Peer-reviewed article
Nutrition status of nulliparous married Indian women 15-24 years: Decadal trends, predictors and program implications.
Vani Sethi, Konsam Dinachandra, Zivai Murira, Jewel Gausman, Arti Bhanot et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined the nutritional status of 11,265 married adolescent girls (15-19 years) and 15,358 young women (20-24 years) in India who have not yet had children, using data from national surveys in 2005-06 and 2015-16. One-third of adolescents and one-quarter of young women were undernourished, while over one-fifth of young women were overweight or obese. The study found that thinness decreased modestly over the decade, and identified specific BMI cut-offs useful for screening this vulnerable group. The authors recommend nutritional screening and treatment programs targeted at nulliparous married young women and adolescents, integrated with family planning services.
Key points
- 35% of married nulliparous adolescents and 26% of young women were thin (BMI <18.5); 4-5% were severely thin
- Overweight or obesity affected 11% of adolescents and 21% of young women, with a 4-5% increase over the decade
- Eight per 1,000 were short, thin and young; six per 1,000 were additionally anemic
- BMI decreased among adolescents and women who wanted to delay childbearing (later than soon)
- Thinness declined by 4 percentage points in adolescents and 8 percentage points in young women over the decade, with regional variation
Limitations
This is a descriptive analysis of survey data showing trends and associations, not an intervention evaluation, so it cannot demonstrate what interventions would improve nutritional status or reproductive outcomes. The study is cross-sectional and cannot establish causal relationships.
Abstract
In India, 66% of 8 million married adolescents (~5.3 million) are nulliparous and likely to conceive soon. Among married young women aged 20-24 years about 9.1 million are nulliparous. This group remains relatively less reached in maternal nutrition programs. Current estimates of their nutritional status and predictors of body mass index (BMI) are unavailable. Thinness (BMI <18.5 kg/m2), severe thinness (BMI <16 kg/m2), overweight or obesity (BMI ≥ 23kg/m2) prevalence estimates are presented based on a sample of 11,265 married nulliparous adolescents (15-19 years, married, no parity) and 15,358 young women (20-24 years, married, no parity) drawn from the National Family Health Surveys 2005-06 and 2015-16. Trends by age, time and state were analysed. Predictors of BMI were investigated using linear regression. Using BMI for age z score (BAZ) as standard reference, BMI cut-off was calculated for thinness (-2SD) and overweight or obesity (+1SD) among married nulliparous adolescents as recommended for population under 19 years. 35% sampled adolescents and 26% young women were thin; 4%-5% severely thin. Overweight or obesity was higher among married nulliparous young women than married nulliparous adolescents (21% versus 11%). Eight in 1000 were short, thin and young and six in 1000 were short, thin, anemic and young. At 15 years of age, prevalence of thinness based on BMI was 46.5% while based on BAZ, 7.6%. At 24 years of age thinness was 22.5%. Decadal reduction in thinness was half among married nulliparous adolescents (4% points) compared with married nulliparous young women (8% points). Decadal increase in overweight/ obesity ranged from 4% to 5% in both age groups. Western states had high prevalence of thinness; Tamil Nadu had highest prevalence of overweight or obesity. Incremental increase in age and wealth increased BMI among young women more than adolescents. BMI was lower among adolescents and young women wanting a child later than soon [β -0.28 (CI -0.49- -0.07), β -0.33(CI -0.56- -0.093), respectively]. BMI cut-off 16.49 kg/m2 and 24.12 kg/m2 had a high sensitivity (100%, 99.7%) and specificity (98.9%, 98.5%) to screen thin and overweight or obese adolescents, respectively. Owing to the high prevalence of both thinness and overweight/obesity among nulliparous married adolescents and women, nutritional anthropometry based screening should be initiated for this target group, along with a treatment package in states with high and persistent malnutrition. Family planning services should be integrated in nutrition programs for this target group to achieve normal nutritional status before conception.