National Nutrition Monitoring Bureau Research Articles

Socio-demographic factors, overweight/obesity and nutrients associated with hypertension among rural adults (≥18 years): Findings from National Nutrition Monitoring Bureau survey

BackgroundHypertension is the leading cause of death throughout the world. The study was conducted to assess the prevalence, determinants and knowledge & practices about hypertension among rural adults in India. MethodsA community-based cross-sectional study was carried out in 10 major states of India. Information on socio-economic & demographic particulars was collected and anthropometric measurements like height, weight, waist & hip circumference and blood pressure were measured. Foods and nutrient intakes were assessed by 24-h recall method. Analysis was done using SPSS window 22. ResultsThe prevalence of pre-hypertension was 45.3% (95% CI: 44.6–46.0) and hypertension was 22% (95% CI: 21.5–22.3) (age standardized prevalence; 20.2%) while, overweight/obesity was 22.6% (95% CI: 22.2–23.0) as per Asian cut offs (BMI≥23). The prevalence of hypertension was higher in West Bengal (29.5%) and Kerala (28.9%) and low in Madhya Pradesh and Uttar Pradesh (16–19%). The odds of hypertension was 1.2 times higher among forward communities, businessmen, tobacco users and those consuming alcohol, 2–3 times higher among overweight (CI: 1.87–2.25) and obese (2.65–3.27). The odds of hypertension was 1.2 times higher among those consuming lower tertile of carbohydrates (CI = 1.02–1.41) and zinc (CI = 1.11–1.42). About 76% were aware of hypertension, 21% were old hypertensive & 19% were on treatment. Conclusions: Age standardized prevalence of hypertension was 20% among adults and was associated with age, occupation, overweight/obesity, tobacco and alcohol use, low intake of carbohydrates and zinc. Therefore, increasing awareness and consumption of healthy diet through behavior change communication will help to control hypertension among adults.

Intake of Foods That Could Be Fortified and of Nutrients That Could Potentially Contribute to Anemia Among Indian Women Before Fortification Implementation

Objectives1) To estimate intake of staple foods and condiments that could be fortified if 2018 fortification regulations released by the Food Safety and Standards Authority of India for oil, wheat flour, rice, salt, and milk were implemented effectively under social protection programs; and 2) To estimate intake of nutrients that could potentially contribute to anemia among women of reproductive age (WRA) (15–49 y) in India, prior to fortification implementation. MethodsWe estimated WRA’s mean food intake and intake of iron, vitamin A, vitamin C, riboflavin, thiamine, zinc, and folate by integrating single-day 24-h dietary recall from the National Nutrition Monitoring Bureau (NNMB) Rural Survey 2009–2012 (n = 11,625) and our food composition table (FCT). This FCT was created using the 1989 and 2017 Indian FCTs, FCT for Bangladesh, and USDA’s Food Data Central to estimate WRA’s intake of nutrients that were not included in the original NNMB: copper, vitamin B12, vitamin B6, and vitamin E. ResultsOn a daily basis prior to fortification, WRA consumed on average 10.5 (SD 11.6) g of oil, 78.9 (SD 133.8) g of wheat flour, 227.4 (SD 158.8) g of rice, 0.4 (SD 4.6) g of salt, and 55.4 (SD 79.7) g of milk. On a daily basis, 73.1%, 45.5%, 85.5%, 12.8%, and 59.5% of WRA consumed oil, wheat flour, rice, salt and milk, respectively. Prior to fortification, WRA consumed on average 12.3 (SD 7.4) mg of iron, 190.7 (SD 473.1) mcg of vitamin A, 37.8 (SD 36.8) mg of vitamin C, 0.7 (SD 0.3), mg of riboflavin, 1.1 (SD 0.5) mg of thiamine, 7.8 (SD 3.6) mg of zinc, 235.4 (SD 419.6) mcg of folate, 1.9 (SD 0.8) mg of copper, 1.3 (SD 3.3) mcg of vitamin B12, 1.1 (SD 0.5) mg of vitamin B6, and 3.3 (SD 3.5) mg of vitamin E. ConclusionsStaple food consumption suggests that wheat flour, rice, and milk are good fortification vehicles to reach WRA. The percentage of women consuming condiments suggests oil is a good fortification vehicle for WRA. However, WRA’s intake of nutrients that could potentially contribute to anemia is varied. Our food composition table provides a unique opportunity to analyze nutrients in addition to those included in the NNMB. The NNMB data can be used to model the potential nutrient contribution of fortified foods among WRA in India. Funding SourcesGlobal Affairs Canada.

