 Body mass index is an useful indicator to the status of adult health  It shows the current nutritional status and is an effective predictor of morbidity and mortality rates.  Women with low BMI (< 18.5) leads to chronic energy deficiency (CED) which ultimately leads to higher rate of mortality, low birth weight etc  In India, 29 % women have a BMI less than 18.5 (NFHS-3)

On the other hand, in the twentieth century, BMI is increasing, resulting to a good proportion of people suffering from obesity. It is regarded that due to increase of urbanization, availability of processed and fast foods and dependence on Television for leisure, people are fast adopting less physical activities and consuming ‘energy-dense, nutrient-poor’ diets leads to overweight and obese (WHO, 2003; Bell et al. 2002; Popkin, 2002; 2001; Popkin et al and Drewnowski & Popkin, 1997). Obesity has a great effect on mortality because it is associated with hypertension, diabetes, gallstones, gout and some type of cancers.

Data set: Second National Family Health Survey (NFHS-2) data, conducted in by International Institute for Population Sciences and to see the temporal trend, NFHS-3 (2005-6) have been considered. Sample size 81,712 (NFHS-2) and 1,18,781 (NFHS-3). Criteria of the data: Ever married reproductive aged (15-49 years) women along with their husbands of all states in India.

Body Mass Index (BMI) Obese :  30.0 Overweight : 25.0 – 29.9 Normal : 18.5 – 24.9 Chronic energy deficient (CED) : <18.5 Weight in kilogram divided by height in meters squared (kg / m 2 )

 Besides BMI, the other variables are:  Women’s Age  Women’s Education  Drinking Water  Toilet Facilities  Electricity  Religion and Caste  Husband’s Educational Level  Husband’s Occupation  Women’s Occupation  Standard of Living Index (SLI) Variables taken:

Clarification of each variables Age group Women’s education IlliteratePrimarySecondaryHigher Drinking water OpenClose Toilet facility YesNo Electricity YesNo

Religion and Caste STSCHinduMuslimOthers Husband’s education IlliteratePrimarySecondaryHigher Husband’s occupation NilProfessionalAgricultureManual Women’s occupation NilProfessionalAgricultureManual Standard of Living Index HighMediumLow Clarification of each variables

Methodology Individual percentage distribution of all the variables Association of BMI with different socio-economic variables is done : through percentage and multivariate linear regression analysis Statistical package used : SPSS, version 12.0

Results Percentage of women according to classification of BMI in India during NFHS-2 & NFHS-3 NFHS-2NFHS-3

Results Percentage distribution of CED among women in different zones of India NFHS-2 NFHS-3

Results Percentage distribution of normal women in different zones of India

Results Percentage distribution of obese & Overweight among women in different zones of India NFHS-2 NFHS-3

Results Percentage distribution of CED and Obesity in different zones of India by rural/urban differences (NFHS-2)

Results Low prevalence of CED (< 20 %) among women are found in the following states of India during NFHS-2 & NFHS-3

Results High prevalence of CED (> 35 %) are found among women in the following states of India during NFHS-2 & NFHS-3

Results Temporal trends of CED in India between NFHS-2 & NFHS-3

Results Low prevalence of overweight & obesity (<10 %) among women are found in the following states of India during NFHS-2 & NFHS-3 NFHS-2 NFHS-3

Results High prevalence of overweight & obesity (>20 %) among women are found in the following states of India during NFHS-2 & NFHS-3 NFHS-2NFHS-3

Results Temporal trends of overweight & obese in India between NFHS-2 & NFHS-3

Features of Socio-economic development: A) Education

 Illiterate Women (Zone-wise) Features of Socio-economic development:

Maximum occurrence of different occupational categories among women in different states of India Categories of work UnemployedPunjab (91.1 %) ProfessionalManipur (21.6 %) AgricultureArunachal Pradesh (50.0%) ManualManipur (17.4 %) B) Occupation

Household development indicators (highest occurrence, followed in descending order): Drinking water Toilet facility Electricity Open Closed Not available Available Not available Available (State-wise) Kerala (73.9 %) Punjab (99.2 %) Bihar (83.0 %) Mizoram (97.8 %) Bihar (82.3 %) New Delhi (98.3 %) Nagaland (52.5 %) New Delhi (98.9 %) Orissa (82.0 %) New Delhi (94.3 %) West Bengal (59.5 %) Himachal Pradesh (98.1 %) Manipur (51.5 %) West Bengal (91.1 %) Madhya Pradesh (76.4 %) Manipur ((92.9 %) Orissa (58.8 %) Punjab (97.0 %) (Zone-wise) North-east (34.8 %) West (84.3 %) Central (74.6 %) North-east (77.7 %) East (67.3 %) West (88.3 %) Central (25.1 %) North (83.1) East (72.4 %) West (53.8 %) Central (42.7 %) North (85.5 %)

Relationship of CED and Obesity with some socioeconomic variables: India VariablesCEDOverweight/ Obese N Age-group Place of residence Rural Urban Women’s education Illiterate Primary Secondary Higher

VariablesCED Overweight/ Obese N ________________________________________________________________ Husband’s education Illiterate Primary Secondary Higher Drinking water Open Closed Toilet facility NA Pit+Flush

