Rural and Urban dichotomy in body mass index among children of Tamil Nadu, India

Background: Optimal nutritional conditions during early childhood are vital for growth, cognitive development, and enduring health status. The Body Mass Index (BMI) is one of the tools used to measure overall health status, including physiological and nutritional aspects. In regions undergoing dietary and lifestyle changes, the dual burden of malnutrition, undernutrition, and overweight pose significant public health challenges. Objectives: This present study assessed and compared the Body Mass Index-based physiological and nutritional health status among children aged 2–6 years in two demographically distinct areas: rural Udayarpalayam Taluk and the urban Thanjavur Corporation in Tamil Nadu. Accordingly, the International Obesity Task Force (IOTF) guidelines were used to study and determine age and sex-specific Body Mass Index distributions, as well as the prevalence of thinness and overweight, between rural and urban areas. Methods: A cross-sectional survey was conducted among 2,020 children in rural Udayarpalayam Taluk (985 boys, 1,035 girls) and 1,020 children in Thanjavur Corporation (544 boys, 476 girls). The Body Mass Index was estimated and categorised into thinness (Grades I–III), normal, and overweight. Descriptive statistics and Karl Pearson correlation techniques were used to analyse and compare the trends of rural and urban cohorts by age and sex. Results: Therefore, a clear dual burden of malnutrition was observed. Rural children in Udayarpalayam Taluk showed higher rates of severe thinness, particularly 5-year-old boys (33.91%) and 6-year-old girls (27.51%). In Thanjavur, urban children were found to have a higher rate of overweight health conditions, particularly among 2-year-old girls, where 25.9% were affected. Girls living in urban areas of this region also displayed higher normal Body Mass Index (BMI) levels compared to those in rural areas. Conclusion: The findings revealed differences in nutritional and physiological health status between children living in rural and urban settings. These results emphasise the necessity for tailored interventions aimed at tackling both undernutrition and emerging overweight issues in early childhood.