The National Nutrition Monitoring Bureau surveys and the National Family Health Surveys indicate that the prevalence of overweight/obesity among female adults is higher than among their male counterparts. In some states, the prevalence of overweight/obesity among female adults is more than 50%.
As per World Health Organization (WHO), as of June 2021, worldwide obesity has tripled compared to 1975. It notes that a major share of the obese population has shifted from high-income developed countries to developing countries. Increased intake of energy-dense food that are high in fat & sugars along with inactive & sedentary lifestyle are among the fundamental causes of overweight & obesity.
Recently on 04 February 2022, responding to a question in the Lok Sabha seeking information on laws & regulations directing disclosure of information of contents in processed junk food, and details of obese population, the government provided data on the prevalence of obesity. The Government cited the surveys carried out by the Indian Council of Medical Research (ICMR), the National Institute of Nutrition (NIN) and NNMB (National Nutrition Monitoring Bureau) to ascertain the prevalence of Overweight & Obesity in the country.
Prevalence of Overweight and Obesity was 11.8% of the adults surveyed as part of the NNMB Rural survey
The National Nutrition Monitoring Bureau (NNMB) was established in 1972 by ICMR in 11 states and has been conducting diet & nutrition surveys on a regular basis. Repeat surveys were carried out by NNMB in Rural areas with an interval of 10 years. The Baseline survey was conducted in 1975-79, with the first two repeat surveys in 1988-90 & 1996-97.
The most recent NNMB Rural survey i.e. third repeat survey was in 2011-12. In wake of the global studies reporting an increase in the prevalence of diet-related chronic disease, an assessment of the prevalence of overweight/obesity was also conducted in 10 states. The overall survey included varied parameters to collect information relating to diet, nutrition, the prevalence of diabetes, hypertension, obesity, etc among others. Specific to obesity/overweight, anthropometry and clinical examinations were conducted for 23,889 households in 1,195 villages, across 10 states.
WHO’s standards were used to determine the prevalence of obesity/overweight. In the case of Children, WHO’s Standard Deviation (SD) classification was used:
In the case of adults (≥ 18 years), WHO advised Nutritional grades based on BMI (Body Mass Index) were used.
As per the survey, out of the 56,425 adults surveyed in the select villages across 10 states, the prevalence of overweight/obese population is 11.8%. The prevalence of overweight/obesity among female Rural population has a higher prevalence at 13.5% compared to males, where the prevalence was 10%.
The prevalence of overweight/obesity is lower among the surveyed children.
- Of the 8,400 children between 5-9 years of age who were part of the survey, the prevalence was 1.1%.
- 6,692 children aged 10-13 years were surveyed, and the prevalence of obesity among them was 2.2%.
- Among the children between 14-17 years, the prevalence was 2%.
Among the states surveyed, Kerala has the highest prevalence of obesity in its rural population
As highlighted, the Rural survey was carried out in 10 states in 2011-12. Among these surveyed states, Kerala has a higher prevalence of overweight/obesity among its rural population compared to other states. This is the case across both males & females and across age groups.
- In Kerala, the prevalence was 18.1% of the male adult population, followed by the other southern states of Tamil Nadu, Karnataka & Andhra Pradesh.
- Among the male-children population, Kerala has a comparatively higher prevalence among the states.
- The same trend is observed even in the case of the female population. While the prevalence is higher than the male population, the trends among the states are similar.
- In 7 out of 10 States, the prevalence is more than 10% among its rural adult female population who participated in the survey. In the case of Kerala, the prevalence is more than 30% in this demographic.
- A higher prevalence even among the children in Kerala, and to an extent, Tamil Nadu is evident from the survey.
The prevalence of Obesity is around 34% in Male & 44% in the Female urban population
A comprehensive Urban Nutrition survey was carried out by NNMB in 2015-16 to assess the Diet & Nutritional status of the Urban Population and prevalence of obesity, hypertension, diabetes, etc. The survey was carried out among the urban population of 16 states in India. Anthropometry, Clinical Examination & BIA was carried out for 3600 households. The same criteria used for determining obesity among children & adults in the Rural survey were used even for the Urban survey.
The prevalence of overweight/obesity among the urban population is higher among females than males in the higher age groups. 44% of the adult females surveyed were overweight/obese, compared to 33.8% males. For the age group of 14-18, it is 10.2% among females and 9.7% among males. In the case of lower age groups, the prevalence is higher among males compared to that of females.
Since the urban survey was conducted in a different year (2015-16) compared to the Rural survey (2011-12), it might not be appropriate to compare the prevalence between the Rural & Urban population. However, the prevalence of overweight/obesity is much higher among the Urban population compared to that of the Rural population as per the result of these surveys.
The prevalence of obesity among females is more than 50% in 6 out the 16 States/UTs
Around 54% of the female urban adult population surveyed in Tamil Nadu are overweight/obese. The UT of Pondicherry has a higher prevalence at around 59%. Kerala, Gujarat, Rajasthan & New Delhi are the other states, with more than half of the urban representative female adult population being overweight or obese. Among urban adult males, the four southern states of Kerala, Tamil Nadu, Karnataka & Andhra Pradesh have a higher prevalence.
Among the female child population, the prevalence is higher in Assam. Even in the case of male children, Assam has a comparatively higher prevalence of obesity compared to other states, with exception of Kerala.
As per NFHS-5, the prevalence of Overweight shows an increasing trend
The National Family Health Surveys (NFHS) provide information on population, health & nutrition across different indicators. The overweight population among children & adults is also one of the indicators in the NFHS. The latest round of NFHS is NFHS-5 for the 2019-21 period.
Even NFHS follows the same WHO’s criteria of Standard Deviation from the expected weight, the age for Children & BMI for Adults to identify overweight/obese population. However, it differs in terms of the categorization of the age group.
In NFHS, children under the age of 5-years and Adults (14-49) years are considered as two different groups. This rules out any direct comparison between the results of NNMB surveys & NFHS. However, the following broad trends can be observed from the NFHS-5.
- There is an increase in the prevalence of overweight & obese population in 2019-21 compared to NFHS-4 (2015-16).
- The urban population has a higher prevalence compared to the rural population
- Obesity is more prevalent among females compared to males.
These trends correlate with the trends identified in the NNMB surveys.
Responding to the question mentioned earlier, the government stated that there are no laws & regulations in place that mandate symbol-based warnings to warn consumers about harmful levels of fat, salt, and sugar in processed junk foods. However, FSSAI has launched a nationwide media campaign to encourage consumers to make dietary modifications.
Featured Image: Prevalence of Overweight and Obesity