NUTRITIONAL STATUS OF 1-3 YEAR CHILDREN BELONGING TO RURAL AREA OF SELECTED STATES OF INDIA

Background: One-third out of 151 million children are found to reside in India; making the country an outlier even among the developing nations [1,2,3]. Studies suggested that socio-economic conditions of the household play a major role in determining child health status as higher nancial capabilities are linked with better care, health services, quality of food resulting in positive health outcomes [1,4,5]. Methodology: The data for the study was taken from National Nutrition Monitoring Bureau, Technical Report, Rural survey 2001, India. The data was given in accordance with states Kerala(197), Tamil Nadu(408), Karnataka(286), Andhra Pradesh(338), Maharashtra(332), Gujarat(288), Madhya Pradesh(292), Odisha (261), West Bengal(271). The percent Recommended Dietary Allowances or Recommended Daily Allowances (RDA) for Protein, Total Fat, Energy, Calcium, Iron, Vitamin-A, Thiamin, Riboavin, Niacin, Vitamin-C, Free Folic acid was given in the intervals less than 50 ,50-70,greater than equal to 70.The results and conclusions were made further. Results:Results were revealed in accordance with the highest and lowest values of percentage of RDA. Discussion: After observing the data discussion was made for future prospectus

Vitamin A deficiency among children younger than 5 y in India: an analysis of national data sets to reflect on the need for vitamin A supplementation

Biochemical vitamin A deficiency (VAD) is believed to be a serious public health problem (low serum retinol prevalence>20%) in Indian children, justifying universal high-dose vitamin A supplementation (VAS). To evaluate in Indian children younger than 5 y the risk of biochemical VAD from the Comprehensive National Nutrition Survey, as well as dietary vitamin A inadequacy and excess over the tolerable upper limit of intake (TUL) from national and subnational surveys, factoring in fortification and VAS. Child serum retinol data, corrected for inflammation, were examined to evaluate national- and state-level prevalence of VAD. Simultaneously, dietary intakes from the National Sample Survey Office and the National Nutrition Monitoring Bureau were examined for risk of dietary vitamin A deficiency against its average requirement (AR) derived for Indian children. Theoretical estimates of risk reduction with oil and milk vitamin A fortification were evaluated along with the risk of exceeding the TUL, as well as when combined with intake from VAS. The national prevalence of biochemical VAD measured in 9563 children was 15.7% (95% CI: 15.2%, 16.3%), and only 3 states had prevalence significantly >20%. The AR of vitamin A was 198 and 191 µg/d for boys and girls; the risk of dietary inadequacy was ∼70%, which reduced to 25% with oil and milk fortification. Then, the risk of exceeding the TUL was 2% and 1% in 1- to 3-y-old and 4- to 5-y-old children, respectively, but when the VAS dose was added to this intake in a cumulative 6-mo framework, the risk of exceeding the TUL rose to 30% and 8%, respectively. The national prevalence of VAD risk is below 20% in Indian children. Because there is risk of excess intake with food fortification and VAS, serious consideration should be given to a targeted approach in place of the universal VAS program in India.

Protein Intakes in Rural India – Implications of Protein Quality

A prevalence of 18% Low Birth Weight (LBW), 38% stunting in <5y children, and 18% sarcopenia in adults have been recently reported in India. These could partly be due to a poor-quality protein intake, which could support positive birth outcomes, linear growth in children and maintenance of the adult skeletal muscle mass with appropriate exercise. Quality protein is a highly digestible protein with adequate quantity of Indispensable Amino Acids (IAA). The measurement of risk of deficient quality protein intake requires knowledge of IAA requirements and their digestibility from different food proteins. The present analyses, using dietary intake data of different age groups from the latest National Nutrition Monitoring Bureau rural survey, showed that the protein quality of rural Indian diets was suboptimal and had considerable impact on the risk of quality protein deficiency, which varied from 14 to 80% among different age groups. Modest additions of animal source foods (such as milk and egg) could alleviate the risk of quality protein deficiency in the population. Dietary protein quality should be considered while evaluating dietary interventions and framing the policy of supplementary nutrition programs for vulnerable populations.

