Burden and Predictors of Malnutrition Among Indian Adolescents (10–19 Years): Insights From Comprehensive National Nutrition Survey Data

Abstract

Introduction:Malnutrition among adolescents is a persistent problem with a profound impact on different dimensions of health. The objective of this analysis is to assess the burden of malnutrition (Stunting, Thinness, Overweight, and Obesity) and their associated socio-demographic factors among Indian adolescents (10–19 years) from the Comprehensive National Nutritional Survey (CNNS 2016-18) data.MethodsWe used Individual-level data of 35,831 adolescents from the CNNS conducted in 2016–18 for this analysis. CNNS collected data on the nutritional status of adolescents along with socio-demographic variables from all states of India. Burden of stunting (Height for age Z score, HAZ < −2 SD), thinness (BMI for age Z score, BAZ < −2 SD), overweight (BAZ > 1 SD) and obesity (BAZ > 2 SD) were estimated for the entire country and individual states. A multivariable logistic regression analysis was used to assess the socio-demographic factors associated with stunting, thinness, and overweight.ResultsCNNS collected data from 35,831 adolescents, of which 31,941 with BAZ scores, and 32,045 with HAZ scores were included in the final analysis. The burden of stunting and thinness among Indian adolescents was 27.4% (95% CI 26.4, 28.4%) and 24.4% (23.5, 25.4%), respectively. The burden of overweight and obesity was 4.8% (4.5, 5.1%) and 1.1% (0.9, 1.3%), respectively. Adolescents in the age group of 15–19 years (AOR 1.23, 95% CI 1.11, 1.36) compared to 10–14 years, females (AOR 1.20; 1.08, 1.33) compared to males, were at increased odds of getting stunted. Adolescents from lowest wealth index families (AOR 1.66; 1.33, 2.07) were at increased odds of thinness compared to peers of higher wealth index families. Adolescents of 10–14 years (AOR 1.26, 95% CI 1.06, 1.49) compared to 15–19 years, urban residents (AOR 1.43, 95% CI 1.19, 1.71) compared to rural residents, were at increased odds of overweight.ConclusionIndian adolescents face the double burden of malnutrition that is undernutrition (stunting and thinness) alongside overnutrition (overweight and obesity) that are linked with socio-demographic factors. The National Nutritional Programs (POSHAN Abhiyan) should prioritize high-risk groups specifically older age group (15–19 years), females, and low wealth Index quintile families identified in this analysis.

Secular trends and sociodemographic determinants of thinness, overweight and obesity among Chinese children and adolescents aged 7–18 years from 2010 to 2018

“…This further suggests that China should pay attention to the dissemination of nutritional concepts and balanced development of each region while actively building the countryside and ensuring nutritional needs. The older the age, the lower the prevalence of thinness and overweight and obesity in all subgroups, consistent with related studies ( 6 , 8 , 20 ). Some studies also showed opposite results or little difference among different age categories ( 18 ).…”

“…Overall the prevalence of thinness was consistent in boys and girls, and the prevalence of overweight and obesity was higher in boys, consistent with previous studies ( 7 , 8 , 20 , 24 , 25 ). However, some studies showed that girls were more likely to be stunted or thin ( 6 , 21 ) and others demonstrated that boys were more likely to be stunted or thin ( 29 , 39 ). It was speculated that these differences may be related to the country and the different regions.…”

Undernutrition and anaemia among Indian adolescents: role of dietary diversity and hygiene practices

“…But due to lack of comprehensive and representative data on adolescent nutrition, the scope of earlier studies is a limited to specific region or gender ( 8 , 9 , 13 , 14 ) . Two recent studies on adolescent malnutrition ( 15 ) and anaemia ( 16 ) conducted using CNNS (2016–18) data shows substantial socioeconomic and regional disparities in adolescent malnutrition. However, none of these large-scale studies assessed the roles of dietary diversity and individual-level hygiene practices in adolescent malnutrition.…”

Nutritional status of school‐age children (5–19 years) in South Asia: A scoping review

“…Twenty‐one studies explored differences between rural and urban areas and the majority of them (16 studies) (Bellundagi et al, 2022; Bhargava et al, 2016; Biswas et al, 2017; Chakraborty et al, 2018; Ganie et al, 2017; Goonapienuwala et al, 2022; Harding et al, 2019; Hombaiah et al, 2021; Islam et al, 2020; Khan et al, 2022; Khatri et al, 2021; Mohan et al, 2019; Pandurangi et al, 2022; Prasad et al, 2016; Yadav et al, 2018; Young et al, 2020) found a higher prevalence of overweight and/or obesity in urban areas. Differences in overweight/obesity prevalence for males and females were inconsistent across studies; however, a pooled analysis combining 2416 population‐based measurements found that BMI was higher among girls compared to boys in South Asia (NCD Risk Factor Collaboration (NCD‐RisC), 2017).…”