(P17-031-23) Prevalence and Correlates of Triple Burden of Malnutrition Among Children and Adolescents in India: Comprehensive National Nutrition Survey

Objectives: To examine the prevalence and correlates for triple burden of malnutrition (TBM) among children and adolescents (5-19 y), as part of the Comprehensive National Nutrition Survey (CNNS) in India.

Methods: Data from the 2016-2018 CNNS were analyzed to examine the prevalence and correlates of malnutrition in children and adolescents. A total of 40,700 individuals were surveyed, including 17,599 children 5-9 years and 16,184 adolescents 10-19 years of age with available biomarker data. TBM was defined as having the coexistence of undernutrition based on anthropometric measurements (i.e., stunting, underweight), overnutrition/abnormal metabolic markers (i.e., overweight/obesity; elevated fasting blood glucose, glycosylated hemoglobin, total serum cholesterol, total serum triglycerides, LDL, or lower HDL), and anemia or micronutrient deficiency (i.e., low iron, zinc, vitamin A, vitamin D, vitamin B12, or folate status based on serum biomarker concentrations). The prevalence of TBM were estimated using corresponding CNNS sample weights to account for probabilistic selection and reported as % (95% Confidence Interval (CI)). Socioeconomic status was measured based on the possession of a number of common household items and was categorized as a quintile. Parental education was assessed by questions such as “Has your mother/father ever attended school?”. We used binomial regression to determine correlates of TBM in children and adolescents separately.

Results: The prevalence of TBM was 14.4% (95% CI: 13.8 - 14.9) in children 5-9 y and 12.7% (95% CI: 12.1-13.4) in adolescents 10 to < 19 y. There was variability across different states – with the prevalence of TBM ranging from 0% to 24.5% for 5-9 y and 5.0% to 24.0% for 10 to < 19y. Parental education and socioeconomic status were associated with lower risk of TBM in multivariate analyses.

Conclusions: The prevalence of triple burden of malnutrition is substantial in children and adolescents in India. Findings could help inform and target public health programs for child and adolescent nutrition.

Funding Sources: Conflicts of Interest: SM is an unpaid board member for and has an equity stake in a diagnostic start up focused on developing point-of-case assays for nutritional status informed by his research as a faculty member at Cornell University. All other authors have no conflicts of interest.