Double burden of malnutrition at household level: A comparative study among Bangladesh, Nepal, Pakistan, and Myanmar

Anik, Asibul Islam; Rahman, Md. Mizanoor; Rahman, Md. Mostafizur; Tareque, Md. Ismail; Khan, Nuruzzaman; Alam, Md. Mahmudul

doi:10.1371/journal.pone.0221274

Cited by 62 publications

(88 citation statements)

References 54 publications

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“…Thereby, such high-risk group populations are more prone to face detrimental health issues compared with men 18. Regional territories also reported similar vulnerability to these reproductive aged group women indicating the prime need to reflect on this nutritional health problem 19–21…”

Section: Introductionmentioning

confidence: 99%

Differences in prevalence and associated factors of underweight and overweight/obesity according to rural–urban residence strata among women of reproductive age in Bangladesh: evidence from a cross-sectional national survey

et al. 2020

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ObjectivesThis 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.DesignSecondary analysis of cross-sectional nationwide data.SettingThis study used Bangladesh Demographic and Health Survey 2014 data.ParticipantsA weighted sample of 16 478 women of reproductive age (15–49 years) were included in the analysis.Primary and secondary outcome measuresUsing the Asian-specific cut-off for body mass index, the primary outcome of this study was categorised as: underweight (<18.5 kg/m2), normal weight (18.5 to <23.0) kg/m2and overweight/obese (≥23.0 kg/m2) stratified according to rural–urban residence.ResultsMore 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.ConclusionsThis 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.

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Section: Introductionmentioning

confidence: 99%

Differences in prevalence and associated factors of underweight and overweight/obesity according to rural–urban residence strata among women of reproductive age in Bangladesh: evidence from a cross-sectional national survey

et al. 2020

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“…With about one-quarter of the global population, South Asia is both the most populous and the most densely populated region in the world. All the eight countries (Afghanistan, Bhutan, Bangladesh, India, Nepal, Maldives, Pakistan and Sri Lanka) that make up the region experience high rates of poverty, food insecurity and malnutrition, with child malnutrition being one of the most persistent public health challenges across the region (Akhtar 2016;Anik et al 2019;Swaminathan et al 2019;Wali et al 2019). In fact, South Asia has been known as the global hotspot for malnutrition with the highest number of stunted, wasted and underweight children in the world (Harding et al 2018;Khan et al 2019).…”

Section: Introductionmentioning

confidence: 99%

Overweight and obesity among under-five children in South Asia

Bishwajit

Yaya

2020

Child and Adolescent Obesity

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In parallel with high prevalence of undernutrition, the low-middle-income countries like those in South Asia are experiencing an increasing burden of overweight and obesity among under-five children. The present study aims to measure the prevalence of overweight and obesity and their sociodemographic correlates among under-five children in selected South Asian countries. Methods: Cross-sectional data on 132,231 mother-child pairs were extracted from Demographic and Health Surveys conducted in Bangladesh (2014), India -16), Maldives (2016-17), Nepal (2016 and Pakistan (2017-18). Singleton children aged 6 to 59 months regardless of breastfeeding status were included in the analysis. Childhood overweight (>2 SD) and obesity (>3 SD) were measured by BMI z-Scores using WHO guidelines for reference population. Generalised linear models (binomial family) were used to analyse the risk ratios of having overweight/obesity. Results: The overall prevalence of overweight and obese children was 1.91% and 0.89%, respectively, with the prevalence being highest in Maldives (3.9% and 1.5%, respectively) and lowest in Nepal (1.2% and 0.2%, respectively). Child's dietary diversity, maternal BMI and education, and household wealth status were significantly associated with childhood overweight/obesity. Having adequate dietary diversity increased the risk of overweight/obesity by 27% [RR = 1.27, 95%CI = 1.13,1.42]. Children whose mothers had normal [RR = 1.81, 95%CI = 1.62,2.03], overweight [RR = 1.99, 95%CI = 1.71,2.31] and obesity [RR = 1.88, 95%CI = 1.48,2.40] had higher risks of having overweight/ obesity. Children from households that ranked higher in the wealth quintile also had a higher risk of having overweight/obesity. Conclusion:The prevalence of overweight and obesity among under-five children in South Asian countries is relatively low compared with that in high-income countries. There exists important sociodemographic pattern in the distribution of childhood overweight/obesity across the countries, signifying the role of sociocultural factors in the epidemiology of overnutrition in this population.

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“…In addition, overweight or obesity of women of reproductive age (defined by a BMI ≥ 25 kg/m 2 ) is on the rise from 20•2 % in 1999 to 35•1 % in 2015 (17) . Despite a growing number of studies on DBMN in LMIC, to the best of the author's knowledge, only one study in Myanmar has investigated the national prevalence (5•54 %) of a stunted child with an overweight/obese mother (19) . The study defined maternal overweight or obesity as a BMI ≥ 25 kg/m 2 , as in other studies in the Southeast Asia region (5,9,(19)(20)(21)(22)(23) .…”

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confidence: 99%

Prevalence and regional variations of coexistence of child stunting and maternal overweight or obesity in Myanmar

Hong

2020

Public Health Nutr.

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Objective: The current study aimed to investigate double burden of malnutrition within households at the national and subnational levels and to identify its association with sociodemographic factors in Myanmar. Design: All the variables were extracted from children’s file of the Myanmar Demographic and Health Survey 2015–2016. Children under five were identified as stunted based on a height-for-age < −2 sd below the WHO reference median. Maternal overweight/obesity was defined as a BMI ≥ 23 kg/m2. A stunted child with an overweight/obese mother (SCOM) was classified as a double-burden household. Setting: A national household survey in Myanmar. Participants: Children under five and their mothers (n 3954 pairs). Results: Mean ages of children and mothers were 29 (se 0·14) months and 30·9 (se 0·32) years, respectively. National prevalence of childhood stunting and maternal overweight/obesity was 28·0 % and 39·4 %, respectively, and the prevalence of SCOM was 9·1 %. Significant regional differences were found in SCOM, ranging from 3·6 % in Naypyitaw to 12 % in Kachin and Mon and 14·6 % in Kayah. In the multinomial logistic regression analysis, relative to neither a stunted child nor an overweight/obese mother, child’s age, maternal age, maternal experience of a teen birth, short mothers, mothers with primary education and in middle or rich wealth tertiles, and some regions (Kachin, Kayah, Shan, Sagaing, Taninthayi, Ayeyarwaddy, Mon and Yangon) were associated with greater odds of SCOM. Conclusions: The current study showed a relatively high national prevalence of SCOM and significant regional variations. Overarching policies and programmes with culturally sensitive strategies need to be formulated and implemented.

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Double burden of malnutrition at household level: A comparative study among Bangladesh, Nepal, Pakistan, and Myanmar

Cited by 62 publications

References 54 publications

Differences in prevalence and associated factors of underweight and overweight/obesity according to rural–urban residence strata among women of reproductive age in Bangladesh: evidence from a cross-sectional national survey

Differences in prevalence and associated factors of underweight and overweight/obesity according to rural–urban residence strata among women of reproductive age in Bangladesh: evidence from a cross-sectional national survey

Overweight and obesity among under-five children in South Asia

Prevalence and regional variations of coexistence of child stunting and maternal overweight or obesity in Myanmar

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