A meta-analysis of 45 Indian studies found 56% of adolescents aged 10-19 have nutritional anaemia, with girls affected at nearly twice the rate of boys . Iron deficiency, low socioeconomic status, and poor dietary diversity are the primary drivers, while current supplementation approaches remain inadequate.
Nutritional anaemia among Indian adolescents is not a niche health problem. This systematic review, which analyzed 45 separate studies covering nearly 160,000 adolescents across diverse Indian regions, documents a public health crisis affecting the majority of young people during critical years of physical growth and cognitive development.
The headline number is stark: 56% pooled prevalence overall. But the breakdown reveals a sharp gender divide. Girls experience anaemia at 62% prevalence compared to 39% in boys, a gap largely attributable to menstrual blood loss in addition to dietary factors. Geography matters too. States like Bihar and Uttar Pradesh show particularly high rates, pointing to regional variation in nutritional status, dietary patterns, and healthcare access.
The causal picture is multifactorial. Iron deficiency emerged as the strongest single predictor, with odds ratios ranging from 2.38 to 4.68 depending on the study. But iron deficiency alone doesn't explain the full picture. The meta-analysis identified additional micronutrient deficiencies (likely vitamin-b6, folate, and vitamin-a based on Indian epidemiology), low socioeconomic status, and poor dietary diversity as consistent risk factors. Inadequate supplementation coverage, despite existing national programs, represents a critical implementation gap.
The pattern suggests that while India has established adolescent supplementation initiatives, they reach insufficient populations, maintain poor adherence, or fail to address the full spectrum of micronutrient needs. The data support the authors' conclusion that one-size-fits-all approaches are unlikely to work across India's diverse regions and dietary contexts.
If you are an adolescent in India or a caregiver for one: This prevalence suggests anaemia screening should be routine, not exceptional. Beyond formal supplementation programs, dietary diversity becomes critical. Access to iron-rich foods (legumes, dark leafy greens, fortified grains) alongside vitamin C sources to enhance iron absorption is foundational. Protein at every meal helps ensure adequate micronutrient intake overall.
If you work in public health or nutrition policy: The 56% figure represents a failure of current interventions at scale. The data point toward need for tailored supplementation based on regional dietary patterns, not centralized one-size-fits-all protocols. Addressing socioeconomic barriers to food access likely matters as much as supplementation itself.
If you are a researcher: The heterogeneity by state and gender suggests future work should investigate specific regional dietary gaps, cultural factors affecting supplement adherence, and whether multi-micronutrient formulations outperform iron-only approaches in these populations.
The study provides no evidence that supplementation alone, without addressing dietary diversity and socioeconomic factors, will substantially move the needle on prevalence.
| Detail | Information |
|---|---|
| Study type | Systematic review with meta-analysis of prevalence |
| Sample size | 45 studies; 159,979 adolescents analyzed |
| Population | Indian adolescents aged 10-19 years |
| Primary outcome | Pooled prevalence of nutritional anaemia |
| Pooled prevalence overall | 56% (95% CI: 49%-63%) |
| Prevalence in girls | 62% |
| Prevalence in boys | 39% |
| Key risk factors | Iron deficiency (OR 2.38-4.68), micronutrient deficiencies, low SES, poor dietary diversity, female gender, inadequate supplementation |
| High-burden states | Bihar, Uttar Pradesh, Punjab |
| Quality assessment | Modified Newcastle-Ottawa Scale |
| Journal | Annals of Medicine |
| Published | 2025 |
| PubMed ID | 42610344 |
1. Study: Prevalence and risk factors of nutritional anaemia among adolescents in India: a systematic review with meta-analysis of prevalence. Annals of Medicine. https://pubmed.ncbi.nlm.nih.gov/42610344/
ProtocolEngine provides general health information based on published research. This is not medical advice. Consult a healthcare professional before starting any supplement or health protocol.