Double burden of malnutrition among adolescents in rural West Bengal, India

Abstract Objective To investigate the prevalence of underweight, stunting, and overweight among adolescents in rural West Bengal, India and identified factors contributing to these forms of malnutrition. Research Methods and Procedures We conducted a cross-sectional study within the Birbhum Health and Demographic Surveillance System in West Bengal, India. Participants were male and female adolescents ages 10-19 were enrolled (n=5,521). Body mass index (BMI) was calculated using measured heights and weights and z-scores based on the 2007 World Health Organization growth standards. Information on demographics, diet, and health behaviors was collected through face-to-face interviews using a standardized questionnaire. Log-poisson regression was used to estimate prevalence ratios and 95% confidence intervals for the association between each risk factor and outcome. Results The proportion of underweight was 26.6% overall, 31.1% among males, and 21.1% among females. The proportion of stunting was 25.0% overall, 23.3% among males and 26.9% among females. A total of 4.6% participants overall, 4.1% males and 5.2% of females were overweight or obese. Compared to males, females had a reduced likelihood of being underweight (Adjusted prevalence ratio (PR) 0.67, 95% CI 0.59, 0.75). Multivariate models also showed that socioeconomic status was strongly associated with all nutritional outcomes. Not having a toilet facility in one's household and poor hand hygiene were also associated with a greater likelihood of stunting. Conclusion Our results suggest that adolescents in Birbhum, India are substantially affected by the double burden of malnutrition. Nutritional interventions should incorporate efforts to reduce socioeconomic inequality.