OBJECTIVES: India still faces the burden of undernutrition and communicable diseases, and the prevalence of overweight/obesity is steadily increasing. The discourse regarding the dual burden of underweight and overweight/obesity has not yet been widely explored in both men and women. The present study assessed the determinants of underweight and overweight/obesity in India among adult men and women aged 15-49.METHODS: Population-based cross-sectional and nationally representative data from the National Family Health Survey-4 (2015-16), consisting of a sample of men and women, were analyzed. Stratified 2-stage sampling was used in the NFHS-4 study protocol. In the present study, bivariate and adjusted multinomial logistic regression analyses were performed to determine the correlates of underweight and overweight/obesity.RESULTS: The results suggested a persistently high prevalence of underweight coexisting with an increased prevalence of overweight/obesity in India. The risk of underweight was highest in the central and western regions and was also relatively high among those who used either smoking or smokeless tobacco. Overweight/obesity was more prevalent in urban areas, in the southern region, and among adults aged 35-49. Furthermore, level of education and wealth index were positively associated with overweight/obesity. More educated and wealthier adults were less likely to be underweight.CONCLUSIONS: In India, underweight has been prevalent, and the prevalence of overweight/obesity is increasing rapidly, particularly among men. The dual burden of underweight and overweight/obesity is alarming and needs to be considered; public health measures to address this situation must also be adopted through policy initiatives.

Underweight defined as body mass index (BMI) < 18.5 is associated with negative health and quality of life outcomes including mortality. Yet, little is known about the socioeconomic differentials in underweight and its association with health and well-being among older adults in India. This study examined the socioeconomic differentials in underweight among respondents aged ≥50 in India. Consequently, three outcomes of the association of underweight were studied. These are poor self-rated health, cognition and quality of life. Cross-sectional data on 6,372 older adults derived from the first wave of the WHO’s Study on global AGEing and adult health (SAGE), a nationally representative survey conducted in six states of India during 2007–8, were used. Bivariate and multivariate regression analyses were applied to fulfil the objectives. The overall prevalence of underweight was 38 percent in the study population. Further, socioeconomic status showed a significant and negative association with underweight. The association of underweight with poor self-rated health (OR = 1.60; p < .001), cognition (β = –0.95; p < .001) and quality of life (β = –1.90; p < .001) were remained statistically significant after adjusting for age, sex, place of residence, marital status, years of schooling, wealth quintile, sleep problems, chronic diseases, low back pain and state/province. The results indicated significant socioeconomic differentials in underweight and its association with poor self-rated health, cognition and quality of life outcomes. Interventions focussing on underweight older adults are important to enhance the overall wellbeing of the growing older population in India.

Handgrip strength, a measure of muscular strength is a powerful predictor of declines in intrinsic capacity, functional abilities, the onset of morbidity and mortality among older adults. This study documents socioeconomic (SES) differences in handgrip strength among older adults aged 50 years and over in six middle-income countries and investigates the association of handgrip strength with measures of intrinsic capacity—a composite of all the physical and mental capacities of an individual. Secondary data analysis of cross-sectional population-based data from six countries from the WHO’s Study on global AGEing and adult health (SAGE) Wave 1 were conducted. Three-level linear hierarchical models examine the association of demographic, socioeconomic status and multimorbidity variables with handgrip strength. Regression-based Relative Index of Inequality (RII) examines socioeconomic inequalities in handgrip strength; and multilevel linear and logistic hierarchical regression models document the association between handgrip strength and five domains of intrinsic capacity: locomotion, psychological, cognitive capacity, vitality and sensory. Wealth quintiles are positively associated with handgrip strength among men across all countries except South Africa while the differences by education were notable for China and India. Work and nutritional status are positively associated with handgrip strength. Our findings provide new evidence of robust association between handgrip strength and other measures of intrinsic capacity and confirms that handgrip strength is a single most important measure of capacity among older persons.