Protein intakes of pregnant women and children in India-protein quality implications.

The recent National Family Health Survey (NFHS‐4, 2016) reports a national average of 18% for low birthweight (LBW) and 38% for stunting in children <5 years. Nutrition and environmental influences (chronic enteric pathogenic exposure through poor water, sanitation, and hygiene) are two critical factors that impact the health outcomes of the populxation. This is particularly relevant for vulnerable age groups such as pregnant women and children <5 years, who bear long‐lasting and intergenerational consequences of impoverished nutrition and suboptimal living conditions. The present review provides, for the first time, an analysis of indispensable amino acid (IAA) requirements for pregnant women, separately for the second and third trimesters, using protein accretion data from a recent Indian study. Furthermore, using these estimates for pregnancy, and the current IAA requirements for young children, the quality of protein was assessed in Indian diets consumed by pregnant women and children (1–3 and 4–6 years) from national representative rural National Nutrition Monitoring Bureau survey. The assessment was considered in the context of an adverse environment and in relation to outcomes such as LBW, stunting, and underweight. Finally, an assessment was made of the proportion of the surveyed population at risk of dietary quality protein inadequacy and implications for planning nutrition intervention programmes. Specifically, state‐wise estimates of the risk of quality protein inadequacy are provided, in addition to evaluations of additional dietary supplementation, which could inform the policy of supplementary nutrition programmes to improve health outcomes.

Is calorie intake the fundamental driver of noncommunicable diseases in India - A systematic review.

Nutrition epidemiology initially focused on few nutrients thought to be responsible for noncommunicable diseases (NCDs). The database of Indian Nutrition Survey is based majorly on calorie intake. The objective was to compare the change in the average calorie intake from 1990 to 2012 with the emerging epidemic of diabetes and hypertension (HTN) in India since 1990. A comprehensive search was made in National Library of Medicine's PubMed database and Google Scholar from March to August 2018, on the above-mentioned subjects. Reports of national surveys (National Sample Survey Office and National Nutrition Monitoring Bureau) were included for average calorie intake among different states from year 1990 onward. Region-wise search depicted by national nutrition surveys resulted in 277 and 587 abstracts on the prevalence of HTN and diabetes mellitus, respectively. There were 51 full-text articles and abstracts on the prevalence of HTN and diabetes from the above regions. The average calorie intake per capita per day in the four zones of country in rural areas decreased from 1990 to 2012. An increasing trend in the prevalence of diabetes from rural areas was observed from 1994 to 2012. The per capita average calorie intake per day in urban areas from 1999 through 2011 in all zones except the eastern part of country was on rise. There was no consistent trend in the prevalence of HTN in any of the zones. It is not just an increase in calories, but a trade-off between the demand for calories and the demand for healthy lifestyles determines the prevalence of NCDs.

Association between anthropometric-based and food-based nutritional failure among children in India, 2015.

Inadequate dietary intake is a critical underlying determinant of child undernutrition. This study examined the association between anthropometric-based and food-based nutritional failure among children in India. We used the 2015-2016 National Nutrition Monitoring Bureau data where anthropometric outcomes and food intake were both measured for each child. We followed the World Health Organization child growth reference standards to define anthropometric failures (i.e., height-for-age z score<-2 SD for stunting, weight-for-age z score<-2 SD for underweight, and weight-for-height z score<-2 SD for wasting), and the Indian Council of Medical Research recommended dietary allowance (RDA) to define adequacy in intake of calorie, protein, and fat. We used descriptive and regression-based assessments to test the association between the two indicators of nutritional failure and also computed the area under the receiver operating characteristic curve (AUC). The prevalence of stunting, underweight, and wasting was 28.6%, 24.3%, and 12.8%, respectively, whereas 78.2%, 27.4%, and 50.8% of the children had below RDA norms consumption of calorie, protein, and fat, respectively. We found weak-to-null correlation between anthropometric failures and food failures (Pearson correlation ranging from -0.013 to 0.147) and poor discriminatory accuracy (AUC<0.62), suggesting that in the Indian context, anthropometric failures are not directly associated with food intake. This finding highlights the need for improving adequate intake of macronutrients and draws attention toward adopting a multifactorial approach to improve child nutrition in India. Poor food intake itself merits exclusive policy focus as it is an important nutrition and health concern.

