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Early childhood growth and nutritional status in India: trends in five National Family Health Surveys spanning 1992 and 2021

Abstract

Background/Objective

To evaluate the weight and height status of under-five children between 1992 and 2021 in relation to nutritional context.

Subjects/Methods

The study is based on the lengths/heights and weights of children <5 years in five national surveys (n = 505,026). After evaluating normality of the distributions, heights, and weights were expressed as z-scores relative to the WHO reference. Nonparametric tests were used as the heights and weights did not have normal distributions.

Results

Heights and weights of boys and girls increased systematically, on average, across the five national surveys, indicating improvement in nutritional status over time. Nevertheless, median z-scores for height and weight relative to the WHO reference indicated the persistence of relatively poor nutritional status across the surveys.

Conclusions

The growth status of Indian children <5 years improved over three decades, indicating that national initiatives promoting child health had a positive impact. Unfortunately, the nutritional status of significant numbers of children has not sufficiently improved and merits further attention.

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Fig. 1
Fig. 2: Changes in median weights by age groups for under-five children across five national surveys in India between 1992 and 2021.
Fig. 3: Changes in median heights by age groups for under-five children across five national surveys in India between 1992 and 2021.
Fig. 4: Independent-samples median tests by survey for the total samples of children based on z-scores of height-for-age, weight-for-height, weight-for-age, and BMI-for-age.
Fig. 5: Sex-specific independent-samples median tests by survey for the respective total samples based on z-scores of height-for-age, weight-for-height, weight-for-age, and BMI-for-age.
Fig. 6

Data availability

The NFHS datasets are accessible through the DHS website at https://dhsprogram.com/Data/.

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Acknowledgements

The authors would like to acknowledge the Demographic and Health Surveys (DHS) and National Family Health Survey (NFHS) for providing data.

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Authors and Affiliations

  1. Department of Anthropology, West Bengal State University, Kolkata, India

    Ramendra Nath Kundu

  2. Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Poznań, Poland

    Grażyna Liczbińska

  3. Department of Anthropology, Dr. Harisingh Gour Vishwavidyalaya (A Central University), Sagar, India

    Rajesh K. Gautam

  4. Former Associate Scientist, Sociological Research Unit, Indian Statistical Institute, Kolkata, India

    Susmita Bharati

  5. Former Professor, Economic Research Unit, Indian Statistical Institute, Kolkata, India

    Manoranjan Pal

  6. Former Professor, Biological Anthropology Unit, Indian Statistical Institute, Kolkata, India

    Premananda Bharati

  7. Professor Emeritus, Department of Kinesiology and Health Education, University of Texas, Austin, TX, USA

    Robert M. Malina

  8. Adjunct Professor, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA

    Robert M. Malina

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Contributions

RNK conceived the presented idea, designed the methodology and data curation, performed the analysis and data interpretation, drafted the manuscript, and finalized it. GL verified the analytical methods, contributed to the interpretation of the statistical analysis, critically reviewed and edited the manuscript, and finalized the manuscript. RKG verified the analytical methods, critically reviewed and edited the manuscript, and finalized the manuscript. SB data interpretation and finalized the manuscript. MP verified the analytical methods, and critically reviewed and edited the manuscript. PB conceived the presented idea, designed methodology, verified the analytical methods, critically reviewed and edited the manuscript, and supervised the study. RMM contributed to the interpretation of the statistical analysis and critically reviewed, edited, and finalized the manuscript. All the authors read and approved the manuscript.

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Correspondence to
Grażyna Liczbińska.

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Kundu, R.N., Liczbińska, G., Gautam, R.K. et al. Early childhood growth and nutritional status in India: trends in five National Family Health Surveys spanning 1992 and 2021.
Eur J Clin Nutr (2025). https://doi.org/10.1038/s41430-025-01568-3

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  • Received: 21 July 2024

  • Revised: 23 December 2024

  • Accepted: 15 January 2025

  • Published: 27 January 2025

  • DOI: https://doi.org/10.1038/s41430-025-01568-3

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