Prevalence and associated factors of undernutrition among adolescents in India: a systematic review

Abstract

Background

Undernutrition is a major public health challenge among Indian adolescents in India where 253 million of them are in the age group of 10–19 years. In spite of several intensive efforts through various program interventions and care, research studies find a less encouraging improvement in nutritional scenarios. The present systematic review aimed to determine the pooled prevalence and associated factors of undernutrition (stunting and underweight) among Indian adolescents.

Methods

We searched e-databases of MEDLINE/PubMed, EMBASE, Google Scholar, and Cochrane library for the period between the years 2000 and 2021. The peer-reviewed and empirical studies analyzing the prevalence of undernutrition among Indian adolescents and its associated factors were eligible for inclusion. The quality of the study reports included in the review was evaluated using the Newcastle–Ottawa Scale. The random-effect model with the Dersimonian and Laird method, at 95% confidence intervals, was used for estimating the overall effect. Subgroup analysis was conducted to investigate the possible sources of heterogeneity. Publication bias was assessed through visual examination of funnel plots and objectively by Egger’s regression test.

Results

A total of forty eligible studies with a pooled sample size of 67,865 adolescents were included to determine the prevalence of undernutrition among adolescents in India. The pooled prevalence of stunting and underweight in India was 41.1% (95% CI: 35.9, 46.0) and 32.6% (95% CI: 26.8, 37.1) respectively. It was also found that the rate of stunting prevalence was high among late adolescents and underweight was high among early adolescents. Age, gender, income, family size, caste, parental education, and occupation were the significant associated factors of the prevalence of stunting and underweight among adolescents in India.

Conclusion

The prevalence of stunting and underweight among adolescents is still a high concern in India. The results of this review posit the need of an integrated effort to reduce undernutrition in India and identify research priorities in this field.