Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh.
Department of Global Health Entrepreneurship, Division of Public Health, Tokyo Medical and Dental University, Tokyo, Japan.
PLoS One. 2019 Jul 25;14(7):e0219968. doi: 10.1371/journal.pone.0219968. eCollection 2019.
The prevalence of overweightness in Bangladesh is increasing, while underweightness also continues to persist. A better understanding of the patterns and socioeconomic risk factors of both conditions, particularly among women, is critical in order to promote the development of interventions to improve maternal health in Bangladesh. This study therefore sought to assess the patterns of under- and overweightness between 2004 and 2014 and to examine the predictors of individual and community-level inequalities of under- and overnutrition in Bangladesh.
Cross-sectional data of 10, 431, and 16,478 ever-married nonpregnant women aged between 15 and 49 years who did not give birth in the two months preceding the survey were extracted from the 2004 and 2014 Bangladesh Demographic and Health Surveys, respectively. Body mass index was used to measure weight status, and underweightness, at-risk for overweightness, overweightness, and obesity were the main outcome variables. Patterns of nutritional change over time was examined by considering the annual average rate of change. Multilevel multinomial logistic regression and quantile regression were used to identify the inequalities.
In 2014, the age-adjusted prevalence values of underweightness, at-risk for overweightness, overweightness, and obesity were 19.7%, 14.9%, 18.1% and 4.0%, respectively. A higher average annual rate of reduction of underweightness was found among wealthier, highly educated, and wealthier community-living women, while a rate of increase of overweightness was found among poorer, uneducated, and poor community-living women. Individual and community-level inequalities of malnutrition were observed among these populations. In comparison with women living in low wealth communities, women from wealthier communities were at an increased risk of being at-risk for overweightness [adjusted odds ratio (AOR): 1.53, 95% confidence interval (CI): 1.23-1.91], overweight (AOR: 1.60, 95% CI: 1.27-2.00), and obese (AOR: 2.12, 95% CI: 1.42-3.18).
This study suggests the coexistence of a double burden of under- and overnutrition in Bangladesh and that the prevalence of overweightness surpasses that of underweightness. The burdens of under- and overnutrition are strongly associated with women's individual socioeconomic positions and the nature of the community in which they live.
孟加拉国超重的患病率在增加，同时消瘦的情况仍在持续。更好地了解这两种情况（尤其是在女性中）的模式和社会经济风险因素，对于促进干预措施的发展以改善孟加拉国的产妇健康至关重要。因此，本研究旨在评估 2004 年至 2014 年期间消瘦和超重的模式，并研究孟加拉国个体和社区营养不良和营养过剩不平等的预测因素。
本研究从 2004 年和 2014 年孟加拉国人口与健康调查中分别提取了 10,431 名和 16,478 名年龄在 15 至 49 岁之间、在调查前两个月内未生育的已婚非孕妇的横断面数据。使用体重指数来衡量体重状况，消瘦、超重风险、超重和肥胖是主要的结果变量。通过考虑年平均变化率来检查随时间的营养变化模式。使用多水平多项逻辑回归和分位数回归来确定不平等现象。
2014 年，消瘦、超重风险、超重和肥胖的年龄调整患病率分别为 19.7%、14.9%、18.1%和 4.0%。在较富裕、受教育程度较高和较富裕社区居住的妇女中，消瘦的平均年下降速度较高，而在较贫穷、未受教育和贫穷社区居住的妇女中，超重的增加速度较高。在这些人群中观察到营养不良的个体和社区水平的不平等。与居住在低财富社区的妇女相比，来自较富裕社区的妇女超重风险增加（调整后的优势比（AOR）：1.53，95%置信区间（CI）：1.23-1.91）、超重（AOR：1.60，95%CI：1.27-2.00）和肥胖（AOR：2.12，95%CI：1.42-3.18）。
本研究表明，孟加拉国同时存在消瘦和营养过剩的双重负担，超重的患病率超过消瘦。消瘦和营养过剩的负担与妇女的个体社会经济地位以及她们所居住社区的性质密切相关。
