Trends and Determinants of Low Body Mass Index (BMI) Among 750,000 Adolescents and Women of Reproductive Age in India (P10-086-19)

Abstract

ObjectivesLow BMI among women and girls has implications for their health and that of the next generation. Yet, little is known about the determinants of low BMI despite the known high burden of undernutrition in India. We aimed to use nationally representative data to examine national and state trends for BMI and to identify the determinants of low BMI among adolescent girls and women. MethodsWe used India’s National Family Health Survey (NFHS), collected in 2005–2006 and 2015–16. Using data on adolescents 15–19y (N = 21,450; N = 117,722) and women 20–49y (N = 89,437; N = 527,471), we examined national and state trends for BMI. We used multiple regression analysis to examine the role of individual (e.g., diet), interpersonal (e.g., domestic violence) and family-level factors (e.g., socio-economic status (SES)) on low BMI (defined as BMI z-score <-1 for adolescents; BMI <18.5 for adults). ResultsBetween 2006 and 2016, at the national level there was right shift in BMI distributions with concurrent decreases in low BMI and increases in overweight/obesity. Low BMI declined from 42.7% to 38.3% among adolescents and 33.0% to 18.8% among women, while overweight/obesity increased by 2 to 14%, respectively. The prevalence of low BMI among women was less than 30% in all states in 2016, a shift from 2006 when nearly half were over 30%. In contrast, only 4 states moved from a high prevalence of low BMI among adolescents to less than 30% in 2016. There was large variation in improvement and low BMI burden across states. Key protective factors among adolescents and women, respectively, included improved diet diversity (OR: 0.90 and 0.75), higher SES (OR: 0.75 and 0.37) and access to improved latrine (OR 0.94 and 0.77). Higher education levels, decision-making, and ownership of money among women was protective; while working for pay contributed to low BMI. ConclusionsDespite overall declines in low BMI among women and adolescents in India, regional and age disparities remain and further improvements are required. Furthermore, the reductions in low BMI are accompanied with concerning increases in overweight/obesity calling for multidisciplinary approaches for ensuring heathy BMI status among adolescent girls and women in India. Funding SourcesBill & Melinda Gates Foundation, led by International Food Policy Research Institute.