Validation of APLS, Argall and Luscombe Formulae for Estimating Weight among Indian Children.

Weight estimation in pediatric emergencies is often required for calculation of drug dosages, fluid therapy and defibrillation. The 'gold standard' of actually weighing the patient is not practically possible in emergency conditions. The aim of this study is to validate common age-based formulae (APLS, Luscombe and Argall's) and their accuracy in estimating weight of under 5-y-old Indian children by secondary data analysis from a cross-sectional study conducted by the National Nutrition Monitoring Bureau (NNMB), National Institute of Nutrition, Hyderabad, in 10 states of India in 2011-12 among under five-year-old children. Their measured weights were compared to their estimated weights as calculated using the APLS formula, the Luscombe and Argall formulae. There is a need to adjust the formulae for accurate estimation of weight among Indian children as all the three age-based weight formulae namely APLS, Argyll and Luscombe overestimated the weight among the Indian children.

Infant and young child feeding practices, sociodemographic factors and their association with nutritional status of children aged &lt;3 years in India: findings of the National Nutrition Monitoring Bureau survey, 2011-2012.

To study infant and young child feeding (IYCF) practices and their association with nutritional status among young children. A community-based, cross-sectional study was carried out in ten states of India, using a multistage random sampling method. Anthropometric measurements such as length/height and weight were conducted and nutritional assessment was done using the WHO child growth standards. National Nutrition Monitoring Bureau survey, 2011-2012.ParticipantsChildren aged &lt;3 years and their mothers. Only 36 % of infants received breast-feeding within an hour of birth and 50 % were exclusively breast-fed up to 6 months. Prevalence of underweight, stunting and wasting was 38, 41 and 22 %, respectively. The chance of undernutrition among &lt;3-year-old children was significantly higher among those from scheduled caste/scheduled tribe communities, the lowest-income group, with illiterate mothers and lack of sanitary latrine. Among infants, the chance of undernutrition was significantly higher among low-birth-weight babies, and among children whose mother had not consumed iron-folic acid tablets during pregnancy. Immunization practices and minimum dietary diversity were observed to be associated with undernutrition among 12-23-month-old children. Undernutrition is still an important public health problem in India and observed to be associated with low socio-economic status, illiteracy of mother, low birth weight and dietary diversity. Improving socio-economic and literacy status of mothers can help in improving maternal nutrition during pregnancy and thus low birth weight. Also, improving knowledge of mothers about IYCF practices will help in improving children's nutritional status.

Dietary and nondietary determinants of nutritional status among adolescent girls and adult women in India

AbstractAdolescence appears to be the next available critical period to improve inadequacies in nutrition, growth, and development from childhood. In this analysis, we describe the dietary and nondietary determinants of nutritional status among adolescent girls and adult women residing in rural areas of India. We used data pertaining to 3930 adolescents (10–19 years) and 11,058 adult women (20–49 years) from the National Nutrition Monitoring Bureau Survey, 2011–2012 database. Logistic regression analysis was conducted to understand the effects of various individual‐ and household‐level determinants of thinness and underweight among adolescents and adult women, respectively. Almost one‐third of the adolescents and adult women were undernourished. Factors other than dietary adequacy and diversity had a greater impact on undernutrition in both the adolescents and adult women. The nondietary determinants (e.g., higher age group, higher household wealth status, access to improved water, better maternal work status, and living in better type of houses) predicted good nutritional status in the adolescent girls. In addition, the women's own higher education and household occupation status and better sanitation facilities improved undernutrition in adult women. Therefore, India needs multipronged strategies along with dietary interventions and effective implementation programs to achieve good health and well‐being of adolescents and adult women.

