Epidemiology of Overweight in Under-Five Children in India: Insights from National Family Health Survey

Childhood overweight is not only an immediate health concern due to its implications but also significantly increases the risk of persistent obesity and consequently cardiovascular diseases in the future, posing a serious threat to public health. The objective of this study was to examine the trends and associated factors of childhood overweight in India, using nationally representative data from three rounds of the National Family Health Survey. For the primary analysis, we used data from 199,375 children aged 0 - 59 months from NFHS-5. Overweight was defined as Body mass index-for-age Z (BMI Z) score >+2 SD above the World Health Organization growth standards median. We compared the prevalence estimates of childhood overweight with NFHS-3 and NFHS-4. Potential risk factors were identified through multiple logistic regression analyses. The prevalence of overweight increased from 1·9% in NFHS-3 to 4·0% in NFHS-5, a trend seen across most states and union territories, with the Northeast region showing the highest prevalence. The BMI Z-score distributions from the latest two surveys indicated that the increase in overweight was substantially larger than the decrease in underweight. The consistent upward trend in the prevalence across different demographic groups raises important public health concerns. While undernutrition rates have remained relatively stable, there has been a noticeable rise in the incidence of overweight during the same time frame. The increasing trend of overweight among children in India calls for immediate action.