Trends of under- and overweight among rural and urban poor women indicate the double burden of malnutrition in Bangladesh

Background Although undernutrition and communicable diseases dominate the current disease burden in resource-poor countries, the prevalence of diet related chronic diseases is increasing. This paper explores current trends of under- and overweight in Bangladeshi women.

Method Nationally representative data on reproductive age women from rural Bangladesh (n = 2 42 433) and selected urban poor areas (n = 39 749) collected by the Nutritional Surveillance Project during 2000–2004 were analyzed.

Results While the prevalence of chronic energy deficiency [CED, body mass index (BMI) < 18.5 kg/m2] continues to be major nutritional problem among Bangladeshi women (38.8% rural, 29.7% urban poor; P < 0.001), between 2000–2004, 9.1% of urban poor and 4.1% of rural women were overweight (BMI ≥ 25 kg/m2, P < 0.001). In addition, 9.8% of urban poor and 5.5% of rural women were found to be ‘at risk of overweight’ (BMI 23.0–<25 kg/m2). From 2000 to 2004, prevalence of CED decreased (urban poor: 33.8–29.3%; rural: 42.6–36.6%), while prevalence of overweight increased (urban poor: 6.8–9.1%; rural: 2.8–5.5%). The risk of being overweight was higher among women who were older and of higher socioeconomic status. Rural women with at least 14 years of education had a 8.1-fold increased risk of being overweight compared with non-educated women [95% confidence intervals (CI): 6.6−8.7]. Women living in houses of at least 1000 sqft (93 m2) were 3.7 times more likely to be overweight compared with women living in <250 sqft (23 m2) houses (95% CI: 3.2−4.3).

Conclusion The recent increase in overweight prevalence among both urban poor and rural women, along with high prevalence of CED, indicates the emergence of a double burden of malnutrition in Bangladesh.