HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Supplemental Table Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Subramanian, S V Articles by Smith, G. D. Search for Related Content PubMed PubMed Citation Articles by Subramanian, S V Articles by Smith, G. D. Agricola Articles by Subramanian, S V Articles by Smith, G. D.

Patterns, distribution, and determinants of under- and overnutrition: a population-based study of women in India^1,2,3

¹ From the Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA (SVS), and the Department of Social Medicine, University of Bristol, Bristol, United Kingdom (GDS)

Background: Little systematic evidence exists for the relation between socioeconomic position and nutritional status in countries experiencing the simultaneous presence of under- and overnutrition.

Objective: We investigated the socioeconomic distribution of nutritional status in India and whether state-level macroeconomic factors modify the relation between socioeconomic position and nutritional status.

Design: Our analysis was based on a nationally representative sample of 77 220 women from India, with multiple categories of body mass index (BMI; in kg/m²) as the outcome, namely, <18.5 (underweight), 23–24.9 (pre-overweight), 25–29.9 (overweight), or 30 (obese), with 18.5–22.9 as the reference category.

Results: In adjusted models, being underweight was inversely related to socioeconomic position, whereas socioeconomic position was positively related to being pre-overweight, overweight, and obese, and the socioeconomic gradient was most marked for obesity. State-level measures of affluence did not modify the positive association between socioeconomic position and categories of overweight. The risk of underweight was lower in affluent states, but this was seen mainly in women of high socioeconomic position.

Conclusions: Undernutrition and overnutrition are epidemics of the impoverished and the affluent, respectively, in India, and this association is consistent at the individual and ecologic levels. Policies should focus on the complex patterns of social distribution of both under- and overnutrition in the Indian context.

Key Words: Nutritional transition • underweight • overweight • socioeconomic position • India

This article has been cited by other articles:

				L. K. Ackerson and S. V. Subramanian Domestic Violence and Chronic Malnutrition among Women and Children in India Am. J. Epidemiol., May 15, 2008; 167(10): 1188 - 1196. [Abstract] [Full Text] [PDF]

				C. Sauvaget, K. Ramadas, G. Thomas, J. Vinoda, S. Thara, and R. Sankaranarayanan Body mass index, weight change and mortality risk in a prospective study in India Int. J. Epidemiol., April 3, 2008; (2008) dyn059v1. [Abstract] [Full Text] [PDF]

				S V Subramanian, I. Kawachi, and G. D. Smith Income inequality and the double burden of under- and overnutrition in India J. Epidemiol. Community Health, September 1, 2007; 61(9): 802 - 809. [Abstract] [Full Text] [PDF]

				S. Subramanian, L. K Ackerson, M. A Subramanyam, and R. J Wright Domestic violence is associated with adult and childhood asthma prevalence in India Int. J. Epidemiol., June 1, 2007; 36(3): 569 - 579. [Abstract] [Full Text] [PDF]