A review of selected nutrition & health surveys in India.

Assessment of the status of health and nutrition of a population is imperative to design and implement sound public health policies and programmes. The various extensive national health and nutrition surveys provide national-level information on different domains of health. These provide vital information and statistics for the country, and the data generated are used to identify the prevalence and risk factors for the diseases and health challenges faced by a country. This review describes the various national health and nutrition surveys conducted in India and also compares the information generated by each of these surveys. These include the National Family Health Survey, District Level Household Survey, Annual Health Survey, National Nutrition Monitoring Bureau Survey, Rapid Survey on Children and Comprehensive National Nutrition Survey.

Trends of nutritional status among rural adults in six states of India: findings from national survey data

IntroductionThere is lack of evidence available on understanding of exact trend and distribution of dual burden of nutrition in India. ObjectiveThe study aimed to find out 25years trend of nutritional status among rural adults of six states in India, pooled estimate for India and predict the estimate for future 20years. DesignThe body mass index (BMI) data of both men and women of six states and India for the year 1992–2011 was collected from the publicly available reports of National Nutrition Monitoring Bureau (NNMB) and for 2014–15 was taken from National Family and Health Survey –IV (NFHS-IV). The data for monthly per capita expenditure was extracted from national sample survey (NSS) reports. The 25-year historical BMI prevalence data between 1991–92 and 2014 were tested for linear, quadratic and cubic trends. The analysis was done using STATA. SettingsData for six states of India and pooled estimate of India was collected and analyzed. Main findingsAll states show a decline trend in underweight and increase trend in overweight/obesity. The pooled estimates for India reports though the trend of underweight is declining in both men and women still it is above 20% and after 20years the prevalence will be 10%. The trend test for overweight/obesity was found to be significant at P value<0.05 in all the six states and India in both the sex. ConclusionThe regional variances in prevalence of the nutrition among rural Indians and suggests state specific nutritional policy should be developed for double burden of nutrition.

Assessment of annual intake of thorium from animal origin food consumed by population residing in monazite rich area of southern India

Thorium (232Th) concentration was determined by Instrumental Neutron Activation Analysis (INAA) in animal origin food groups widely consumed by population residing in monazite rich area of Tamil Nadu, India. The annual intake was evaluated based on market basket study method for female and male population for different age groups. Annual committed effective dose due to 232Th intake from the ingestion was evaluated for different age groups of individuals, using the ICRP ingestion dose coefficients and annual consumption rate obtained from National Nutrition Monitoring Bureau (NNMB). Annual intake values of 232Th for adult members of the population were obtained from food items as, fish from 0.2 to 0.8; flesh food (meat, beef and chicken), from 0.03 to 0.12; and milk from 0.2 to 0.3 Bq year−1. The total annual internal dose resulting from ingestion of radioisotope in these food groups was 0.2 µSv year−1 for male adult population.

Trends in nutrient intakes, nutritional status, and correlates of undernutrition among rural children below 5 years of age: The National Nutrition Monitoring Bureau Survey 2012.

Background:In spite of several national nutrition intervention programs that have been in operation since the past four decades, undernutrition continues to be an important public health problem in India.Aim:The aim of the present study was to assess the trends in food and nutrient intakes and nutritional status of children in India below 5 years of age.Setting and Design:A community-based, cross-sectional study was carried out in ten National Nutrition Monitoring Bureau states by adopting a multistage random sampling procedure.Methods:Data were collected on the household (HH) socioeconomic and demographic particulars, and anthropometric measurements of the children, such as their length/height and weight, were noted. A 24-h dietary recall method was used for assessing dietary intake.Results:Intake of all the foodstuffs except pulses, vegetables, and fats and oils declined over a period of time (1975–1979 to 2011–2012) while the intake of all the micronutrients except Vitamins A and C declined during the same period. The prevalence of undernutrition, i.e. underweight, stunting, and wasting has declined from 76%, 82%, and 27%, respectively in 1975–1979 to 42%, 44%, and 19%, respectively, in 2011–2012 among 1-5 year children. The severe form of undernutrition has also declined during the same period. The prevalence of undernutrition was significantly (P < 0.01) higher among children of illiterate mothers, those belonging to lower socioeconomic status, and those living in nuclear families.Conclusions:The prevalence of undernutrition declined over the period despite the decrease in food and nutrient intake. However, the pace of decline was slower and it was attributed to improved health-care services coupled with control of communicable diseases and increase in the HHs income. Further efforts are needed to improve the literacy of parents, environmental and personal hygiene, along with the food security of HHs through a public distribution system.

