{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:05:00Z","timestamp":1790697900109,"version":"4.1.0"},"reference-count":30,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi260985-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Evidence is lacking on long-term trends across Indian states and union territories (UTs) and on the attainability of the 2030 Global Nutrition Target (GNT) goals within these specific regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260985-5\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the trends in overweight and obesity among children younger than 5 years across 36 states and UTs in India between 2006 and 2024 and to assess the feasibility of achieving the GNT of restricting the overweight burden to 5% or less by 2030.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260985-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>For this cross-sectional study, microdata and aggregate data were used from the 4 most recent waves of the National Family Health Survey (repeated cross-sectional surveys conducted between January 1, 2006, and December 31, 2024). The analysis included individual-level samples of 41\u202f306 children in 2006, 225\u202f002 in 2016, and 201\u202f687 in 2021, alongside aggregate estimates of overweight from the 2024 wave. Data were analyzed in January and updated in July 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260985-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Following World Health Organization definitions of overweight and obesity in children younger than 5 years (overweight is defined as weight for height &amp;amp;gt;2 SDs above the World Health Organization median and obesity as &amp;amp;gt;3 SDs), their prevalence and standardized annualized changes for 5 timeframes (2006-2016, 2016-2021, 2021-2024, 2006-2021, and 2006-2024) were computed. Additionally, the fractional logistic regression was used to model national and state-level overweight trajectories, forecasting probability of achieving the 5% or less 2030 GNT threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260985-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final sample included 467\u202f995 children (241\u202f645 [51.6%] male, 226\u202f350 [48.4%] female) aged 0 to 59 months from NFHSs conducted between 2006 and 2021. Mean (SD) child age remained consistent from 2006 to 2021: 30.1 (17.1) months in 2006, 30.1 (17.0) months in 2016, and 29.9 (17.2) months in 2021. Between 2006 and 2021, the prevalence of overweight increased from 1.55% to 3.42%, whereas obesity prevalence increased from 0.50% to 1.30% before overweight prevalence decreased to 1.3% in 2024. Although India was projected to sustain the 2030 overweight target nationally, 9 states and UTs (Arunachal Pradesh, Assam, Himachal Pradesh, Jammu and Kashmir, Kerala, Mizoram, Nagaland, Sikkim, and Tripura) maintained a low to moderate probability of adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi260985-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this cross-sectional study of Indian children younger than 5 years from 2006 to 2024, a historical overweight increase reversed in 2024. However, profound subnational disparities remained, suggesting that targeted regional interventions are needed to achieve the 2030 GNT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.36750","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:30:28Z","timestamp":1790695828000},"page":"e2636750","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of Overweight and Obesity Among Children Younger Than 5 Years in India"],"prefix":"10.1001","volume":"9","author":[{"given":"Rajesh Kumar","family":"Rai","sequence":"first","affiliation":[{"name":"Division of Global Health Management and Policy, School of Public Health, San Diego State University, San Diego, California"},{"name":"Birbhum Population Project, Society for Health and Demographic Surveillance, Suri, West Bengal, India"},{"name":"ImplactLoop Ltd, London, UK"},{"name":"Human Nutrition Unit, Institute of Nutrition, Mahidol University, Phutthamonthon, Nakhon Pathom, Thailand"},{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Matsuzaki","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Community Nutrition Unit, Institute of Nutrition, Mahidol University, Phutthamonthon, Nakhon Pathom, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Walter","family":"De Neve","sequence":"additional","affiliation":[{"name":"Division of Global Health