Academic journal article Journal of Health Population and Nutrition

Dual Burden of Underweight and Overweight among Women in Bangladesh: Patterns, Prevalence, and Sociodemographic Correlates

Academic journal article Journal of Health Population and Nutrition

Dual Burden of Underweight and Overweight among Women in Bangladesh: Patterns, Prevalence, and Sociodemographic Correlates

Article excerpt


Due to economic situation of developed countries, health concern mainly on overweight receives graver attention. The 'dual burden' of health concern caused through both underweight and overweight is significantly important for public health policy in developing nations to address (1-3). Studies confirm that these days the problem of overweight in developing nations is gradually taking the driving seat superseding the concerns of underweight due to changes of food habit and lifestyle and working culture (1). There is evidence that this increase has been faster in the developing countries (2). The positive relationship between obesity and socioeconomic position in developing countries stood in sharp contrast with the inverse association observed in developed countries where the prevalence of obesity is higher among women from low socioeconomic groups (3).

A landmark review of studies on socioeconomic status and obesity supports the view that obesity in the developing world would be essentially a noncommunicable disease of the socioeconomic elite (2). The problem relating to body mass index (BMI) for both men and women should receive equal attention. However, concerns relating to women in developing countries deserve extra attention because of cultural and economic backdrops, which hinder the blanching between male and female counterparts. An augmented number of literature asserts that an increased BMI of women is independently associated with increasing risk of adverse obstetric and neonatal outcome (4-6). The risks of overweight also include diabetes mellitus, increased risk of cardiovascular disease, cancer, hypertension, and other medical problems (7-16). Besides, a low BMI is often associated with low nutritional status and adverse health outcomes (12), such as preterm birth (17,18), low birthweight (17), mental health impairment (19), increased risk of early mortality (20), and higher risk of infant mortality (14). Early and late stillbirths are also associated with underweight mothers compared to their normal-weight counterparts. Anaemia is also associated with maternal underweight (9). Low pre-pregnancy BMI and short stature of women are known risk factors of poor maternal and birth outcomes. In developing countries, like Bangladesh, maternal underweight is a leading risk factor of preventable death and diseases.

Both lean and obese women carry a risk of adverse pregnancy outcome and overall poor maternal and child health status. Thus, there is growing recognition of a 'double burden' of malnutrition among populations in both affluent and less-affluent countries (21), i.e. the co-existence of undernutrition (e.g. stunting or underweight) with overweight, which has been observed at the national and household levels (22); this suggests the necessity of population-based assessments of the patterns, prevalence, and determinants of underweight and overweight among women of reproductive age. Using BMI as an important indicator of nutritional status, it is our aim to examine the nature of the relation between individual sociodemographic category and nutritional status among married women of Bangladesh and also investigate to what extent the factors influence the women to be underweight and overweight.


Data for this study have been used from the most recent 2011 Bangladesh Demographic and Health Survey (BDHS) (23). A nationally-representative household-based sample was created through a stratified and two-stage cluster-sampling strategy. A uniform sampling design was adopted across all regions with urban and rural samples drawn separately and in proportion to the population of the regions, unless oversampling was required for any region or group. For both urban and rural areas, geographic sampling units were obtained, and random sampling of households was done in chosen units. The survey provides consistent and reliable estimates of fertility, age at first marriage, family planning, utilization of maternal and child healthcare services, nutrition of children and adults, maternal and child health, knowledge and awareness about sexually transmitted diseases (STDs)/sexually transmitted infections (STIs), HIV/AIDS, and other health-related indicators at the national as well as the regional levels. …

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