Prevalence and risk factors of hypertension and diabetes in the Katkari tribe of coastal Maharashtra.

Background and Objectives:Urban and rural India are both going through health epidemiological transition and will soon face huge burden of noncommunicable diseases (NCDs). Information on the status of NCDs in tribals is limited. Although the prevalence of hypertension in scheduled tribes (STs) has been studied in several states by the National Nutrition Monitoring Bureau, tribe-specific data are very scanty. The objective of this study was to generate data on the status of hypertension and diabetes, the two objectively measurable NCDs in Katkaris, the dominant ST in the Raigad district of coastal Maharashtra.Methods:The study was conducted in 410 adult Katkaris (women 219) of both sexes of ≥18 years of age in three adjoining tehsils of the district. Using the Institution Review Board approved protocol; information was obtained on sociodemographic parameters, educational level, dietary pattern, and substance abuse. Prevalence of overweight, hypertension, and diabetes was measured using standard field-based procedures and techniques.Results:Katkaris, who are mostly landless manual laborers, subsist on a protein-poor, imbalanced diet. About half of women and one-third of men have body mass index (BMI) <18.5 kg/m2, an indication of undernutrition. On the other hand, about 2% of participants were obese (BMI ≥30 kg/m2). The overall prevalence of hypertension and diabetes was 16.8% and 7.3%, respectively. Hypercholesterolemia was recorded in about 3% of the participants.Interpretation and Conclusions:Prevalence of diabetes and hypertension in Katkaris is still lower than that of urban and rural populations, closer to the latter. This may be due to the absence of known risk factors such as obesity, sedentary lifestyle, and hyperlipidemia in this community. Fast acculturation of the STs suggests that NCDs will soon become a major health issue in them too. It is time to launch a multicentric national study to gather baseline information on the status of NCDs in STs.

The Persistent Problem of Malnutrition In India

India contributes to about a third of the total number of the under -nourished in the world. Generally, under-nutrition is assessed as under-weight or stunting and/or wasting. The Periodic surveys by the National Nutrition Monitoring Bureau (NNMB) and the National Family Health Survey (NFHS) reveal unacceptably high prevalence of under-weight and stunting among Indian children of 0-59 months of age. About 19% Indian children are born with low birth weight (<2500 g) due to chronic maternal under-nutrition. About a third of the rural adults also have chronic ener gy deficiency (BMI <18.5). Anaemia, as assessed by low haemoglobin, is widespread among the vulnerable segments of population. Calorie inadequacy, with or without protein inadequacy, is the predominant dietary problem and a lar ge majority of individuals consume less than 70% of the recommended dietary allowance of micronutrients. Though the periodic surveys by NNMB and/or NFHS indicate gradual reduction in under-nutrition over time, its prevalence is unacceptably high. However, all the nutrient intakes show a decline over the last four decades. Even if India achieves the WHO Assembly’s first of the six global nutrition targets of 40% reduction by 2025 in the extent of stunted in under-5 children, unacceptably high proportion of one in four children might still be stunted. Nutritional anaemia and sub-clinical vitamin A deficiency are widespread. Deficiencies of other micronutrients like riboflavin, folic acid, vitamin B 12 and vitamin D are also rampant. Among the adults, while there is a gradual reduction in chronic energy deficiency over the four decade follow-up period, there is also a gradual increase in overweight and obesity. Substantial increases in economic growth experienced over the past two decades did not translate into a similar substantial reduction in under -nutrition, perhaps due to unequal economic growth excluding the poor. Nutrition-sensitive interventions and programmes in agriculture, social safety nets, early child development, education, women’s empowerment and access to safe drinking water and sanitation have enormous potential to scale-up and enhance the effectiveness of nutrition-specific interventions.