Management and Policy, School of Public Health, San Diego State University, San Diego, California"},{"name":"Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumaira","family":"Zafar","sequence":"additional","affiliation":[{"name":"Community Nutrition Unit, Institute of Nutrition, Mahidol University, Phutthamonthon, Nakhon Pathom, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabri","family":"Bromage","sequence":"additional","affiliation":[{"name":"Community Nutrition Unit, Institute of Nutrition, Mahidol University, Phutthamonthon, Nakhon Pathom, Thailand"},{"name":"Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rockli","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea"},{"name":"Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. V.","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Harvard Center for Population and Development Studies, Cambridge, Massachusetts"},{"name":"Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"issue":"12","key":"zoi260985r2","doi-asserted-by":"publisher","DOI":"10.1111\/ijpo.70055","article-title":"Prevalence of overweight\/obesity among under-five children in lower middle-income countries and assessment of the reported associated factors: a systematic review and meta-analysis.","volume":"20","author":"Talukdar","year":"2025","journal-title":"Pediatr Obes"},{"issue":"8","key":"zoi260985r3","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1001\/jamapediatrics.2024.1576","article-title":"Global prevalence of overweight and obesity in children and adolescents: a systematic review and meta-analysis.","volume":"178","author":"Zhang","year":"2024","journal-title":"JAMA Pediatr"},{"issue":"10217","key":"zoi260985r4","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/S0140-6736(19)32497-3","article-title":"Dynamics of the double burden of malnutrition and the changing nutrition reality.","volume":"395","author":"Popkin","year":"2020","journal-title":"Lancet"},{"issue":"11","key":"zoi260985r5","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1111\/j.1467-789X.2012.01015.x","article-title":"The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review.","volume":"13","author":"Park","year":"2012","journal-title":"Obes Rev"},{"issue":"5","key":"zoi260985r6","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1111\/j.1467-789X.2008.00475.x","article-title":"Tracking of childhood overweight into adulthood: a systematic review of the literature.","volume":"9","author":"Singh","year":"2008","journal-title":"Obes Rev"},{"issue":"2","key":"zoi260985r13","doi-asserted-by":"publisher","first-page":"101","DOI":"10.4103\/IJEM.IJEM_144_24","article-title":"Tackling the rising tide: understanding the prevalence of childhood obesity in India.","volume":"28","author":"Jacob","year":"2024","journal-title":"Indian J Endocrinol Metab"},{"key":"zoi260985r14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2023.101390","article-title":"Childhood obesity in India: a two-decade meta-analysis of prevalence and socioeconomic correlates.","volume":"23","author":"Singh","year":"2023","journal-title":"Clin Epidemiol Glob Health"},{"issue":"7","key":"zoi260985r15","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1017\/S1368980016003323","article-title":"Programming maternal and child overweight and obesity in the context of undernutrition: current evidence and key considerations for low- and middle-income countries.","volume":"20","author":"Jaacks","year":"2017","journal-title":"Public Health Nutr"},{"issue":"9890","key":"zoi260985r16","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/S0140-6736(13)60937-X","article-title":"Maternal and child undernutrition and overweight in low-income and middle-income countries.","volume":"382","author":"Black","year":"2013","journal-title":"Lancet"},{"issue":"12","key":"zoi260985r17","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1007\/s13312-023-3066-z","article-title":"Indian Academy of Pediatrics Revised Guidelines on evaluation, prevention and management of childhood obesity.","volume":"60","author":"Khadilkar","year":"2023","journal-title":"Indian Pediatr"},{"issue":"10526","key":"zoi260985r18","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/S0140-6736(25)02169-5","article-title":"The Lancet Commission on a citizen-centred health system for India.","volume":"407","author":"Patel","year":"2026","journal-title":"Lancet"},{"key":"zoi260985r21","article-title":"Progress on Sustainable Development Goal indicators in 707 