Date Published: July 28, 2017
Publisher: Public Library of Science
Author(s): Tuhin Biswas, Md. Jasim Uddin, Abdullah Al Mamun, Sonia Pervin, Sarah P Garnett, David Meyre.
Overweight and obesity are a particular concern for women of reproductive age. They not only increase the risk of chronic diseases but they are also associated with adverse perinatal, neonatal, infant and child outcomes. The objective of this study was to examine the trend of overweight and obesity among Bangladeshi women of reproductive age between 2004 and 2014.
This is a secondary data analysis of the 2004, 2007, 2011 and 2014 Bangladesh Demographic and Health Surveys (BDHS). We determined the age standardized prevalence of overweight and obesity of women aged 15–49 years, who had their weight and height measured. Overweight and obesity were determined using the Asian specific BMI cut-offs criteria.
The prevalence of overweight increased from 11.4% [95% CI: 10.4to 12.5] in 2004 to 25.2% [95% CI: 24.0 to 26.4] in 2014. The prevalence of obesity increased from 3.5% [95% CI: 3.0to4.2] to 11.2% [95% CI: 10.1to12.5%] over the same period of time. This was seen in all age groups. However, the greatest increase was observed in women aged 35 to 49 years. The highest prevalence of overweight and obesity were observed in those women with the highest education level and wealth, larger family size, living in urban areas and not being in paid employment.
The prevalence of overweight and obesity among women of reproductive age in Bangladesh is high and increasing. We speculate that this has the potential to jeopardize the improvements that have been made in maternal and infant health over the last two decades. Evidence based prevention strategies are required to address this serious public health issue.
Overweight and obesity are an increasing public health problem in both developed and developing countries[1, 2]. In 2014, the World Health Organization (WHO) estimated 39% of adults aged 18 years and over were overweight or obese[3, 4]. The prevalence of overweight and obesity varies widely between countries and tends to increase with income level. Hence, the WHO Region of the Americas has the highest prevalence and the WHO Region for Southeast Asia the lowest. Nevertheless, with increasing economic development in Southeast Asia, increasing rates of overweight and obesity have been reported in most countries including Malaysia, India and Indonesia.
The number of participants and the socio-demographic characteristics of the women in 2004, 2007, 2011 and 2014 are presented in Table 1. Between 2004 and 2014 the number of women who had primary and above level education increased from 60.5% to 75.6% and the number of women in paid work increased from 22.6% to 32.4%. Over the same period, the proportion of large families (ie households who had ≥5 residents) declined from 67.2% to 57.6%.
We found that the prevalence of overweight and obesity among women of reproductive age in Bangladesh increased by over 2.2 times for overweight, from 11.4% in 2004 to 25.2% in 2014 and 3.2 times for obesity, from 3.5 in 2004 to 11,2% in 2014. Of particular note was that the rate of increase appears to be accelerating overtime potentially indicating that Bangladeshi women are on a trajectory to higher levels. The high and increasing proportion of overweight and obesity that we report threatens the substantial gains that have been made in maternal and infant health in Bangladesh over the last two decades. Overweight and obesity in women during pre-pregnancy or early pregnancy, living in low and middle income countries, has been associated with increased morbidity in the mother, including hypertension, pre-eclampsia and diabetes, more complicated deliveries, post-partum haemorrhage and fetal morbidity and mortality. In India, a neighbouring country with similar rates of overweight and obesity (25% in women >20 years) the burden of overweight and obesity before and/or during pregnancy on health is considered to be greater than under nutrition.
We assessed the prevalence of overweight and obesity among Bangladeshi women of reproductive age using a decade of data. The increase in the prevalence of overweight and obesity was especially significant in older, higher educated women with increased wealth. Our study also indicated that the burden of overweight and obesity among women of reproductive age is high and continuing to increase over time. Overweight and obesity in reproductive age are associated with poor reproductive outcomes of women and increased risk of non-communicable diseases and therefore, demands attention from public health program authorities for continuous success in women and child health indicators.