National Centre for Disease Informatics & Research, Indian Council of Medical Research, Bengaluru, India.
INCLEN Institute of Global Health, The INCLEN Trust International, New Delhi, India.
Indian J Med Res. 2019 Jun;149(6):695-705. doi: 10.4103/ijmr.IJMR_1703_18.
Large population-based surveys by the Government of India and several other regional studies have reconfirmed the coexisting burden of over- and undernutrition. While time trends from the 2, 3 and 4 rounds of the National Family Health Survey show declining trends in the prevalence of the underweight, it also highlights increasing rates in the overweight/obesity. Dose-response relationships with different micro- and macronutrient consumption with overweight/obesity prevalence have been established. In this context, it was attempted to identify the specific diet pattern and socio-behavioural determinants of overnutrition along with its combat strategies. This review highlights that while the proportion of chronic energy deficiency is decreasing in India, the intake of micronutrients and food groups continues to be below the recommended dietary allowance set by the Indian Council of Medical Research. Distal factors that determine the nutritional imbalance among Indians are presented under (i) household contextual factors, (ii) peer and socio-cultural influencers, and (iii) business and neighbourhood environment. Accumulation of such factors increases the density of obesogenic environment around individuals. Further, the review offers action points at individual, society and policy levels, presented in a 'logframe matrix' for bringing convergence actions across sectors in consultation with programme managers from different ministries/departments.
基于人口的大型调查由印度政府和其他几个地区的研究已经再次证实了存在营养过剩和不足的双重负担。虽然来自全国家庭健康调查的第 2、3 和 4 轮的时间趋势表明体重不足的流行率呈下降趋势,但也突显了超重/肥胖的发病率不断上升。不同微量和宏量营养素的摄入与超重/肥胖流行率之间的剂量反应关系已经建立。在这种情况下,尝试确定超重的具体饮食模式和社会行为决定因素及其防治策略。这篇综述强调,虽然印度慢性能量缺乏的比例正在下降,但印度医学研究理事会规定的微量营养素和食物组的摄入量继续低于推荐的膳食允许量。决定印度人营养失衡的远端因素包括:(i)家庭背景因素,(ii)同伴和社会文化影响者,以及 (iii)商业和邻里环境。这些因素的积累增加了个体周围肥胖环境的密度。此外,该综述在个人、社会和政策层面提供了行动要点,以“逻辑框架矩阵”的形式呈现,以便在与不同部委/部门的项目管理人员协商的情况下,在各部门之间采取趋同行动。