Variables CED Overweight/ Obese N___ Electricity: No Yes Religion_Caste ST SC Hindu Muslim Others

Variables CED Overweight/ Obese N___ Husband’s Occupation Professional Unemployed Manual Agriculture Women’s occupation Professional Unemployed Manual Agriculture SLI Low Medium High

Relationship of CED and Obesity with some socioeconomic variables: India, Rural Variables CEDOverweight/Obese N___ Age-group Women’s education Illiterate Primary Secondary Higher

Variables CED Overweight/Obese N____ Husband’s education Illiterate Primary Secondary Higher Drinking water Open Closed Toilet facility NA Pit+Flush Electricity: No Yes

Variables CED Overweight/Obese N___ Husband’s Occupation Professional Unemployed Manual Agriculture Religion_Caste ST SC Hindu Muslim Others

Variables CED Overweight/ Obese N___ Women’s occupation Professional Unemployed Manual Agriculture SLI Low Medium High

Relationship of CED and Obesity with some socioeconomic variables: India, Urban VariablesCEDOverweight/ Obese N___ Age-group Women’s education Illiterate Primary Secondary Higher

VariablesCED Overweight/Obese N__ Husband’s Occupation Professional Unemployed Manual Agriculture Religion_Caste ST SC Hindu Muslim Others

VariablesCEDOverweight/Obese N___ Women’s occupation Professional Unemployed Manual Agriculture SLI Low Medium High

Regression analysis of women’s BMI on socio-economic variables : Independent variables BMI ________________________________________ Rural Urban (R + U) _______________________________________________________________ Women’s age37.15***26.77***7.361*** Women’s educational level17.38***33.90***28.676*** Drinking water ***9.751*** Toilet facility81.000***63.45***97.728*** Electricity 37.48***53.28***40.896*** Religion _caste14.56***23.63***15.331*** Husband’s education level 4.883***7.922**5.791*** Husband’s occupation13.29***14.17***18.705*** Women’s occupation 18.19***33.55*** *** Standard of living index 31.42***39.08***50.578*** _________________________________________________________________________ <0.01 = 1% level ***

Findings: Socio-economic variables Body mass index

Findings  70 to 85 % normal health women are found in most of the North-eastern states (both NFHSs).  Highest percentage of chronic energy deficient (CED) women are found from east to west through its central part.  Thus, it appears that the middle belt of India is mostly affected region of CED.  North-east zones of India are in a better position in respect of BMI than the other zones of India.

The facts which support the precondition of this findings are: 1.The highest percentage of women are working in North-eastern states. For ex. Manipur (70 %), Nagaland (64%) and Arunachal Pradesh (60 %) which gives the financial support for the betterment of their families. 2.Self employment is the most important employment (28 %) among women in Manipur which indicates the better standard of living among them. 3.Percentage of educated women is highest in North-eastern states. 4.The main inhabitant of North-east zone are tribes. But religiously, In Mizoram. Nagaland and Maghalaya, 82 to 96 % and in Manipur, 37% are Christian and Christianity may be one of the reason for enhancement of education. 5.Toilet facility is also highest in North –east India which reflects the awareness and indicates the resultant of education. 6.Literacy gap between male and female is least in Mizoram and Meghalaya.

 Central and Eastern part of India where percentage of illiterate women (mainly in Bihar and Jharkhand) and toilet facilities are least. Ethnicity is also the regulatory factor for CED because Madhya Pradesh is one of the state of Central India which is mainly inhabited by Tribes. East India is possessing 30 % SC people, Bihar is concentrated of 50% OBC. So this zones are mainly inhabitation of low caste and tribal people which reflects the causes of lowest literacy and less awareness. It is also evident that in Bihar, impact of mass media like TV, Radio are very low.

Kerala and Goa have high percentage of obese women, associated with higher literacy rate : Proportion who do not belongs to SC, ST and OBC are higher in Goa (87 %) and Delhi (66 %) Regular exposure to TV is highest in Delhi (90 %).

Rural–urban differences a)nearly fifty percent or more women are malnourished in rural areas. b) nearly six times more overweight & obese women are found in urban than rural areas. It may be due the effect of urbanization, processed and fast food, dependence on TV, Radio etc. less physical activity and consuming ‘energy-dense, nutrient –poor’ diets.

Summary of the study:  According to BMI indicator, most of the states of north-eastern zone are normal health women  Temporal trend indicates that 6.45 % undernourished have decreased and 33% Overweight & obesity have increased among women between NFHS-2 and NFHS-3  Bihar, Orissa and Central India are least privileged in respect of adult female nutritional status which ultimately focus the poor health of women.  On the other hand, New Delhi, Kerala, Punjab, Goa, are taking upper rung of overweight & obesity due to over nutrition.  Nutritional deficiency is acute among the women in rural areas, illiterate, younger women and also from low standard of living households.

 Women health status is associated with many socio-economic indicators.  Education and awareness are the two most important catalyst for socio-economic changes.  The best example is the North east zone of India because North-east zone can boast of having the lowest percentage of illiterate mother and highest percentage of toilet facility though this zone is not privileged so far as electricity connection or high standard of living. Conclusion