Secular Trends in Heights and Weights in Boys and Girls Over 3 Decades in Rural India.

Secular trends in height reported from developing countries are few and scarce. To assess secular trends in linear growth in boys and girls from birth to 18 years of life in rural households of India based on periodical cross-sectional surveys conducted over a period of 35 years. The present study uses data from baseline and final surveys of National Nutrition Monitoring Bureau from 1975 to 1979 (N = 6043) to 2012 to 2013 (N = 11 910) on anthropometry from birth to 18 years from 7 states in households of rural India. The overall improvement in 18+ boys and girls was 3.1 and 1.0 cm, respectively, over a period of 35 years. The increments in height of 18+ were highest for both boys (7.4 cm) and girls (4.8 cm) in the state of Kerala followed by Tamil Nadu (boys, 7.3 cm and girls, 3.8 cm). Under-5 stunting rates reduced from 82% in the baseline survey to 45.7% in the final survey at 1.35% per year in the pooled states and was similar in both boys and girls. The recovery in stunting was highest in Tamil Nadu (1.63% per year) followed by Kerala (1.46% per year). The pattern of secular trends in height in rural India seen over 3 decades was strikingly similar to that of developed countries. The phenomenal improvement in linear growth in Kerala and Tamil Nadu in children younger than 5 years and adolescents suggests that growth potential for Indians is similar to that of developed countries.

Economic Growth, Poverty and Malnutrition in India

The present study evaluated the inter-linkages between economic growth, poverty and malnutrition to explain if the economic growth lead reduction in poverty has been able to combat malnutrition level over the period of study from 1993-94 to 2004-05 using National Sample Survey, National Family Health Survey and National Nutrition Monitoring Bureau. The study found improvements in level of poverty from 1993-94 to 2004-05 however the nutritional status showed no improvements especially from 1998-99 to 2005-06. The reduction in poverty did not improve the level of nutrients intake which has been declining during the period of study. At all India level the study found there exist a connect between economic growth and poverty as well as poverty and malnutrition however states wise analysis showed otherwise for some of the states. The study also found prevalence of malnutrition level in children below three years of age among the richer wealth groups. The results reinforced that poverty or income is not the only factor causing the malnutrition level in the children; there exist factors other than poverty and calorie intake affecting the nutritional status of the children estimated using logistic regression at unit level such as household, social and demographic characteristics.

Trends in nutritional status and nutrient intakes and correlates of overweight/obesity among rural adult women (≥18-60 years) in India: National Nutrition Monitoring Bureau (NNMB) national surveys.

To assess trends in nutrient intakes and nutritional status of rural adult women (≥18-60 years) and the association of sociodemographic characteristics with overweight/obesity. Community-based cross-sectional studies carried out during 1975-79 to 2011-12 by the National Nutrition Monitoring Bureau (NNMB) were used. Anthropometric measurements such as height, weight and waist circumference, carried out during the surveys, were used. Association and logistic regression analyses between sociodemographic characteristics and overweight/obesity and abdominal obesity were conducted using a complex samples procedure. Ten NNMB states of India. Non-pregnant and non-lactating rural women aged ≥18-60 years covered during the above periods from ten states in India. The prevalence of chronic energy deficiency has declined from 52 % during 1975-79 to 34 % during 2011-12, while that of overweight/obesity has increased from 7 % to 24 % during the same period. Median intakes of most of the nutrients have increased over the same period, although they were below recommended levels. The chance of overweight/obesity and abdominal obesity was significantly (P<0·01) higher among women aged 40-60 years, those belonging to Christian religion and other backward communities, women living in pucca houses, literate women, women engaged in service and business, and those having higher per capita income. Prevalence of chronic energy deficiency has declined significantly; however, overweight/obesity has increased during the same period. This increase in overweight/obesity may be attributed to increased consumption of fatty foods, sedentary lifestyle and improved socio-economic status. There is a need to educate the community about regular physical exercise, low intakes of fats and oils, and a balanced diet.