title: Dual burden of underweight and overweight among women in Bangladesh: patterns, prevalence, and sociodemographic correlates.
abstract: The discourse of dual burden caused through underweight and overweight is well-documented globally but this issue and its connection with women's health in Bangladesh is yet to be explored widely. To enrich the current debate, this study, in the context of Bangladesh, examines the patterns, prevalence, and socioeconomic factors influencing the ever-married women of being underweight and overweight over normal weight. Data used in this study have been extracted from the most recent 2011 Bangladesh Demographic and Health Survey. To achieve results connected with the research objectives, both bivariate and multivariate statistical analyses have been employed. In bivariate analysis, we used seven categories of BMI cutoff points for Asian countries as prescribed by World Health Organization (WHO). Multinomial logistic regression model was constructed to investigate the net effect of socioeconomic factors on underweight, pre-overweight, and overweight over normal weight. The results confirm the co-existence of underweight and overweight among women as we found the prevalence of underweight, normal weight, pre-overweight, overweight, and obesity to be 24.1%, 46.7%, 12.8%, 13.5%, and 2.9% respectively. Compared to the richest, the women from the poorest households were significantly (p<0.001) most likely to be underweight (OR=2.75, 95% CI 2.27-3.35) and least likely to be overweight (OR=0.15, 95% CI 0.12-0.19) over normal weight. The urban women, compared to their rural counterparts, were significantly (p<0.001) less likely to be underweight (OR=0.80, 95% CI 0.71-0.91) and more likely to be overweight (OR=1.33, 95% CI 1.18-1.51) than normal weight. The other socioeconomic grades that were most marked to be underweight and overweight are age, women's education, marital status, age at first childbirth, parity, number of children aged ≤ 5 years at the household, and food security. The findings confirm the dual burden of both under- and overweight. Systematic and regular monitoring and surveillance of the social trajectory of nutritional status of women and men in Bangladesh is crucial to develop opposite strategy that addresses the persistent and chronic problem of underweight and the emerging problem of overweight. The dual existence of both types of malnutrition among women in Bangladesh must be taken into consideration so that public health interventions may be adopted through appropriate policy.
authors.affiliation: Department of Mathematics, Islamic University, Kushtia 7003, Bangladesh and Visiting Research Fellow, Unit for the Enhancement of Academic Performance, University of Malaya, 50603 Kuala Lumpur, Malaysia.
authors.forename: S M Mostafa
authors.initials: SM
authors.lastname: Kamal
authors.affiliation: Unit for the Enhancement of Academic Performance, University of Malaya, 50603 Kuala Lumpur, Malaysia.
authors.forename: Che Hashim
authors.initials: CH
authors.lastname: Hassan
authors.affiliation: Unit for the Enhancement of Academic Performance, University of Malaya, 50603 Kuala Lumpur, Malaysia.
authors.forename: Gazi Mahabubul
authors.initials: GM
authors.lastname: Alam
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013851:Thinness / Q000453:epidemiology*; D055815:Young Adult
keywords: Bangladesh; Dual burden; Malnutrition; Overweight; Underweight