Nutritional status of Indian pre-school children and WHO nutrition targets for 2025

Authors

  • Kalaivani K. Department of public health nutrition, Nutrition foundation of India, C-13 Qutub institutional area, New Delhi, India
  • Prema Ramachandran Department of public health nutrition, Nutrition foundation of India, C-13 Qutub institutional area, New Delhi, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20220871

Keywords:

Growth of Indian children, Stunting, Underweight, Wasting, Pre-school children, WHO nutrition goals

Abstract

Background: India has been food secure and has been implementing food supplementation programmes for decades but prevalence of under-nutrition in pre-school children is high. Data from two large scale surveys were analysed to document current nutritional status of pre-school children and assess whether India will be able to achieve the WHO targets by 2025.

Methods: District level household survey 4 and annual health survey (2013-2015) undertook height and weight measurements in pre-school children (DLHS4 74717 and AHS 139157 children). Mean weight, height and BMI-for-age were computed for girls and boys in 0-5 years and compared with WHO MGRS growth standards. Prevalence of stunting, under-weight, wasting, over-nutrition and combined stunting and wasting were computed in each survey in relation to age.

Results: The mean height and weight-for-age in boys and girls during 6-60 months was around the -2SD and mean BMI-for-age was between the mean and -1SD of the WHO standards. Frequency distribution of Z scores for all three indices in Indian children were to the left of the WHO standards. In under-five children stunting rates were highest, wasting rates lower and over-nutrition rates the lowest. Prevalence of stunting increased and wasting decreased with increasing age of the children. Prevalence of under-nutrition was higher in children surveyed in AHS.

Conclusions: It might not be possible to achieve rapid reduction in low birthweight or stunting. It might be possible to achieve the targets for sustained reduction in wasting in some states. Early detection and management of over-nutrition in children can prevent the rise in over-nutrition.

References

Food and Agriculture Organization of the United Nations, technical report series. Available at: https://apps.who.int/iris/handle/10665/40921. Accessed on 28 August 2021.

Waterlow JC. Classification and definition of protein-calorie malnutrition. Br Med J. 1972;3:566-9.

Physical status: the use and interpretation of anthropometry technical report series. Available at: http://whqlibdoc.who.int/trs/WHO_TRS_854.pdf. Accessed on 28 August 2021.

de Onis M, Onyango AW, Borghi E, Garza C, Yang H. Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes. Public Health Nutr. 2006;9(7):942-7.

Ramachandran P, Gopalan HS. Assessment of nutritional status in Indian preschool children using WHO 2006 Growth Standards. Indian J Med Res. 2011;134:5-11.

WHO Global Database on Child Growth and Malnutrition, Geneva, Switzerland. Available at: https://www.who.int/teams/nutrition-and-food-safety/databases/nutgrowthdb accessed on 27.8.2021. Accessed on 28 August 2021.

WHO nutrition landscape information system (NLIS) country profile indicators: interpretation guide 2019. Available at: https://apps.who.int/iris/bitstream /handle/10665/332223/9789241516952-eng.pdf?is Allowed=y &sequence=1. Accessed on 28 August 2021.

The state of food security and nutrition in the world. Available at: http://www.fao.org/publications/sofi/ 2021/en/ . Accessed on 28 August 2021.

Ramachandran P. Food and nutrition security: challenges in the new millennium. Indian J Med Res. 2013;138(3):373-82.

IIPS National Family Health Survey (NFHS-4), 2015-16. Available at: http://rchiips.org. Accessed on 28 August 2021.

Prentice AM, Ward KA, Goldberg GR, Jarjou LM, Moore SE, Fulford AJ, et al. Critical windows for nutritional interventions against stunting. Am J Clin Nutr. 2013;97(5):911-8.

Richard SA, Black RE, Gilman RH, Guerrant RL, Kang G, Lanata CF. Wasting is associated with stunting in early childhood. J Nutr. 2012;142(7):1291-6.

Khara T, Mwangome M, Ngari M, Dolan C. Children concurrently wasted and stunted: a meta-analysis of prevalence data of children 6-59 months from 84 countries. Matern Child Nutr. 2018;14(2):e12516.

Myatt M, Khara T, Schoenbuchner S, Pietzsch S, Dolan C, Lelijveld N, et al. Children who are both wasted and stunted are also underweight and have a high risk of death: a descriptive epidemiology of multiple anthropometric deficits using data from 51 countries. Arch Public Health. 2018;76:28.

