- 45% of children were stunted at age 2 in urban slums of Tamil Nadu's Vellore
- By age 7, 26.3% were thin and 5.2% overweight or obese in the studied cohort
- At age 9, 21.6% were underweight and 14.6% were overweight or obese
A study that evaluated long-term patterns of body mass index from birth to age nine in 251 children from urban slums in Tamil Nadu's Vellore has found that 45 per cent of the cohort was stunted at age two.
By age 7, more than 26 per cent of the children were classified 'thin' and 5.2 per cent classified 'overweight/obese', findings published in The Lancet Regional Health Southeast Asia journal show.
Researchers, including those from Hyderabad's Tata Institute of Fundamental Research and Christian Medical College in Vellore, also found that by age nine, the prevalence of underweight was 21.6 per cent, while that of overweight-or-obesity increased to 14.6 per cent.
Maternal body mass index (BMI) was a predictor of childhood thinness, particularly at ages five and nine, the team said.
They added that the double burden of malnutrition -- marked by concurrent malnourishment and obesity -- is largely prevalent in low and middle-income countries.
"Approximately 45 per cent of children were stunted at 2 years of age. By 7 years, 26.3 per cent of children were classified as thin with 5.2 per cent of children classified as overweight/obese," the authors wrote.
"DBM (double burden of malnutrition) though present in early childhood, became more pronounced after 5 years of age and intensified by 9 years. Low maternal BMI was associated with the BMI trajectory of the offspring," they said.
The team added, "Hence, age-specific and maternal health interventions are crucial for addressing the risk of DBM in vulnerable children." The study is the first to report an onset of double burden of malnutrition in children by mid-childhood in India using data from the Malnutrition and Enteric Diseases (MAL-ED) cohort, the authors said.
The findings are in line with those described in the United Nations Children's Fund (UNICEF) 2025 Child Nutrition Report which estimated that 20 per cent of the children aged 5-19 years have either overweight or obesity, thus highlighting the burgeoning overnutrition concern, the researchers said.
The sharpest rise in overweight and obesity among school-age children and adolescents were reported in low and middle-income countries, reflecting a rapid nutritional transition in these populations, they said.
The analyses also indicated that maternal BMI could be an important factor driving the emergence of double burden of malnutrition.
While children born to mothers with a low BMI were seen to have a higher risk of thinness, a high maternal BMI did not seem to be related with obesity between age five and nine, the researchers found.
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