Double burden of Malnutrition among women in Reproductive Age (15-49 Years) in India: Evidence from National Family and Health Survey 2019-21 (NFHS-5)

Abstract Background: This study explores the double burden of underweight and overnourished among reproductive-aged women (15–49 years) in India, aiming to identify key predictors and inform targeted interventions. Methods: Utilising data from a nationally representative sample of Indian women, we applied multivariate logistic regression models to calculate relative risk ratios (RRRs) and 95% confidence intervals (CIs) for various demographic, socioeconomic, and behavioural predictors of nutritional status. Results: Age significantly influences nutritional outcomes, women age group 20-24 had a higher risk of being underweight (RRR= 0.69 CI: 0.65-0.75) and the lower risk of being overnourished (RRR=1.63, CI: 1.48-1.79) conversely the women age group 45-49 have the lower risk of underweight (RRR=0.28, CI: 0.26-0.31) and higher risk of overnourished (RRR= 5.49 CI: 4.93-6.11). Residing in rural areas had a higher risk of being underweight (RRR=1.13, CI: 1.07-1.18) and a lower risk of being overnourished (RRR= 0.83 CI: 0.8-0.86). On considering zones of the country, the Southern region shows higher risk of being overnourished (RRR= 1.52, CI: 1.44-1.61) and Western region shows higher risk of being underweight (RRR= 1.61, CI 1.52-1.72) Women with a higher wealth quintile exhibited a higher risk of overnourished (RRR=3.46, CI: 3.19-3.75) and women with a poorer section have higher risk of underweight. Higher education level shows lesser risk of being underweight (RRR=0.67, CI: 0.62-0.72). In the social group, ST has a lower risk of being overnourished (RRR= 0.68, CI: 63-0.74). Smoking increased the risk of being underweight (RRR=1.31, CI: 1.15-1.50), while alcohol consumption was associated with a lower likelihood of being overnourished. Conclusion: The study highlights the determinants of malnutrition among Indian women, emphasizing the need for targeted, age-specific, and region-specific interventions. Comprehensive nutrition education and policy reforms addressing socioeconomic disparities are crucial for mitigating India's double burden of malnutrition.