Prevalence of Nutritional Deficiencies Among Patients Attending a Nutrition Clinic at a Tertiary Care Hospital in Andhra Pradesh, South India: A Retrospective Cross-Sectional Study.

Abstract

Background Nutritional deficiencies persist as a major public health challenge in India alongside a rising non-communicable disease burden. The Center for Nutritional Health at AIIMS Mangalagiri provides comprehensive nutritional services including counseling, anthropometric assessment, and laboratory diagnosis of key deficiencies. We aimed to determine the prevalence of anemia, vitamin D and vitamin B12 deficiencies, and malnutrition (underweight and overweight/obesity); examine gender-based differences in nutritional parameters; identify patterns of multiple concurrent deficiencies; and analyze their age-wise distribution among patients attending the center, to inform targeted intervention strategies. Methodology We conducted a cross-sectional study using retrospective clinical data from 2,303 patients attending the Center for Nutritional Health at AIIMS Mangalagiri over 30 months. Demographic, anthropometric, hemoglobin, 25-hydroxyvitamin D (25(OH)D), vitamin B12, calcium, and 24-hour dietary recall data were obtained from routine clinical records. Deficiencies were defined using World Health Organization (WHO) anemia criteria, standard international vitamin reference ranges, and Asian-specific body mass index (BMI) cutoffs. Analyses included Pearson chi-square, Mann-Whitney U, Spearman rank correlation, and multivariable binary logistic regression. Results Among 2,303 participants (1,681 women (73.0%); mean age, 42.4 ± 13.9 years), anemia affected 1,195 of those tested (74.2%), of whom 764 (47.5%) had moderate-to-severe anemia. Vitamin D deficiency (<20 ng/mL) was present in 658 participants (59.5%), vitamin B12 deficiency in 250 (41.9%), overweight/obesity in 1,240 (78.0%), and underweight in 88 (5.5%). Women had higher odds of anemia (OR, 3.64; 95% CI, 2.83-4.68; P < 0.001) and suboptimal vitamin D status (insufficient/deficient, <30 ng/mL vs. sufficient, ≥30 ng/mL) (OR, 2.11; 95% CI, 1.17-3.81; P = 0.018). Multivariable regression identified female sex (adjusted OR, 1.60; 95% CI, 1.16-2.21; P = 0.004) and younger age (adjusted OR, 0.98 per year; 95% CI, 0.97-0.99; P = 0.001) as independent predictors of vitamin D deficiency (<20 ng/mL). Multiple concurrent deficiencies occurred in 386 (21.4%) patients, most commonly anemia with vitamin D deficiency in 182 (10.1%), with a female-to-male ratio of 3.1:1. Anemia peaked at ages <18 years 52 (81.2%) and 30-44 years 524 (80%); overweight/obesity was highest at 45-59 years, 395 (84.9%) and 30-44 years, 516 (82%). Conclusions This study documents a substantial burden of anemia, vitamin D and B12 deficiencies, and overweight/obesity among patients at a specialized primary-care nutrition center in South India, with women aged 30-44 years carrying the peak micronutrient-deficiency burden and adults aged 18-29 years representing the critical obesity-prevention window. Four key primary-care actions are needed: replacing indication-driven testing with a bundled baseline panel that includes hemoglobin, 25(OH)D, vitamin B12, and an Asian-specific BMI cutoff; prioritizing women aged 30 to 44 years for protocolized iron-folic acid and vitamin B12 supplementation with serum-guided vitamin D therapy instead of empirical treatment; providing structured lifestyle counseling to adults aged 18 to 29 years; and expanding food fortification efforts while integrating the center model into Ayushman Bharat Health and Wellness Centers to embed comprehensive nutritional care into routine primary care.