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Rates of overweight exceed that of underweight in South Asia: Study on pre-pregnancy malnutrition

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Rates of overweight exceed that of underweight in South Asia: Study on pre-pregnancy malnutrition


According to the study ,there is a growing double burden of malnutrition among women in South Asia before pregnancy, as the prevalence of overweight now surpasses underweight, while anaemia and micronutrient deficiencies remain alarmingly high | Image used for representational purpose only
| Photo Credit: Getty Images

Highlighting a growing burden of malnutrition among married women in South Asia prior to conceiving, an analysis shows that prevalence of being overweight has surpassed that of being underweight.

Key findings

The analysis, published in The Lancet Regional Health Southeast Asia journal, also finds that short stature continues to be an issue, especially in India and Bangladesh, pointing to persistent concerns about malnutrition during early childhood and its long-term effects.

Researchers, including those from University College London, UK, and Population Council, India, analysed data collected through national surveys of South Asian countries — such as the National Family Health Survey in India — to understand the nutritional status of women before becoming pregnant.

The team published a series of papers related to aspects of pre-pregnancy nutrition, including prevalence of anaemia and micronutrient deficiency in population. They also reviewed public policies and programmes that deliver interventions on preconception nutrition.

“Our analysis of nationally-representative survey data reveals a growing double burden of malnutrition among preconception women in South Asia, as the prevalence of overweight (ranging from 29 per cent to 57.8 per cent) now surpasses that of underweight (4.6 per cent to 15.7 per cent) among married women,” the authors wrote.

Prevalence of short stature was estimated to be 10.7 per cent in India.

Lifestyle and diet associated health risks across South Asia

Urbanisation, migration, along with an increased availability of ultra-processed foods, even in rural areas, have driven a higher intake of fats, sugars, and calories, contributing to a worsening nutritional status, the authors said. They added that anaemia remains persistently high in South Asia, despite intervention efforts.

Anaemia prevalence in India has stagnated at 53.2 per cent during 2015-16 to 54 per cent during 2019-21, while it has marginally increased in Bangladesh (26 per cent in 2011-12 to 28.9 per cent in 2019-20), the study found. The team also looked at micronutrient deficiencies — another critical aspect of malnutrition among women in South Asia — by reviewing previously published studies.

For example, low serum ferritin — a marker of iron deficiency — is common in India (31 per cent to nearly 88 per cent) but much lower in Bangladesh, the researchers said. Deficiency of serum folate were found to be the highest in Sri Lanka (up to 52.5 per cent) and Pakistan (over 50 per cent), and lower in India (up to eight per cent) and Bangladesh (up to 30 per cent).

However, looking at red blood cell folate deficiency, the researchers found a high prevalence in India — ranging from 22 per cent to nearly 80 per cent — and Bangladesh (over 76 per cent). Vitamin D deficiency is a key concern, the authors said, with studies reporting over two thirds of women in South Asia being deficient.

Policy gaps and cultural barriers limit nutrition support

National survey data of Afghanistan shows that over 95 per cent of women in Afghanistan are low on vitamin D, the study said. Estimates of vitamin D deficiency appear to have reduced over time in India, but remain high in Pakistan and Afghanistan — both predominantly Muslim countries where most women wear clothing that reduces their skin’s exposure to the sun, the authors said.

Looking at public policies and programmes related to preconception nutrition in eight South Asian countries, the authors said that most countries, except Sri Lanka, lack a universal programme for health and nutrition screening and at providing essential micronutrients. The countries also lack a counselling on healthy eating and treatment for at-risk women, the authors said.

They added that in countries where supportive policies are present, implementation of comprehensive nutrition services for pre-pregnant women faces significant bottlenecks. Addressing these barriers is critical to improving intervention effectiveness, programme implementation, and informed decision-making, the team said.



