PMID- 32569312
OWN - NLM
STAT- MEDLINE
DCOM- 20200828
LR  - 20200828
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 15
IP  - 6
DP  - 2020
TI  - Nutritional status of Indian adolescents (15-19 years) from National Family 
      Health Surveys 3 and 4: Revised estimates using WHO 2007 Growth reference.
PG  - e0234570
LID - 10.1371/journal.pone.0234570 [doi]
LID - e0234570
AB  - BACKGROUND: The National Family Health Surveys (NFHS) in India apply adult 
      cutoffs of nutritional status for the estimation of undernutrition/overweight in 
      the 15-19 age group. The prevalence of thinness in boys and girls thus estimated 
      is 58.1% and 46.8% in NFHS-3, and 45% and 42% in NFHS-4 respectively. But the WHO 
      recommends using age and sex-specific reference for adolescents. We reanalyzed 
      the nutritional status of the adolescents using the WHO 2007 Growth Reference to 
      obtain revised estimates of thinness, overweight and stunting across states, 
      rural-urban residence, and wealth quintiles. METHODS AND FINDINGS: Demographic 
      information, anthropometric data, and wealth index were accessed from the 
      Demographic and Health Survey (DHS) database. We re-analyzed the anthropometric 
      data using WHO AnthroPlus software which uses the WHO 2007 Growth reference. The 
      revised estimates of thinness assessed by BMI-for-age z-scores in boys and girls 
      was 22.3% (95%CI: 21.6, 23.0) and 9.9% (95%CI: 9.5, 10.3) in NFHS-3 and 16.5% 
      (95%CI: 16.0,17.0) and 9% (95%CI: 8.9, 9.2) in NFHS-4 respectively. Stunting was 
      found to be 32.2% (95% CI: 31.6, 32.9) in boys and 34.4% (95% CI: 34.2, 34.7) in 
      girls in NFHS-4. This was higher than that in NFHS-3; 25.2% (95% CI: 24.4, 26) in 
      boys and 31.2 (95% CI: 30.6, 31.8) in girls. There was a clear socioeconomic 
      gradient as there were higher thinness and stunting in rural areas. There was 
      wide variation among the states with pockets of a double burden of malnutrition. 
      CONCLUSION: Using the adult cutoffs significantly overestimates thinness in 
      adolescents in the age group of 15-19 years old in India. Stunting, which is an 
      indicator of long term nutrition is also widely prevalent in them. Future 
      editions of DHS and NFHS should consider adolescents as a separate age group for 
      nutritional assessment for a better understanding of nutritional transition in 
      the population.
FAU - Bhargava, Madhavi
AU  - Bhargava M
AUID- ORCID: 0000-0001-7480-566X
AD  - Department of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, 
      India.
AD  - Center for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore, 
      Karnataka, India.
FAU - Bhargava, Anurag
AU  - Bhargava A
AD  - Center for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore, 
      Karnataka, India.
AD  - Department of General Medicine, Yenepoya Medical College, Mangalore, Karnataka, 
      India.
FAU - Ghate, Sudeep D
AU  - Ghate SD
AD  - Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, 
      Karnataka, India.
FAU - Rao, R Shyama Prasad
AU  - Rao RSP
AUID- ORCID: 0000-0002-2285-6788
AD  - Yenepoya Research Centre, Yenepoya (Deemed to be University), Mangalore, 
      Karnataka, India.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200622
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
EIN - PLoS One. 2020 Sep 24;15(9):e0239923. PMID: 32970776
MH  - Adolescent
MH  - *Family Health
MH  - Growth Disorders/epidemiology/etiology
MH  - *Health Surveys
MH  - Humans
MH  - India
MH  - Male
MH  - *Nutritional Status
MH  - Overweight/epidemiology/etiology
MH  - Rural Population
MH  - Sex Factors
MH  - Socioeconomic Factors
MH  - Thinness/epidemiology/etiology
MH  - World Health Organization
MH  - Young Adult
PMC - PMC7307767
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/06/23 06:00
MHDA- 2020/08/29 06:00
PMCR- 2020/06/22
CRDT- 2020/06/23 06:00
PHST- 2020/03/31 00:00 [received]
PHST- 2020/05/27 00:00 [accepted]
PHST- 2020/06/23 06:00 [entrez]
PHST- 2020/06/23 06:00 [pubmed]
PHST- 2020/08/29 06:00 [medline]
PHST- 2020/06/22 00:00 [pmc-release]
AID - PONE-D-20-09042 [pii]
AID - 10.1371/journal.pone.0234570 [doi]
PST - epublish
SO  - PLoS One. 2020 Jun 22;15(6):e0234570. doi: 10.1371/journal.pone.0234570. 
      eCollection 2020.