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IJE Advance Access originally published online on January 22, 2007
International Journal of Epidemiology 2007 36(2):449-457; doi:10.1093/ije/dyl306
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2007; all rights reserved.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

Trends of under- and overweight among rural and urban poor women indicate the double burden of malnutrition in Bangladesh

Sohana Shafique1,*, Nasima Akhter1, Gudrun Stallkamp1, Saskia de Pee2, Dora Panagides3 and Martin W Bloem4

1Helen Keller International, Gulshan, Dhaka, Bangladesh.
2Helen Keller International, Asia-Pacific Regional Office, Singapore.
3Helen Keller International, Harare, Zimbabwe.
4World Food Programme, Rome, Italy and Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

* Corresponding author. Helen Keller International, PO Box 6066, Gulshan, Dhaka-1212, Bangladesh. E-mail: sohana{at}hkidhaka.org


  Abstract

Background Although undernutrition and communicable diseases dominate the current disease burden in resource-poor countries, the prevalence of diet related chronic diseases is increasing. This paper explores current trends of under- and overweight in Bangladeshi women.

Method Nationally representative data on reproductive age women from rural Bangladesh (n = 2 42 433) and selected urban poor areas (n = 39 749) collected by the Nutritional Surveillance Project during 2000–2004 were analyzed.

Results While the prevalence of chronic energy deficiency [CED, body mass index (BMI) < 18.5 kg/m2] continues to be major nutritional problem among Bangladeshi women (38.8% rural, 29.7% urban poor; P < 0.001), between 2000–2004, 9.1% of urban poor and 4.1% of rural women were overweight (BMI ≥ 25 kg/m2, P < 0.001). In addition, 9.8% of urban poor and 5.5% of rural women were found to be ‘at risk of overweight’ (BMI 23.0–<25 kg/m2). From 2000 to 2004, prevalence of CED decreased (urban poor: 33.8–29.3%; rural: 42.6–36.6%), while prevalence of overweight increased (urban poor: 6.8–9.1%; rural: 2.8–5.5%). The risk of being overweight was higher among women who were older and of higher socioeconomic status. Rural women with at least 14 years of education had a 8.1-fold increased risk of being overweight compared with non-educated women [95% confidence intervals (CI): 6.6–8.7]. Women living in houses of at least 1000 sqft (93 m2) were 3.7 times more likely to be overweight compared with women living in <250 sqft (23 m2) houses (95% CI: 3.2–4.3).

Conclusion The recent increase in overweight prevalence among both urban poor and rural women, along with high prevalence of CED, indicates the emergence of a double burden of malnutrition in Bangladesh.

Keywords Anthropometry, chronic energy deficiency, developing countries, overweight, socioeconomic status

Accepted 15 December 2006


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