Anthropology of Undernutrition Among Indian Tribal Adults: A Comprehensive Review

ABSTRACT: This review aimed to synthesize evidence from 2010–2024 on the nutritional status of adult tribal populations in India, with a focus on Chronic Energy Deficiency (CED) as assessed by Body Mass Index (BMI). Given the persistent health disparities among India’s Scheduled Tribes (STs), the study sought to examine geographic patterns, sex differentials, and contextual determinants of undernutrition across major tribal regions of the country. A systematic literature search was conducted using Google Scholar, PubMed, and JSTOR to identify peer-reviewed studies on adult tribal nutrition in India published between 2010 and 2024. National datasets—including the Census of India (2011) and the National Family Health Survey (NFHS-5, 2019–2021)—were used to provide demographic and health context. Eligible studies reported BMI-based nutritional assessments using the WHO (1995) BMI classification (CED defined as BMI < 18.5 kg/m²). Forty-four studies met the inclusion criteria. Extracted data were summarized by region, tribe, sex, and CED prevalence. The review reveals pronounced regional and sex‑based disparities in CED among tribal adults. Northern and Northeastern tribal groups exhibited highly variable CED levels, ranging from very low in the Apatani (≤2%) to extremely high among Gujjar and Bakerwal women (90.7%). Eastern India showed consistently elevated CED, particularly among the Bhumij, Lodha, Kheria, and Santal tribes, with female CED often exceeding 50%. Central and Western tribes—including the Gonds, Kharwar, Mawasi, and Tadvi—displayed widespread undernutrition driven by food insecurity, poverty, and limited healthcare access. Southern India showed critical CED prevalence among Jenu Kuruba and Koraga adults (>90%), while island populations such as the Shompens exhibited low CED but high anaemia burdens. NFHS-5 corroborated these findings, indicating serious national-level CED prevalence among ST adults (18.4% in men, 25.5% in women). Across regions, coexisting burdens of anaemia, tuberculosis, hemoglobinopathies (e.g., sickle cell disease), leprosy, and vector-borne diseases further compounded poor nutritional status. Adult tribal populations in India experience disproportionately high levels of CED, shaped by intersecting structural and cultural determinants including poverty, geographic isolation, gender inequality, food insecurity, and limited access to health services. The wide regional variability underscores the need for targeted, culturally informed, region-specific nutritional interventions. Strengthening surveillance, improving healthcare accessibility, and promoting community-engaged, bottom-up health strategies are essential for reducing disparities and achieving national commitments to the Sustainable Development Goals, particularly the mandate to “Leave no one behind”.