Low dietary intake, repeated pregnancy and lactation and infections were major factors responsible for under-nutrition and anaemia in women. Under-nutrition and anaemia in pregnant women is a major factor responsible for low birth weight of the offspring. In the new century under-nutrition and anaemia continue to be major nutrition problems; in addition there has been progressive rise in over nutrition in women in all segments of the population both in urban and in rural areas. The rise in over-nutrition is associated with increase in the prevalence of non-communicable diseases. This article reviews the problem of triple burden of malnutrition (under-nutrition, over-nutrition and anaemia) in women and health hazards associated with these.

Dietary Intake in Women:

In the existing scenario, there is a need to increase the pulse and vegetable intake so that the protein and micro-nutrient requirements of women are met.

Physical Activity:

Research studies in urban areas and surveys carried out by National Nutrition Monitoring Bureau (NNMB) in rural areas showed that, by the mid-1990s a majority of Indian women had become sedentary. There is an urgent need to ensure that all women do undertake moderate physical activity.

Economic Growth and Energy Consumption:

Between the years 1990 and 1990, the Indian economy grew relatively slowly. In the new century, India became one of the fastest-growing economies in the world. Global experience has shown that when developing countries experience rapid economic growth, there is an increase in total energy intake and consumption of animal foods. This did not happen in India National Sample Survey Organisation showed that the higher GDP growth and rise in per capita incomes in the last three decades was associated with a progressive reduction in per capita energy intake in both urban and rural areas. It is believed that there is a possibility of perceptive Indians having realised the steep decrease in their physical activity and therefore voluntarily reduced the energy intake.

Nutritional Status of Women:

National Nutrition Monitoring Bureau (NNMB) repeat rural surveys showed that, between 1975 and 2012, there was a reduction in under-nutrition from 52 per cent to 33 per cent in women. Over the same period, the prevalence of over-nutrition increased from 3 to 16 per cent in women. It Is a matter of concern that the reduction in under-nutrition was matched by the rise in over-nutrition, and so the proportion of normally-nourished persons remained unchanged at around 60 per cent.

Over-nutrition:

Over-nutrition is associated with increased risk of non-communicable disease (NCDs) such as hypertension and diabetes. In view of this prevention, early detection and effective management of over-nutrition are of paramount important. It is, therefore, essential to ensure that women do seek periodic health check-ups. Health education to women clearly informing them that undue weight gain is harmful and it is essential to seek periodic check-up for early detection and effective management of non-communicable diseases has to be done using all modes, of communication.

Anaemia in Women:

Indian women have and continue to have the highest prevalence of anaemia in the world. India, the prevalence of anaemia is high because of:

• Low overall dietary intake, poor iron and folic acid intake
• Poor bio-availability of iron in the phytate fibre-rich Indian diet resulting in widespread iron and folic acid deficiencies
• Chronic blood loss due to infections such as malaria and took worm infestations.

In India, anaemia begins right from infancy, continues into childhood, increases in severity during adolescence in girls, and gets aggravated during pregnancy and among the elderly. The prevalence of anaemia is high not only among under-nourished persons but also in normal and over-nourished individuals. There is an urgent need to use all available interventions to accelerate the pace of reduction prevalence of anaemia. The three-pronged strategy will accelerate the pace of reduction in anaemia and enable the country to achieve the SDG target for reduction in anaemia

• Increasing iron intake of all persons of the household through dietary diversification and use of iron-fortified iodized salt
• Iron and folic acid supplementation to women
• Testing for, detecting and treating anaemia as and when women access health care for any reason.

Efforts to undertake screen for under-nutrition, over-nutrition, anaemia and NCDs in women as an essential component of preventive health care at all levels, will go a long way in accelerating the pace of women becoming healthy and well nourished. They will then be able to bring about improvement in health and nutritional status of households. The country can benefit from women fulfilling their role as agents of national development.