Nutritional transition among women in Bangladesh: analysis of eight waves of population-level data from 1996 to 2022
Md Arif Billah, Sharmin Akhtar, M Mofizul IslamAbstract
Objective:
To examine trends and determinants of women’s nutritional status over the last two decades in Bangladesh, using BMI distribution and BMI-based categories of underweight and overweight/obesity.
Design:
We analysed women’s data from the Bangladesh Demographic Health Surveys, conducted between 1996 and 2022. Sociodemographic characteristics, changes in BMI distribution and underweight and overweight prevalence were estimated at national and urban–rural levels. Associated factors were identified using multilevel mixed-effect logistic regression, with survey year as a random intercept. Multinomial regressions were used for the individual survey waves.
Setting:
Nationally representative cross-sectional survey.
Participants:
90 510 reproductive-aged women.
Results:
There is an epidemiological transition from underweight to overweight by approximately 5 kg/m 2 over the period. The prevalence of underweight women declined by 41·34 %, while overweight/obesity increased by 33·62 %. For urban–rural disparities, the prevalence of underweight was consistently higher among rural women, whereas overweight was more common among urban women. Increased age and higher education had higher odds of being overweight/obese and relatively higher socio-economic status had higher odds of being overweight and lower odds of being underweight. Access to television had mostly higher odds of being overweight. Age, education, socio-economic status and watching television showed consistent risks over time, while other factors showed inconsistent risks at different survey times.
Conclusions:
There was an epidemiological transition in BMI, with a declining trend in underweight and a substantial increase in overweight. Targeted interventions are needed to tackle the persistent undernutrition in rural areas and the rapidly escalating epidemic of overweight/obesity, particularly in urban settings.