Schoenbuchner S, Dolan C, Mwangome M, Hall A, Richard S, Wells JC, et al. The relationship between wasting and stunting: a retrospective cohort analysis of longitudinal data in Gambian children from 1976-2016. Am J Clin Nutr. 2019;110(2):498-507.

Angood C, Khara T, Dolan C, Berkley JA, Wa S. Research priorities on the relationship between wasting and stunting. PLoS One. 2016;11(5):e0153221. Available at: https://doi.org/10.1371/journal.pone. 0153221. Accessed on 28 August 2021.

Briend A, Khara T, Dolan C. Wasting and stunting similarities and differences: policy and programmatic implications. Food Nutr Bull. 2015;36(1):S15-23.

Martorell R, Young MF. Patterns of stunting and wasting: potential explanatory factors. Adv Nutr. 2012;3(2):227-33.

Khara T, Dolan C. Associations between wasting and stunting, policy, programming and research implications. Emerg Nutr Net Tech. 2014;6:34-8.

Global nutrition targets 2025: wasting policy brief. Available at: https://apps.who.int/iris/handle/ 10665/149023. Accessed on 28 August 2021.

Global nutrition targets 2025: stunting policy brief. Available at: https://apps.who.int/iris/handle/10665/ 149019. Accessed on 28 August 2021.

Global nutrition targets 2025: childhood overweight policy brief. Available at: https://apps.who.int/iris/ bitstream/handle/10665/149021/WHO_NMH_NHD_14.6_eng.pdf. Accessed on 28 August 2021.

Ghosh S, Bhargava SK, Madhavan S, Taskar AD, Bhargava V, Nigam SK. Intra-uterine growth of North Indian babies. Pediatrics. 1971;47:826-30.

Gopalan S. Low birth weight causes, consequences and interventions to achieve reduction. Proc Indian Natn Sci Acad. 2018;84(4):843-51.

Ghosh S, Bharghava SK, Moriyamma IW. Longitudinal study of survival and outcomes of a birth cohort. Rep Res Pr. 2015;12:45-6.

Ramachandran P. Nutrition and child survival in India. Indian J Pediatr. 2010;77:1-305.

Ramalingaswami V, Jonsson U, Rhode J. Malnutrition: a south Asian enigma. In: Gillespie S, eds. Malnutrition in South Asia: a regional profile. Netherlands: Springer Nature; 1997:11-22.

Prabhakar K, Kalaivani K, Kowsalya S. Ramachandran P 33 use of mother child protection card for improving infant feeding practices. Ind Nutr Diet. 2019;56(4): 351-64.

Lakshmi RV, Subapriya SM, Kalaivani K, Ramachandran P. Morbidity due to infections in preschool children from urban low income households. Ind Nutr Diet. 2018;55(4):488-99.

Prabhakar P, Kowsalya S, Kalaivani K, Ramachandran P. Growth monitoring in under-three children using the mother child protection card. Ind Nutr Diet. 2020; 57(4):368-86.

Paul VK, Sachdev HPS, Mavalankar D, Ramachandran P, Sankar MJ, Bhandari N, et al. Towards Universal Health Coverage, Reproductive health, and child health and nutrition in India: meeting the challenge. Lancet. 2011;431:675-9.

Lakshmi RV, Subapriya SM, Kalaivani K, Ramachandran P. Nutritional status of pre-school children from urban low income families. Ind Nutr Diet. 2019;56(3):265-73.

Bhargava SK, Sachdev HPS, Fall C, Osmond C, Lakshmy R, Barker DJP, et al. Relation of serial changes in childhood body mass index to impaired glucose tolerance in young adulthood. N Engl J Med. 2004;350:865-75.

Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371(9609):340-57.

Richter LM, Victora CG, Hallal PC, Adair LS, Bhargava SK, Fall CHD, et al. Cohort profile: the consortium of health-orientated research in transitioning societies. Int J Epidemiol. 2012;41(3): 621-6.

Fall CH, Sachdev HS, Osmond C, Restrepo-Mendez MC, Victora C, Martorell R, et al. COHORTS investigators. Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration). Lancet Glob Health. 2015;3(7):e366-77.

Fall CH. Nutrition in fetal life and childhood and its linkage with adult non-communicable disease: lessons from birth cohort studies in India. Natn Sci Acad. 2015;84(4):881-9.

Downloads

Published

2022-03-25

How to Cite

K., K., & Ramachandran, P. (2022). Nutritional status of Indian pre-school children and WHO nutrition targets for 2025. International Journal Of Community Medicine And Public Health, 9(4), 1896–1902. https://doi.org/10.18203/2394-6040.ijcmph20220871

Issue

Section

Original Research Articles