Underweight and overweight/obesity among adults in Afghanistan: prevalence and correlates from a national survey in 2018

BACKGROUND: The study aimed to estimate the prevalence and correlates of underweight and overweight/obesity among adults in Afghanistan. METHODS: National cross-sectional survey data of 3779 persons aged 18–69 years were analysed. Multinomial logistic regression was used to estimate factors associated with underweight and overweight/obesity relative to normal weight. RESULTS: In all, 7.8% of the study sample was underweight (BMI < 18.5 kg/m(2)), 49.5% had normal weight (BMI 18.5–24.9 kg/m(2)), 25.5% overweight (25.0–29.9 kg/m(2)), and 17.2% obesity. In adjusted multinomial logistic regression, factors negatively associated with underweight were male sex (adjusted relative risk ratio (ARRR): 0.30, 95% confidence interval (CI): 0.15–0.58) and hypertension (ARRR: 0.51, 95% CI: 0.27–0.95) and factors positively associated with underweight were sedentary behaviour (ARRR: 1.85, 95% CI: 1.11–3.10) and current tobacco use (ARRR: 2.58, 95% CI: 1.08–6.16). Factors positively associated with overweight/obesity were aged 30–44 years (ARRR: 2.00, CI: 1.51–2.66) and aged 45–69 years (ARRR: 1.58, CI: 1.09–2.31) (compared to 18–29 years) (ARRR: 1.28, CI: 1.14–2.18), hypertension (ARRR: 2.74, CI: 1.89–3.96), and type 2 diabetes (ARRR: 1.82, CI: 1.13–2.94), and high physical activity (ARRR: 0.70, CI: 0.50–0.98) was negatively associated with overweight/obesity. CONCLUSION: Almost one in ten adult respondents were underweight and more than two in five were overweight/obese, confirming a dual burden of malnutrition in Afghanistan.