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NEET-UG 2024: 26 MBBS students suspended for malpractice, 42 candidates debarred for three years

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In a major crackdown on irregularities in the NEET-UG 2024 examination, the Central Bureau of Investigation (CBI) and the National Testing Agency (NTA) have uncovered multiple instances of malpractice, including impersonation and the use of leaked question papers.
| Photo Credit: PTI

In a major crackdown on irregularities in the NEET-UG 2024 examination, the Central Bureau of Investigation (CBI) and the National Testing Agency (NTA) have uncovered multiple instances of malpractice, including impersonation and the use of leaked question papers.

Following the probe, the National Medical Commission (NMC) has directed medical colleges and institutions to immediately suspend 26 MBBS students found complicit in the violations. Additionally, admissions of 14 other students for the academic year 2024–25 have been cancelled, according to a senior official in the Union Health Ministry.

“The gravity of these offences threatens the credibility of the medical education system. The Commission has taken a serious view of the matter,” the official told The Hindu.

The latest directive comes just ahead of the NEET-UG 2025 examination, scheduled for May 4.

The NTA, which conducted NEET-UG 2024, had earlier flagged several cases as “Unfair Means (UFM)”, which were reviewed by its dedicated UFM Committee. Based on the committee’s findings, 42 candidates have been debarred from appearing in NEET-UG for three years—2024, 2025, and 2026—while nine others have been barred for two years, covering 2025 and 2026.

In addition, the candidature of 215 candidates remains under review as the investigation continues.

A senior Central Government official said the NMC maintains a zero-tolerance policy toward academic fraud. “Such misconduct compromises the sanctity of the examination process and directly threatens the standards of medical education and public trust,” the official said.

NEET-UG is India’s sole nationwide entrance examination for undergraduate medical programmes and is among the largest in terms of candidates. Allegations of malpractice have plagued the 2024 edition, with reports of question paper leaks leading to arrests in Bihar and raids in Gujarat. The case was subsequently handed over to the CBI.

Further controversy followed the declaration of results on June 4, 2024, when an unprecedented number of top scorers and statistically improbable marks triggered public outcry, legal challenges, and nationwide protests demanding a re-examination.



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WHO defends vaccine safety test standards

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WHO emphasises the “gold standard” process for vaccine development already includes placebo testing for completely new vaccines, but requiring placebo testing for all vaccines, including existing ones adapted for new strains, could be unethical | Image used for representational purpose only
| Photo Credit: File Photo

The World Health Organization (WHO) on Thursday, May 1, 2025, said that “extremely high” safety standards are already applied in the development of vaccines, after reports about plans by the United States for a change to testing.

“We are confident in the assessments that go on around vaccines,” WHO vaccine chief Kate O’Brien told journalists in Geneva. “The safety of vaccines is held to an extremely high standard.” Ms. O’Brien was asked about a Washington Post report Thursday indicating that U.S. Health Secretary Robert F. Kennedy Jr. aims to shift the way vaccines are tested, requiring all new vaccines to undergo placebo testing.

The reported aim would be to increase safety and transparency but medical experts warn such a move could potentially limit access to vaccines and also undermine vaccine confidence. Ms. O’Brien stressed that the “gold standard” process for vaccine development already calls for placebo testing when developing completely new vaccines against diseases for which no immunisation options exist.

But she warned that existing vaccines that are altered to cover new strains for instance, could also be considered new vaccines. In such cases, it could be unethical to give test subjects a placebo — an inert product that does not prevent disease — instead of “vaccines that are life-saving that are already licensed”, she said.

“I think the important part of this is that the quality of clinical trials and safety assessments of those clinical trials are at the heart of what all vaccine development is about,” O’Brien said.

“It’s very important that we not constrain the ability and opportunity to develop better vaccines… The goal is to continue to develop improved vaccines.”

Combatting misinformation and upholding public trust

The WHO warned last week that outbreaks of vaccine-preventable diseases such as measles, meningitis, and yellow fever are on the rise globally amid misinformation and cuts to international aid.

Mr. Kennedy, a vaccine sceptic who has long promoted disproven theories linking childhood vaccines to autism, has also in recent days reportedly made false claims that the measles, mumps and rubella (MMR) vaccine contains “aborted fetus debris”.

