Household Rice Expenditure and Maternal and Child Nutritional Status in Bangladesh

In Bangladesh, poor rural families often deal with high food costs by purchasing primarily rice. Our objective was to characterize the relationship between household expenditure on rice and nonrice foods with maternal and child malnutrition. Food expenditure data and anthropometry were obtained in a population-based sample of 304,856 households in the Bangladesh Nutrition Surveillance Project, 2000–2005. Food expenditures were categorized as rice and nonrice foods and expressed as quintiles of proportional food expenditure. Of children aged 6–11, 12–23, and 24–59 mo, the prevalence of stunting was 33.5, 56.3, and 53.1%, respectively. The prevalence of maternal underweight (BMI < 18.5 kg/m2) was 37.3%. Among children aged 6–11, 12–23, and 24–59 mo, rice expenditures were associated with stunting [odds ratio (OR) 1.11, 95% CI 1.02–1.20, P = 0.01; OR 1.09, 95% CI 1.04–1.13, P < 0.0001; OR 1.13, 95% CI 1.08–1.18, P < 0.0001), respectively, among families in the highest compared with the lowest quintile, adjusting for potential confounders, and nonrice food expenditures were associated with stunting (OR 0.87, 95% CI 0.80–0.95, P = 0.002; OR 0.86, 95% CI 0.83–0.90, P < 0.0001; OR 0.89, 95% CI 0.85–0.94, P < 0.0001) among families in the highest compared with the lowest quintile, adjusting for potential confounders. In the highest compared with the lowest quintile, rice expenditures (OR 1.12, 95% CI 1.08–1.15, P < 0.0001) and nonrice food expenditures (OR 0.93, 95% CI 0.90–0.96, P < 0.0001) were associated with maternal underweight. Households that spent a greater proportion on nonrice foods and less on rice had a lower prevalence of maternal and child malnutrition.