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Underweight among rural Indian adults: burden, and predictors of incidence and recovery.

ABSTRACT: OBJECTIVE:To study the magnitude and predictors of underweight, incident underweight and recovery from underweight among rural Indian adults. DESIGN:Prospective cohort study. Each participant's BMI was measured in 2008 and 2012 and categorized as underweight (BMI<18·5 kg/m2), normal (BMI=18·5-22·9 kg/m2) or overweight/obese (BMI ?23·0 kg/m2). Incident underweight was defined as a transition from normal weight or overweight/obese in 2008 to underweight in 2012, and recovery from underweight as a transition from underweight in 2008 to normal weight in 2012. Bivariate and multivariable logistic regression analyses were employed. SETTING:The Birbhum Health and Demographic Surveillance System, West Bengal, India. SUBJECTS:Predominantly rural individuals (n 6732) aged ?18 years enrolled in 2008 were followed up in 2012. RESULTS:In 2008, the prevalence of underweight was 46·5 %. From 2008 to 2012, 25·8 % of underweight persons transitioned to normal BMI, 12·9 % of normal-weight persons became underweight and 0·1 % of overweight/obese persons became underweight. Multivariable models reveal that people aged 25-49 years, educated and wealthier people, and non-smokers had lower odds of underweight in 2008 and lower odds of incident underweight. Odds of recovery from underweight were lower among people aged ?36 years and higher among educated (Grade 6 or higher) individuals. CONCLUSIONS:The current study highlights a high incidence of underweight and important risk factors and modifiable predictors of underweight in rural India, which may inform the design of local nutrition interventions.

SUBMITTER: Rai RK

PROVIDER: S-EPMC5849053 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Underweight among rural Indian adults: burden, and predictors of incidence and recovery.

Rai Rajesh Kumar RK Fawzi Wafaie Wahib WW Bromage Sabri S Barik Anamitra A Chowdhury Abhijit A

Public health nutrition 20171110 4

<h4>Objective</h4>To study the magnitude and predictors of underweight, incident underweight and recovery from underweight among rural Indian adults.<h4>Design</h4>Prospective cohort study. Each participant's BMI was measured in 2008 and 2012 and categorized as underweight (BMI<18·5 kg/m2), normal (BMI=18·5-22·9 kg/m2) or overweight/obese (BMI ≥23·0 kg/m2). Incident underweight was defined as a transition from normal weight or overweight/obese in 2008 to underweight in 2012, and recovery from un ...[more]

PMID: 29122038

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Project description:BackgroundFew studies have evaluated the association between being underweight and having cardiovascular disease in the general population. We investigated the incidence of stroke, myocardial infarction (MI), and all-cause mortality according to detailed underweight categories in a large population cohort.MethodsWe included 4 164 364 individuals who underwent a health examination that was conducted as part of the Korean National Health Insurance Service between January 2009 and December 2012 and followed them up to determine the incidence of stroke, MI, and all-cause mortality until 31 December 2016. Based on the body mass index, the study population was categorized into normal (18.50-22.99), mild (17.00-18.49), moderate (16.00-16.99), and severe underweight (<16.00) groups. Cox proportional hazards analyses were performed to calculate the hazard ratio for stroke, MI, and mortality according to the severity of underweight in reference to the normal weight. We adjusted for age, sex, lifestyle, economic status, co-morbidity, blood pressure, glucose, lipid level, and waist circumference.ResultsThe mean age of the 4 164 364 eligible subjects in this study cohort was 44.4 ± 14.3 years, and 46.1% of the participants were male; 46 728 strokes, 30 074 MIs, and 121 080 deaths occurred during 27 449 902 person-years. The incidence of stroke, MI, and all-cause mortality increased proportionally with the severity of underweight in the multivariate model. This proportional association became more evident when the waist circumference was additionally adjusted. The respective hazard ratios (95% confidence intervals) for mild, moderate, and severe underweight were 1.10 (1.06-1.15), 1.11 (1.02-1.20), and 1.38 (1.24-1.53) for stroke; 1.19 (1.14-1.25), 1.40 (1.27-1.53), and 1.86 (1.64-2.11) for MI; and 1.63 (1.60-1.67), 2.10 (2.02-2.17), and 2.98 (2.85-3.11) for all-cause mortality. In stratified analyses based on waist circumference, the severity of underweight was consistently associated with a higher risk of stroke, MI, and death.ConclusionsThe severity of underweight was associated with a higher risk of stroke, MI, and all-cause mortality.

Project description:IntroductionMalnutrition 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.

Dataset Information

Underweight among rural Indian adults: burden, and predictors of incidence and recovery.

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Underweight among rural Indian adults: burden, and predictors of incidence and recovery.

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