BackgroundHigh undernutrition is a grave concern in India. Marginalized populations like Indian tribes have been under the serious stress of such nutritional extreme. Women, in particular, are the worst sufferers. Gender-related comprehensive studies regarding the prevalence and risks of undernutrition among the tribes have not been properly pursued in India; the vulnerability of the young females has least been examined.Methods and FindingsWe conducted a cross-sectional study during January 2011 to December 2013 among 1066 males and 1090 females (n = 2156) in the 20–60 years age group belonging to the nine major tribes; Santals, Oraons and Koras (West Bengal): Santals, Bhumijs and Bathudis (Odisha): Dhodias, Kuknas and Chaudharis (Gujarat). The undernutrition burden was estimated and such risks were analyzed for the women in comparison to the men. The overall undernutrition among the females was found to be 47.4% (95% CI 44.4–50.4) against 32.1% (95% CI 29.3–34.9) among males, indicating about a half of the female population undernourished. The odds of risks for underweight status among females were observed to be high in comparison to males with an odds of 1.9 (95% CI, 1.6–2.2; p≤0.001) for the overall undernutrition category, 1.7 (95% CI, 1.3–2.3; p≤0.001) for the mild undernutrition category, 1.3 (95% CI, 1.1–1.6; p≤0.01) for combined moderate and mild undernutrition category and 3.3 (95% CI at 2.3–4.6; p≤0.001) for severe undernutrition category. The young females were observed with a high prevalence of undernutrition along with increased risk. The 30-year mean BMI trend of the Indian population in comparison to the males, females, and overall tribal population places the tribal females at the highest risk.ConclusionIndian tribes are suffering from the higher prevalence of undernutrition by further highlighting a high gender bias. The health and empowerment of adolescent and young tribal girls needs additional focus. Overall, no remarkable control on undernutrition has been achieved among Indian tribes despite various efforts.

BackgroundSocio-cultural transitions among individuals from vulnerable groups introduce epidemiological transition, with a concomitant increase in the prevalence of undernutrition, obesity, and cardiovascular disease risks. An accepted conventional wisdom exists for Indian tribes that they are undernourished and away from lifestyle-related diseases. However, the extent of this triple burden affecting them is unknown. In this study, we assessed this triple burden among the 9 major tribes of India.Methods and FindingsDuring January 2011 to December 2013, we conducted a cross-sectional study among 1066 men and 1090 women constituting a total of 2156 adults belonging to the 9 major tribal groups: Santals, Oraons, and Koras (West Bengal); Santals, Bhumijs, and Bathudis (Odisha); and Dhodias, Kuknas, and Chaudharis (Gujarat) to estimate the prevalence of the triple burden (undernutrition, overweight or obesity, and hypertension). A high prevalence of undernutrition and hypertension was observed among the Koras (51.9%and 10.6%, respectively), Bathudis (51.3% and 12.1%, respectively), and Oraons (49.6% and 16.5%, respectively). However, the prevalence of overweight and hypertension among the Bhumijs (17.7% and 14.7%, respectively), Dhodias (23.8% and 12.9%, respectively), Kuknas (15.8% and 11.3%, respectively), and Santals of West Bengal (12.2% and 11.8%, respectively) and Odisha (15% and 9.6%, respectively) was most alarming. The prevalence of overweight or obesity among the women was 10.9% and 1.5%, respectively, with 14.0% hypertensive women. The prevalence of overweight and obesity among the men was 14.8% and 1.7%, respectively, with 9.2% hypertensive men. Undernutrition was highly prevalent among men and women. However, data from the past 30 years on systolic blood pressure (SBP) and body mass index (BMI) revealed that the studied tribes were at a higher risk than the general Indian population. In addition, a vast gender disparity with relation to the disease and risk prevalence was observed.ConclusionThe alarming trend of an increasing prevalence of overweight/obesity, undernutrition, and hypertension is observed among indigenous populations of India, emphasizing the incorporation of a specific health management policy.

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