Malnutrition among older adults in India: Does gender play a role?

Background: Existence of gender gap in nutrition outcomes is becoming increasingly important in the concurrent times and while this gap has been studied for children and adult, it is not the case with older adults aged 60+. This study tries to address gender gap at both ends of the malnutrition spectrum by covering both underweight and overweight among the older adults. Methods: Data for this study was obtained from the first round of the Longitudinal Ageing Study in India (LASI), with a sample of older adult aged 60+. Binary logistic regression was applied to assess region-wise association of gender with malnutrition. Quantile regression was done to see the differential effects of factors on different parts of body mass index distribution. Multivariate decomposition analysis was performed to assess gender gaps in the prevalence of undernutrition and over-nutrition. Results: While there was no prominent gender differential in the prevalence of underweight among older adults, a marked spatial gradient was observed in the prevalence of overweight among older adults in India. The prevalence of overweight among females was higher than males across all Indian states. Females were more likely to be underweight and overweight than males across all regions. The maximum contribution to gender differentials in both underweight (56%) and overweight (82%) among older adults was explained by difference in health behaviour, followed by individual characteristics (47% for underweight and 13 % for overweight). Conclusion: Inequality in underweight can be eradicated by improving individual characteristics such as education and working status, especially among women. For overweight, health behaviour needs to be targeted and policies pertaining to high alcohol and tobacco consumption among men should be formulated and physical activity among women should be encouraged, especially those women who are not engaged in any occupation.