Unhealthy weight among children and adults in India: urbanicity and the crossover in underweight and overweight.

PURPOSE

Urbanization may promote the rise of dual burdens of underweight and overweight in low- and middle-income countries. We assessed underweight and overweight by urban residence across the lifespan in India.

METHODS

Using nationally representative, directly measured height and weight data (2004-2006; n = 236,039), we estimated and compared the prevalence of underweight and overweight (including obesity) at ages 0 to 54 years by urban and rural residence; absolute burdens of underweight, overweight, and combined unhealthy weight were estimated using 2011 Census data.

RESULTS

Thirty-eight percent of the urban population and 36% of the rural population of India experienced unhealthy weight, amounting to 378 million underweight or overweight individuals. In urban areas, the unhealthy weight burden was largely underweight in childhood and overweight in adulthood. In rural areas, the unhealthy weight burden was largely underweight at all ages. Urban residents compared with rural residents were more likely to be overweight and less likely to be underweight at nearly all ages.

CONCLUSIONS

Combined unhealthy weight was comparable in urban and rural India. Although underweight continues to be the predominant nutritional problem, there is early evidence of an epidemiologic crossover from underweight to overweight. As India experiences urbanization and population aging, low overweight and obesity may be short lived.