Patterns, distribution, and determinants of under- and overnutrition: a population-based study of women in India
Patterns, distribution, and determinants of under- and overnutrition: a population-based study of women in India
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DOI：
10.1093/ajcn/84.3.633
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发表时间：
2006-09-01
影响因子：
7.1
通讯作者：
Smith, George Davey
中科院分区：
文献类型：
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作者：
Subramanian, S. V.;Smith, George Davey
背景：在同时存在营养不足和营养过剩的国家，社会经济地位和营养状况之间的关系几乎没有系统的证据。目的：我们调查了印度营养状况的社会经济分布，以及国家层面的宏观经济因素是否改变了社会经济地位和营养状况之间的关系。设计：我们的分析基于具有全国代表性的77 220名印度妇女的样本，以多个类别的体重指数(BMI；以kg/m(2)为单位)为结果，即<；结果：在调整后的模型中，体重不足与社会经济地位呈负相关，而社会经济地位与超重前、超重和肥胖呈正相关，社会经济地位与超重前、超重和肥胖呈正相关，且肥胖的社会经济梯度最为显著。国家层面的富裕程度并没有改变社会经济地位与超重类别之间的正相关关系。在富裕的邦，体重不足的风险较低，但这主要见于社会经济地位较高的女性。结论：营养不良和营养过剩分别是印度穷人和富人的流行病，这种联系在个体和生态层面上是一致的。政策应侧重于印度情况下营养不足和营养过剩的社会分配的复杂模式。
Background: Little systematic evidence exists for the relation between socioeconomic position and nutritional status in countries experiencing the simultaneous presence of under- and overnutrition.Objective: We investigated the socioeconomic distribution of nutritional status in India and whether state-level macroeconomic factors modify the relation between socioeconomic position and nutritional status.Design: Our analysis was based on a nationally representative sample of 77 220 women from India, with multiple categories of body mass index (BMI; in kg/m(2)) as the outcome, namely, < 18.5 (underweight), 23-24.9 (pre-overweight), 25-29.9 (overweight), or 30 (obese), with 18.5-22.9 as the reference category.Results: In adjusted models, being underweight was inversely related to socioeconomic position, whereas socioeconomic position was positively related to being pre-overweight, overweight, and obese, and the socioeconomic gradient was most marked for obesity. State-level measures of affluence did not modify the positive association between socioeconomic position and categories of overweight. The risk of underweight was lower in affluent states, but this was seen mainly in women of high socioeconomic position.Conclusions: Undernutrition and overnutrition are epidemics of the impoverished and the affluent, respectively, in India, and this association is consistent at the individual and ecologic levels. Policies should focus on the complex patterns of social distribution of both under- and overnutrition in the Indian context.