Children living in high-altitude regions of India may be more susceptible to stunting

Living at high altitudes in India is associated with an increased risk of stunting, with children living in homes above 2,000 meters above sea level having a 40% higher risk than children living in homes below 1,000 meters above sea level, an open study found. This was revealed in a study published in the Access Journal. BMJ Nutrition Prevention and Health.

Children living in rural areas appear to be the most vulnerable, and researchers advocate prioritizing nutrition programs in the country's hilly and mountainous regions.

Despite efforts, child stunting caused by chronic malnutrition remains a major public health challenge in India, affecting more than a third of five-year-olds, researchers say. Pointed out.

Studies in other countries have shown an association between residential altitude and stunting, but it is unclear whether this also applies to India, where a significant number of people live at altitudes above 2,500 meters above sea level.

To investigate this further, the researchers used data from India's leading national household survey, the National Family Health Survey 2015-16 (NFHS-4). Approximately 167,555 children under the age of 5 nationwide were included in the analysis.

GPS data were used to classify altitude levels, and World Health Organization (WHO) criteria were used to define stunting.

Most of the children (98%, 164,874) lived below 1000 meters above sea level. 1.4% (2346 people) lived between 1000 and 1999 meters above sea level. and 0.2% (335 people) lived at altitudes above 2000 meters. Seven out of 10 people lived in rural areas.

The overall prevalence of stunting in these children was 36%, with it being more prevalent in children aged 18 to 59 months (41%) than in children younger than 18 months (27%). The rate was high.

Stunting was more common in children third and subsequent in the birth order (44%) than in firstborn children (30%). And children who were small or very small at birth had even higher rates of stunting (45%).

Maternal education emerged as an influential factor, with the prevalence of stunting decreasing as maternal educational attainment increased. The proportion of children whose mothers had no schooling was more than twice the proportion of children whose mothers had higher education: 48% versus 21%.

Other protective factors included elements of antenatal care such as clinic visits, tetanus vaccination, and iron intake. folic acid supplement; Proximity to medical facilities. and does not belong to any particular caste or indigenous tribe.

The researchers acknowledged that this was an observational study that captured a snapshot of the population at a specific point in time, making it difficult to confirm that altitude was the cause of stunting.

But they suggest there is a plausible explanation for their findings. For example, chronic exposure to high altitude can reduce appetite, limit oxygen delivery to tissues, and limit nutrient absorption.

Food insecurity also tends to be more acute in highlands where crop yields are low and climates are harsh. Similarly, they suggest that access to and provision of health care, including the implementation of nutrition programs, is also more difficult.

“In summary, addressing stunting requires coordinated efforts across the health and nutrition sectors, with a focus on high-risk children in vulnerable communities,” the researchers concluded. I'm wearing it.

“A multifaceted approach needs to combine reproductive health initiatives, women's nutrition programs, infant and young child feeding interventions, and food security measures. Continued research, monitoring and evaluation will help all of India's This will be key to guiding evidence-based policies and targeted actions to ensure that children have opportunities for healthy growth and development. ”

Professor Sumantra Ray, Co-Owner and Executive Director of NNEdPro Global Food, Nutrition and Health Research Institute BMJ Nutrition Prevention and Health and BMJ, addition:

“Public health interventions in India in recent decades have effectively addressed previously prevalent nutritional problems, such as iodine deficiency associated with living at high altitudes.

“However, this study highlights the complexity of malnutrition in hill regions, where there are broad determinants of malnutrition in children under five years of age, and the relative contribution of genetic, environmental, lifestyle and socio-economic factors. Further research is needed to elucidate this contribution.”