Association of childhood disadvantage with malnutrition in older ages in India

Abstract

Introduction: Much research on the association between childhood status and adult health has been focussed on high income countries and, hence, these findings cannot be generalised for all developing economies. Therefore, this study is an attempt to systematically examine the impact of multiple domains of early disadvantage on nutrition status during old age in India, while testing for potential mediation by adult health, socio-economic status and lifestyle.

Methods: The study uses data from the first wave of the Longitudinal Ageing Study in India (LASI), 2017-18. Binary logistic regression was used to assess the adjusted association of childhood and adulthood conditions with nutrition status. Two separate models were run for underweight and overweight. We used the structural equation modelling (SEM) approach to construct latent variables and structural models to test our hypothetical model.

Results: The SEM explained 78% of the variance in underweight. The direct effect of education and childhood conditions on underweight was significant. The SEM explained 68% of the variance in overweight. Results shows that the direct effect of education and working status on overweight was significant. The indirect and total effect of childhood conditions on overweight was significant.

Conclusion: The study underscores the importance of considering both direct and indirect effects in understanding the pathways through which early life experiences influence nutritional status in old age. The unexpected finding regarding the direct effect of childhood conditions on overweight in the Indian context raises important questions about the complexities of nutrition and health in this population.

Keywords: Adulthood; BMI; Childhood; Early life; India; Mediation; Older adults.

Fig. 1

Flowchart for the study sample selection

Fig. 2

A four-step approach for conducting SEM analysis

Fig. 3

Hypothetical conceptual model for the mediating effect of adult conditions on nutrition in old age. Note: Childhood conditions (represented by an ellipse) is a latent variable and adult conditions and nutrition (represented by rectangles) are observed variables. The model also includes other control variables: age group, sex, lifestyle factors (smoking, alcohol consumption and level of physical activity), presence of any chronic diseases, presence of any form of ill-treatment/abuse, and monthly per capita expenditure

Fig. 4

Structural equation model for underweight with path coefficients. Note: fedu- Father’s education; medu- Mother’s education; ht235- Status of childhood wealth; ch_health- Status of childhood health; edu- Education; c_work- Working status

Fig. 5

Structural equation model for overweight with path coefficients. Note: fedu- Father’s education; medu- Mother’s education; ht235- Status of childhood wealth; ch_health- Status of childhood health; edu- Education; c_work- Working status