Underweight and overweight/obesity among middle aged and older adults in India: Prevalence and correlates from a national survey in 2017–2018

Background and Objective : This study aimed to estimate the prevalence and correlates of underweight and overweight/obesity among middle aged and older adults in India. Materials and Methods : The cross-sectional sample consisted of 72,262 individuals (≥45 years) from the Longitudinal Aging Study in India Wave 1 in 2017–2018. Multinomial logistic regression was used to estimate the factors associated with underweight and overweight/obesity relative to normal weight. Results : The prevalence of normal weight (18.5–22.9 kg/m2) was 36.7%, underweight (<18.5 kg/m2) 20.8%, overweight (23.0–24.9 kg/m2) 14.2%, Class I obesity (25.0–29.9 kg/m2) 20.8%, and Class II obesity (≥30.0 kg/m2) 7.4%. In adjusted multinomial logistic regression, the factors positively associated with underweight were older age (≥70 years) (adjusted relative risk ratio [ARRR]: 1.94, confidence interval [CI]: 1.75–2.14), food insecurity (ARRR: 1.19, CI: 1.07–1.33), poor or fair self-rated health status (ARRR: 1.14, CI: 1.05–1.33), and current tobacco use (ARRR: 1.42, CI: 1.31–1.53). The factors negatively associated with underweight were higher education (≥10 years) (ARRR: 0.67, CI: 0.48–0.92), high subjective socioeconomic status (ARRR: 0.78, CI: 0.67–0.92), urban residence (ARRR: 0.72, CI: 0.61–0.84), high life satisfaction (ARRR: 0.83, CI: 0.75–0.91), hypertension (ARRR: 0.64, CI: 0.58–0.69), diabetes (ARRR: 0.50, CI: 0.42–0.59), and heart disease or stroke (ARRR: 0.74, CI: 0.61–0.89). The factors positively associated with overweight/obesity were higher education (≥10 years) (ARRR: 2.09, CI: 1.87–2.33), high subjective socioeconomic status (ARRR: 1.44, CI: 1.31–1.59), urban residence (ARRR: 1.94, CI: 1.79–2.11), high life satisfaction (ARRR: 1.12, CI: 1.04–1.20), hypertension (ARRR: 1.89, CI: 1.76–2.02), type 2 diabetes (ARRR: 1.80, CI: 1.59–2.04), and raised cholesterol (ARRR: 2.75, CI: 2.11–3.58). The factors negatively associated with overweight/obesity were older age (≥70 years) (ARRR: 0.44, CI: 0.39–0.49), male sex (ARRR: 0.59, CI: 0.54–0.64), food insecurity (ARRR: 0.85, CI: 0.76–0.94), vigorous physical activity (>once/week) (ARRR: 0.91, CI: 0.84–0.99), current tobacco use (ARRR: 0.69, CI: 0.64–0.74), and heavy episodic alcohol use (ARRR: 0.70, CI: 0.58–0.85). Conclusion : One in five middle-aged and older adults in India were underweight and more than two in five were overweight/obese, confirming a dual burden of malnutrition in India.