Nearly 40 per cent of all children in India are stunted - of extremely low height for their age - and nearly 30 per cent are underweight, researchers said.
The study from Harvard T H Chan School of Public Health has now pinpointed the five top risk factors responsible for more than two-thirds of the problem.
The study is the first to comprehensively analyses and estimate the relative importance of known risk factors for child under nutrition.
Examining an array of 15 well-known risk factors for chronic under nutrition among children in India, the study found that the five top risk factors were essentially markers of poor socioeconomic conditions as well as poor and insecure nutritional environments in children's households.
Using data on nearly 29,000 children aged 6-59 months from the 3rd India National Family Health Survey, conducted in 2005-06, the researchers found that the five most important predictors of childhood stunting and underweight were short maternal stature, a mother with no education, extreme poverty, poor dietary diversity and maternal underweight.
Meanwhile, factors such as Vitamin A, breastfeeding, use of iodised salt, improved water and sanitation, and even immunisation - all currently high priority interventions in the global discourse on addressing under nutrition - accounted for less than 15 per cent of the cases of under nutrition.
"There is an immediate need to not waste time and resources on short-term and 'doable' interventions," said study senior author S V Subramanian, professor of population health and geography.
"While asking people to change behaviours and offering piecemeal solutions might provide some short-term relief, such strategies cannot be substituted for the urgent need to improve food and livelihood security," Mr Subramanian said.
The study was published in the journal Social Science and Medicine.
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