in 2005-2006 and 2015-2016. The data included height, weight, socioeconomic status, urban residence, education, dietary diversity, and decision-making power.

The proportion of underweight adolescents (43 to 38%) and women (33 to 19%) decreased, while the proportion of overweight/obesity among adolescents (3 to 5%) and women (15 to 25%) increased during the decade between the surveys. Higher socioeconomic status, urban residence, improved diet diversity, latrine use, higher education levels, decision-making, and ownership of money were associated with lower prevalence of underweight among women. Socioeconomic status, urban residence, diet diversity, latrine use, and education were also positively associated with overweight/obesity in women. The factors contributing to underweight and overweight/obesity in adolescents were similar to those found for women. Changes in socioeconomic status contributed to 29% of the reduction in underweight and 46% of the increase in overweight/obesity among women. There were regional and age disparities in the prevalence of underweight and overweight/obesity. The authors concluded that improving socioeconomic status does not ensure healthy weight and that multidisciplinary approaches are needed to address both types of malnutrition.

Reference Young MF, Nguyen P, Tran LM, Avula R, Menon P. A double edged sword? Improvements in economic conditions over a decade in India led to declines in undernutrition as well as increases in overweight among adolescents and women. The Journal of  Nutrition, DOI:

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