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Indian J Med Res. 2018 Nov;148(5):612-620. doi: 10.4103/ijmr.IJMR_1963_18.

Undernutrition in children & critical windows of opportunity in Indian context.

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ICMR-National Institute of Nutrition, Hyderabad, India.
NIN-Tata Centre, ICMR-National Institute of Nutrition, Hyderabad, India.
Division of Biostatistics, ICMR-National Institute of Nutrition, Hyderabad, India.


It is intriguing to note that majority of the wasting among the under 5 yr in India is present at birth. The National Family Health Survey 4 (NFHS-4) data analysis shows 31.9 per cent wasting at birth, which is decreasing to 17.7 per cent in the under five children; clearly suggesting that any reduction in wasting should come from improvement in foetal growth. In addition, children with both severe wasting and severe stunting, in whom the risk of mortality increases many folds, are <1 per cent in almost all the States; and these are the children in whom special care is required under the community-based management of severe acute malnutrition. This article presents an overview of nutrition status in children, their antecedents, and the critical phases; especially, nutrition status before pregnancy that plays a crucial role in all the nutrition status indicators of children. More attention on the critical phases is crucial to maximize the benefits from national programmes.


1000 days; dietary practices; growth faltering; preconception; pregnancy; stunting; wasting

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