districts of India: a quantitative mid-line assessment using the National Family Health Surveys, 2016 and 2021.","volume":"13","author":"Subramanian","year":"2023","journal-title":"Lancet Reg Health Southeast Asia"},{"issue":"6","key":"zoi260985r22","doi-asserted-by":"crossref","first-page":"441","DOI":"10.2471\/BLT.06.034421","article-title":"Standard deviation of anthropometric Z-scores as a data quality assessment tool using the 2006 WHO growth standards: a cross country analysis.","volume":"85","author":"Mei","year":"2007","journal-title":"Bull World Health Organ"},{"issue":"1","key":"zoi260985r23","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1038\/s41597-025-05923-8","article-title":"India policy insights: estimates of population health and social determinants indicators across policy units.","volume":"12","author":"Rajpal","year":"2025","journal-title":"Sci Data"},{"key":"zoi260985r24","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1002\/(SICI)1099-1255(199611)11:6<619::AID-JAE418>3.0.CO;2-1","article-title":"Econometric methods for fractional response variables with an application to 401(k) plan participation rates.","volume":"11","author":"Papke","year":"1996","journal-title":"J Appl Econom"},{"key":"zoi260985r27","article-title":"India\u2019s Poshan Tracker: data-driven tool for maternal and child nutrition.","volume":"25","author":"Jaacks","year":"2024","journal-title":"Lancet Reg Health Southeast Asia"},{"issue":"17","key":"zoi260985r28","doi-asserted-by":"crossref","first-page":"3621","DOI":"10.3390\/nu14173621","article-title":"Overweight\/obesity prevalence among under-five children and risk factors in India: a cross-sectional study using the National Family Health Survey (2015-2016).","volume":"14","author":"Saha","year":"2022","journal-title":"Nutrients"},{"issue":"5","key":"zoi260985r29","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1017\/S0007114524001582","article-title":"Epidemiology of overweight in under-five children in India: insights from National Family Health Survey.","volume":"132","author":"Manapurath","year":"2024","journal-title":"Br J Nutr"},{"key":"zoi260985r7","volume-title":"World Obesity Atlas 2024","author":"World Obesity Federation","year":"2024"},{"key":"zoi260985r8","volume-title":"National Family Health Survey (NFHS-3), 2005\u201306: India","author":"International Institute for Population Sciences (IIPS) and Macro International","year":"2007"},{"key":"zoi260985r9","volume-title":"National Family Health Survey (NFHS-4), 2015-16: India","author":"International Institute for Population Sciences (IIPS) and ICF","year":"2017"},{"key":"zoi260985r10","volume-title":"National Family Health Survey (NFHS-5), 2019-21: India","author":"International Institute for Population Sciences (IIPS) and ICF","year":"2021"},{"key":"zoi260985r11","volume-title":"National Family Health Survey (NFHS-6), 2023-24: India and State\/UT Fact Sheets","author":"International Institute for Population Sciences (IIPS)","year":"2026"},{"key":"zoi260985r12","volume-title":"Towards a Fit and Healthy India: Combating Obesity Through Collective Action","author":"Press Information Bureau","year":"2025"},{"key":"zoi260985r19","volume-title":"National Family Health Survey (MCH and Family Planning), India 1992-93","author":"International Institute for Population Sciences (IIPS)","year":"1995"},{"key":"zoi260985r20","volume-title":"National Family Health Survey (NFHS-2), 1998\u201399: India","author":"International Institute for Population Sciences (IIPS) and ORC Macro","year":"2000"},{"key":"zoi260985r25","volume-title":"Econometric Analysis of Cross Section and Panel Data","author":"Wooldridge","year":"2010"},{"key":"zoi260985r26","author":"StataCorp","year":"2023"},{"key":"zoi260985r30","volume-title":"Demographic and Health Survey Sampling and Household Listing Manual.","year":"2012"},{"key":"zoi260985r1","unstructured":"World Health Organization. Global Nutrition Targets 2030: Childhood Overweight Brief. World Health Organization; 2025. WHO reference number B09441. Accessed August 25, 2026. https:\/\/www.who.int\/publications\/i\/item\/B09441"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2854611\/rai_2026_oi_260985_1790096159.64551.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:30:32Z","timestamp":1790695832000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2854611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2026.36750","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]}}}