Kamal S M Mostafa
Department of Mathematics, Islamic University, Kushtia, Bangladesh.
J Biosoc Sci. 2021 May 17:1-22. doi: 10.1017/S0021932021000195.
The co-existence of under- and overweight at population level around the globe is well documented. However, this has yet to be explored using suitable statistical techniques in the context of Bangladesh. This study aimed to examine the prevalence and risk factors for being underweight and overweight or obese compared with normal weight in ever-married non-pregnant women aged 15-49 years in Bangladesh using data from the most recent Bangladesh Demographic and Health Survey conducted in 2014. Multilevel multinomial logistic regression (MLMLR) and quantile regression models were fitted to examine the associations of socioeconomic and individual-, household- and community-level factors on the nutritional status of women as measured by BMI. Overall, the prevalences of underweight, normal weight, overweight and obese women were 19%, 58%, 19% and 4%, respectively, in 2014. The MLMLR analysis revealed that women of young age, widowed/divorced/separated, having a larger family size and children aged ≤5 years in the household, currently amenorrhoeic and members of non-government organizations were at significantly increased risk of being underweight; those of older age, having higher parity, more educated, frequently watched TV and non-poor were more likely to be overweight or obese relative to normal BMI. Women from more affluent communities and urban areas were more likely to be overweight or obese relative to normal BMI than their counterparts from less-affluent and rural communities. Women's nutritional status was found to be heterogeneous across the regions of the country. The findings indicate that, along with individual-level factors, community-level characteristics are also important in explaining women's BMI in Bangladesh. The issue of under- and overweight or obesity among women in Bangladesh requires the immediate adoption of a public health policy for its mitigation. When developing intervention programmes, important determinants and uniform development of regions should be taken into consideration to combat the dual burden of under- and overweight among women in Bangladesh.
全球人口层面存在体重过轻与超重并存的情况，这已有充分记录。然而，在孟加拉国的背景下，尚未使用合适的统计技术对此进行探究。本研究旨在利用2014年进行的最新孟加拉国人口与健康调查的数据，研究孟加拉国15 - 49岁曾婚未孕女性中体重过轻、超重或肥胖与正常体重相比的患病率及风险因素。采用多水平多项逻辑回归（MLMLR）和分位数回归模型来研究社会经济因素以及个体、家庭和社区层面的因素与通过体重指数（BMI）衡量的女性营养状况之间的关联。总体而言，2014年体重过轻、正常体重、超重和肥胖女性的患病率分别为19%、58%、19%和4%。MLMLR分析显示，年龄较小、丧偶/离异/分居、家庭规模较大且家中有5岁及以下儿童、目前闭经以及是非政府组织成员的女性体重过轻的风险显著增加；年龄较大、生育次数较多、受教育程度较高、经常看电视且非贫困的女性相对于正常BMI更有可能超重或肥胖。相对于来自较贫困和农村社区的女性，来自更富裕社区和城市地区的女性相对于正常BMI更有可能超重或肥胖。该国不同地区的女性营养状况存在差异。研究结果表明，除了个体层面的因素外，社区层面的特征在解释孟加拉国女性的BMI方面也很重要。孟加拉国女性体重过轻和超重或肥胖的问题需要立即采取公共卫生政策来缓解。在制定干预计划时，应考虑重要决定因素和地区的均衡发展，以应对孟加拉国女性体重过轻和超重的双重负担。
