Double Burden of Malnutrition in India: Decadal Changes among Adult Men and Women

The recent COVID-19 pandemic brings to the fore a high fatality rate amongst those with comorbidities of diabetes and hypertension that is often associated with obesity, while it also exposing the vulnerabilities among the less nourished population due to the infection and economic lockdown. An increasing number of developing countries like India have both undernourished people and overnourished individuals posing a large public health challenge. In these contexts, the study here analyses the decadal changes in double burden of malnutrition among adult men and women in India based on NFHS-3 and NFHS-4 data. Undernutrition is assessed by the thinness and overnutrition by overweight and obesity using Asian cut-off values for BMI. By 2015-16 the gender gaps in malnutrition have closed in, than it was in 2005-06 perhaps due to an increase in sample size for men. Undernutrition rates have declined in the past decade but are close to 20 percent or more in the population segments of 20-29 years, rural areas, among the poorest and poor asset quintiles, those with less than 5 years of schooling and in the central and eastern regions of India. The worrisome feature is that the increases in overnutrition rates have replaced the decline in undernutrition rates more than the increases in normal nutrition rates resulting in its widespread increase across all parts of country with 50 percent or more among the richest asset quintile, 15 or more years of schooling and more urbanized states of India. The silver lining is that overnutrition rates have declined marginally among those with 18 or more years of schooling in 2015-16. To address the double burden of malnutrition, the way forward would be to harness the large diversity in India’s food systems with the assistance of local governments and communities and nudging the individuals to a healthy diet and physical exercises using India’s varied fare of traditional and modern options-this could also be in sync with the ongoing call for localness and self-reliance.