Respiratory and Enteric Infections Department, Infectious Disease Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
Centre for Non-Communicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Mohakhali, Dhaka, Bangladesh.
BMJ Open. 2020 Feb 4;10(2):e034321. doi: 10.1136/bmjopen-2019-034321.
This study aimed to investigate the differences in prevalence and factors influencing underweight and overweight/obesity stratified by region of residence among women of reproductive age in Bangladesh.
Secondary analysis of cross-sectional nationwide data.
This study used Bangladesh Demographic and Health Survey 2014 data.
A weighted sample of 16 478 women of reproductive age (15-49 years) were included in the analysis.
Using the Asian-specific cut-off for body mass index, the primary outcome of this study was categorised as: underweight (<18.5 kg/m), normal weight (18.5 to <23.0) kg/m and overweight/obese (≥23.0 kg/m) stratified according to rural-urban residence.
More than half of urban women (53%, n=2493) and one-third of rural women (33%, n=3968) were found to be overweight/obese. Around one-fifth of rural women (21%, n=2490) and almost one in eight urban women (12%, n=571) were reported as underweight. In the final multivariable analyses, increasing age, higher educational status and higher order wealth quintile, each had a significant positive association with being overweight/obese and an inverse association with being underweight. Urban unmarried women had lower odds of being overweight/obese compared with their married counterparts. Rural women who used contraceptives had significantly decreased odds (adjusted OR (AOR) 0.8, 95% CI 0.7 to 0.9) of being underweight compared with contraceptive non-users; no such association was noted in urban women. Women from Sylhet division in both urban (AOR 1.7, 95% CI 1.2 to 2.5) and rural regions (AOR 1.5, 95% CI 1.2 to 1.8) had increased odds of being underweight compared with women in Barisal division.
This study found association of multiple factors with both overweight/obesity and underweight among Bangladeshi women of reproductive age. Public health programmes in Bangladesh aiming to prevent the double burden of malnutrition should focus these factors through comprehensive public awareness and cost-effective operational health interventions.
本研究旨在探讨按居住地区分层的孟加拉国育龄妇女中，体重不足和超重/肥胖的流行情况及其影响因素的差异。
横断面全国数据的二次分析。
本研究使用了孟加拉国 2014 年人口与健康调查的数据。
纳入分析的是一个经过加权的 16478 名育龄妇女（15-49 岁）的样本。
使用亚洲特定的体重指数切点，本研究的主要结果被分类为：体重不足（<18.5kg/m）、正常体重（18.5 至<23.0kg/m）和超重/肥胖（≥23.0kg/m），按城乡居住情况分层。
超过一半的城市妇女（53%，n=2493）和三分之一的农村妇女（33%，n=3968）超重/肥胖。约五分之一的农村妇女（21%，n=2490）和近八分之一的城市妇女（12%，n=571）体重不足。在最终的多变量分析中，年龄增长、更高的教育程度和更高的财富五分位数，都与超重/肥胖呈显著正相关，与体重不足呈负相关。与已婚妇女相比，城市未婚妇女超重/肥胖的可能性较低。与未使用避孕药具的妇女相比，农村使用避孕药具的妇女体重不足的可能性显著降低（调整后的比值比（AOR）0.8，95%置信区间 0.7 至 0.9）；而城市妇女则没有这种关联。与巴里萨尔地区的妇女相比，城市（AOR 1.7，95%置信区间 1.2 至 2.5）和农村（AOR 1.5，95%置信区间 1.2 至 1.8）的锡尔赫特地区的妇女体重不足的可能性增加。
本研究发现，孟加拉国育龄妇女的超重/肥胖和体重不足与多种因素有关。旨在预防营养不良双重负担的孟加拉国公共卫生计划应通过全面的公众意识和具有成本效益的运营卫生干预措施，关注这些因素。
