Changing spectrum of malnutrition in urban cities.

We read with interest the recent study published in [1] regarding persistent levels of undernutrition in city like Chandigarh. The authors have concluded that the prevalence of underweight among under-five year old children remained almost stagnant in the last one decade from 51.6% (1997) to 50.4% (2007). We would like to point out that sampling frame and design of the published study pose limitation in inferencing the prevalence estimates to the whole population of Chandigarh. Their study selectively sampled only one stratum of the society i.e. the children attending the Anganwadis or the nonregistered children staying in close proximity of these Anganwadis. There are nearly 420 Anganwadis in Chandigarh city out of which only 10% of the Anganwadis are located in urban centers whereas rest of the centers are either in rural or slum areas which constitute 40% of total population of Chandigarh. These centers primarily cater to the marginalized populations and study evaluating children in these centers has disproportionately aggravated the overall level of undernutrition in the population of Chandigarh due to sampling and selection bias.