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


METHODS
Nationally representative data on reproductive age women from rural Bangladesh (n = 242,433) 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/m(2)] 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 > or = 25 kg/m(2), 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/m(2)). 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 sq ft (93 m(2)) were 3.7 times more likely to be overweight compared with women living in <250 sq ft (23 m(2)) houses (95% CI: 3.2-4.3).


CONCLUSIONS
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.
Shafique
Sohana
S
Helen Keller International, Gulshan, Dhaka, Bangladesh. sohana@hkidhaka.org
Akhter
Nasima
N
Stallkamp
Gudrun
G
de Pee
Saskia
S
Panagides
Dora
D
Bloem
Martin W
MW
D000293:Adolescent; D000328:Adult; D000886:Anthropometry / Q000379:methods; D001459:Bangladesh / Q000453:epidemiology / Q000208:ethnology; D015992:Body Mass Index; D004522:Educational Status; D005260:Female; D006801:Humans; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D050177:Overweight; D015995:Prevalence; D012423:Rural Health / Q000592:standards / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013851:Thinness; D014504:Urban Health / Q000592:standards / Q000706:statistics & numerical data