“Some of these statements around what is used to produce measles and rubella vaccine, they’re not accurate statements,” Ms. O’Brien said. She urged people with power and influence to help boost confidence in the safety, efficacy and importance of vaccines, which have saved more than 150 million lives in the past five decades, according to the WHO.

“It really is the trust of communities, of people in communities, that forms the impact of vaccines,” she said.



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Are you there God? It’s me, perimenopausal Menaka

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Perimenopause is clearly having its moment now, and long may it last. More and more women are talking about their symptoms, experiences, and how they’re charting a way forward.
| Photo Credit: Getty Images

Last week, I asked Google if itchy breasts were the result of wearing a poor quality bra, or perimenopause. Then I conducted an in-depth investigation into the ties between falling hair and falling estrogen levels. On Reddit.

Soon after, ChatGPT and I had a tete-a-tete about poor memory. Was I struggling to remember someone’s name because I wasn’t paying attention when we were introduced, or because of perimenopause?

‘Honestly, it could be either or neither!’ the chatbot responded. Very helpful.

I find myself asking the internet a lot of questions about perimenopause. It started last year, while working on a project that touched upon menstrual and menopausal health in the workplace. While the women on the team took great pleasure in schooling the men about menstruation, we quickly realised how woefully inadequate our own knowledge around menopause was.

And so, down a terrifying rabbit hole I went, reading about everything I could find that was menopause related: from brain fog and anxiety, to vaginal dryness and night sweats of biblical flood proportions. It seemed as if any and all horrific things a woman might experience with regards to her physical or mental health post the age of 35 might be because of menopause. Or, as the chatbot told me—it might not.

When All Fours blew up group texts

It was around the same time that I read Miranda July’s All Fours. Shortlisted for the Women’s Prize in fiction this year, The New York Times called it “the first great perimenopause novel”. It was being hotly discussed among select groups of urban women in their 40s back then, thanks to a newfound ease about sharing midlife experiences. The book’s protagonist is a 45-year-old artist who abandons her plans to drive from LA to New York solo soon after embarking on the trip, only to check into a motel room not far from her own home.

Miranda July’s All Fours.

In the first part of the book, she transforms the room into a jewel-like sanctuary, and then begins an affair with the decorator’s husband, a younger man who has dreams of becoming a dancer while working at the local Hertz rental. The novel is tender, deliciously dirty, and outrageously funny, raising questions around desire, libido, longing and freedom that were at times uncomfortable and at others, felt like a clarion call. But it was the second half that stayed with me, where the protagonist’s female friends shared their own experiences around perimenopause.

These were lived experiences that July herself gathered while writing the book. It echoed many of the women’s stories I’d read online on discussion forums. There was a real sense of pain, shame, anger, and often bafflement underpinning their experiences. ‘Why did no one warn me this was coming?’ many of them asked.

Midlife Margaret

Perimenopause is clearly having its moment now, and long may it last. More and more women are talking about their symptoms, experiences, and how they’re charting a way forward. And while there’s a slew of recently published books on dealing with menopause, the one that I’d like to read, would be a sequel to Judy Blume’s Are You There God? It’s Me, Margaret. Just as dear Margaret helped a pre-teen me find a safe space to grapple with topics like periods and bras, I’m sure her 43-year-old self is the right medium to comprehend just why my body feels like it’s on fire every now and then.

Judy Blume’s Are You There God? It’s Me, Margaret

But since the likelihood of this is low, my Instagram feed is standing in as an often highly unreliable source of information. I do not recommend this unless you’re willing to wade through reels in which women dance, work out and chug protein shakes while offering up a certain kind of perimenopause related-content: seven top tips to stop night sweats, five supplements to ease perimenopause, the single exercise you need to do to lose weight and build muscle, why Japanese women have less pronounced perimenopausal symptoms and how you can copy them. Wait, is that cultural appropriation? Hang ne a second while I ask Google.

The writer is a children’s book author and columnist based in Bengaluru.



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