Prevalence of Double Burden of Malnutrition among Young Children in Rishikesh, Uttarakhand, India: A Cross-sectional Study

Abstract

Introduction: The double burden of malnutrition (DBM), which refers to the coexistence of obesity and stunting in children, is a newly emerging form of malnutrition and a significant issue in developing countries, including India. Many of these countries are in the third stage of the epidemiological transition and undergoing rapid urbanisation, leading to increased availability of processed food, mechanisation of work, and sedentary lifestyles. These factors present a unique challenge in combating DBM. Due to the lack of evidence on DBM in India, particularly among young children, the current study was conducted. Aim: The aim of this study was to estimate the prevalence of DBM among children under six years of age and identify its biosocial determinants. Materials and Methods: A cross-sectional study was conducted in the Urban Anganwadi Centres of Tehsil Rishikesh, Uttarakhand, India. The study spanned six months, from November 2021 to April 2022, and included a total of 310 children from 13 Anganwadi Centres. Data collection was performed using a validated and pretested semi-structured questionnaire through Epicollect 5.0. The collected data were analysed using the Statistical Package for Social Sciences (SPSS) version 23.0. Pearson’s Chi-square test was employed to examine the association between various biosocial determinants (sociodemographic factors, Infant and Young Child Feeding practices, and screen time) and DBM. Results: The study included 310 children under six years of age, among whom 11 (3.5%) exhibited DBM. The prevalence of DBM was higher in females, with 8 (5.2%) affected, compared to males, with 3 (2%) affected. Among the females, DBM was more prevalent in the age group of 2-5 years, with five cases. Six out of the 11 children with DBM belonged to the lower-middle class. Additionally, 7 (4%) of the DBM children were breastfed immediately, while 4 (3.5%) were breastfed after a few hours or days. The prevalence of DBM in urban areas of Rishikesh (3.5%) was higher than the national average of 2.8% reported in the Comprehensive National Nutrition Survey (CNNS) 2016- 2018 report. Conclusion: Although, the present study had a small sample size, it offers valuable insights and fills the data gap regarding the estimation of DBM at the individual level and the association of various factors in this specific age group. DBM was more prevalent in females compared to males, suggesting a genderrelated disparity in the occurrence of DBM among young children. However, further research is needed to understand the underlying factors contributing to this difference and to develop targeted interventions.