The prevalence of underweight, overweight and obesity in Bangladeshi adults: Data from a national survey

BACKGROUND: Over the two last decades Bangladesh, a low-income country, has experienced a rapid demographic and epidemiological transition. The population has increased substantially with rapid urbanization and changing pattern of disease, which at least in part, can be explained by nutritional changes. However, the nutritional status of the adult population has not been previously described. Hence, the objective of this study was to estimate the prevalence and explore socio-demographic determinants of underweight, overweight and obesity among the Bangladeshi adult population. METHODS: This study is a secondary data analysis of the national 2011 Bangladesh Demographic and Health Survey. We determined the nutritional status of adults aged ≥35 years of age, who had a measured weight and height, using the Asian body mass index (BMI) cut-offs for underweight (BMI <18.5 kg/m(2)), overweight (BMI 23 to <27.5 kg/m(2)) and obesity (BMI ≥27.5 kg/m(2)). Logistic regression modeling was used to determine the association between socio-demographic factors and nutritional status. RESULT: Of total sample (n = 5495), 30.4% were underweight, 18.9% were overweight and 4.6% were obese. Underweight was associated with age, education and wealth. The adjusted odd ratios for underweight were higher for older people (≥70 years) compared to younger, the least educated compared to the most educated and the poorest compared to the wealthiest were 2.51 (95%CI: 1.95–3.23, p<0.001), 3.59 (95%CI: 2.30–5.61, p<0.001) and 3.70 (95%CI: 2.76–4.96, p<0.001), respectively. Younger age (35–44 years), being female, higher education, wealthier and living in urban areas were associated with overweight/obesity with adjusted odds ratios of 1.73 (95%CI: 1.24–2.41, p<0.001), 2.48 (95%CI: 1.87–3.28, p<0.001), 3.98 (95%CI: 2.96–5.33, p<0.001), 7.14 (95%CI: 5.20–9.81, p<0.001) 1.27 (95%CI: 1.05–1.55, p-0.02), respectively. CONCLUSION: Underweight and overweight/obesity are prevalent in Bangladeshi adults. Both conditions are associated with increased morbidity and mortality and increase the risk of developing non-communicable diseases. Effective public health intervention approaches are necessary to address both these conditions.