Adult tribal malnutrition in India: an anthropometric and socio-demographic review Authors Subal Das Department of Anthropology and Tribal Development, Guru Ghasidas Vishwavidyalaya, Bilaspur, Chhattisgarh, India Kaushik Bose Department of Anthropology, Vidyasagar University, Midnapore, West Bengal, India, 721102 DOI: https://doi.org/10.1515/anre-2015-0004 Keywords: Tribes, Indian, nutritional status, malnutrition Abstract The nutritional status and socio-demographic profile of tribal people is an important issue in India due to their marginalization from main stream population with respect to varied facilities. However, data on their nutritional status and socio-demographic profile are limited. This review aims to give an overview of the prevalence of chronic energy deficiency (CED) using Body mass index (BMI) and various demographic profile of Indian tribes based on studies published hitherto. In total 76 studies were reviewed for mean BMI based on the World Health Organization (WHO) classification of the public health problem of low BMI, based on adult populations worldwide. The overall sex specific prevalence of CED showed that both the tribal females (52.0%) and males (49.3%) were passing through the critical situation with respect to nutritional status with females being more underprivileged. In conclusion, although there is a gradual increase in knowledge about the nutritional and socio-demographic status of tribes since last decades; there is still paucity of data and information on more than approximately 600 tribes regarding their bio-social profile. However previous studies clearly indicate the need to enhance the health and nutrition status of the tribes by providing job opportunity and food security. Since the prevalence of CED was higher (critical to serious situation) in tribal populations, concerted efforts should also be made to improve the health status and nutrition uptake among them. Downloads Download data is not yet available. References Abrar A, Bimal R, Harashawaradhana, Venugopal P, Jokhan NS. 2014. A Study of the Basic and Derived Anthropometric Indices among the Healthy Adults of Raji Tribe of Uttarakhand, India. Afr Asian J Anthropol Soc Policy 5(1): 66–72. View in Google Scholar Adak DK, Gautam RK, Bharti S, Gharmi AK. 2006. Body mass index and chronic energy deficiency of adult males of central Indian Populations. Hum Biol 78: 201–218. View in Google Scholar Antony GM, Visweswara RK, Balakrishna N. 2001. Human Development Index: It’s Suitability for the Assessment of Health and Nutritional Status of Indian States. E P W 36: 2976–2979. View in Google Scholar Arlappa N, Balakrishna N, Brahmam GN, Vijayaraghavan K. 2005. 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Being a developing nation, rural India is still facing a serious health problem in form of undernutrition particularly among young children. To optimize this problem, the Central Government has been operating a nationwide nutritional intervention programme in the form of Integrated Child Development Service (ICDS) scheme. Unfortunately, it has failed to achieve the desired goal during last four decades. Therefore the present study was designed to measure the seriousness and severity of overall undernutrition using Composite Index of Anthropometric Failure (CIAF) among the rural Bengalee preschool children of Sagar Block, South 24 Parganas, West Bengal, India. This cross-sectional study was conducted among 656 preschool children (326 boys and 330 girls) aged 3 to 5 years. Height (cm) and weight (kg) measurements were taken according to standard procedure, age and sex specific 2 z-scores values of height-for-age, weight-for-height and weight-for-age were used to assess stunting, wasting and underweight, respectively, as per the World Health Organization Guidelines. CIAF was also computed as per standard methodology to assess the degree of undernutrition among the studied children. The overall age and sex combined prevalence of stunting, wasting, underweight and CIAF was 26.2%, 35.4%, 51.1% and 61.3%, respectively. CIAF showed a higher prevalence of undernutrition (61.28%) in comparison to other three indicators i.e., stunting, wasting and underweight. We conclude that the nutritional status of the subjects was not satisfactory. It was also established that the CIAF is a better indicator of nutritional status than traditional measures of stunting, wasting and underweight, because it determines overall (total) anthropometric failure.

Malnutrition has become one of the serious problems among children and adolescents internationally, especially in developing countries. India, a developing country covers 40% of undernourished children of the world. In India, tribal population is among the most deprived and undernourished people. The present study shows the prevalence of undernutrition among Kolam tribal children and adolescents by comparing different Body Mass Index (BMI) cut off points. Age and sex specific nutritional status of studied population shows 15.01% boys and 18.35% girls are in Chronic Energy Deficiency (CED) III category, 16.22% boys and 19.32% girls are in CEDII, 31.71% boys and 2.72% girls are in CEDI only 0.96% boys and 1.69% girls are in overweight category respectively. Undernutrition is not limited to young children, even adults are also severely underweight in developing countries. Health and nutrition of today’s adolescent girls may have great impact on the quality of next generation. Proper nutritional programs and health policies are needed to be implemented among tribals to solve the problem of undernutrition and similar studies should be planned in other underprivileged sections worldwide.

Mid-upper arm circumference (MUAC) is an alternative anthropometric measurement to assess undernutrition but a universally accepted cut-off is yet to be established. The objectives of the present study are to determine whether the proposed sex-specific global cut-offs are suitable across several tribes in India. This cross-sectional study was conducted among nine tribal populations in India (1046 males, 1087 females). Weight, height and MUAC values were obtained, and body mass index (BMI) was calculated. The BMI cut-off (<18.5 kg/m²) was used to determine chronic energy deficiency (CED). The ROC Curve analyses of binomial logistic regression for MUAC versus CED revealed optimal cut-off point of MUAC as 23.8 cm (in males) and 21.8 cm (in females). MUAC cut-offs were similar in females, relative to males, in all tribes. Males with MUAC<24cm and females with MUAC<22 encompassed significantly higher numbers of CED than those with MUAC≥24 and ≥22 cm, respectively (χ²-value males: 254.9, p<0.001; females: 493.60, p<0.01). A single cut off point of MUAC may not be universally applicable for diverse populations and both sexes as well. It seemed that there is no alternative than to undertake further validation studies in various populations before using the MUAC cut off to identify undernourished or CED condition.