Multilevel exploration of individual- and community-level factors contributing to overweight and obesity among reproductive-aged women: a pooled analysis of Bangladesh Demographic and Health Survey, 2004–2018

Abstract

Objectives: Overweight and obesity have been related to a variety of adverse health outcomes. Understanding the overweight and obesity epidemic in Bangladesh, particularly among reproductive-aged women, is critical for monitoring and designing effective control measures. The purpose of this study was to determine the prevalence of overweight and obesity in reproductive-aged women and to identify the risk factors of overweight and obesity. Design: A total of 70,651 women were obtained from the five most recent and successive Bangladesh Demographic and Health Surveys (BDHS). The multilevel logistic regression model was used to explore the individual-and community-level factors of overweight and obesity. Setting: Five most recent nationally representative household surveys across all regions. Participants: Reproductive aged (15–49 years) non-pregnant women. Results: Approximately 35.2% (95% CI: 34.9-35.6%) of women were either overweight or obese in Bangladesh. At the individual- and community-level, higher age (aOR=5.79, 95% CI: 5.28–6.34), secondary or higher education (aOR=1.69 [1.60–1.78]), relatively wealthiest households (aOR=4.41 [4.10-4.74]), electronic media access (aOR=1.32 [1.26–1.37]), and community high literacy (aOR=1.10 [1.04–1.15]) of women were significantly positively associated with being overweight or obese. Whereas, rural residents (aOR=0.79 [0.76–0.82]), from larger-sized households (aOR=0.80 [0.73–0.87]) and have high community employment (aOR=0.92 [0.88–0.97]) were negatively associated with the probability of being overweight or obese. Conclusion: Individual- and community-level factors influenced the overweight and obesity of Bangladeshi reproductive-aged women. Interventions and a comprehensive public health plan aimed at identifying and addressing the growing burden of overweight and obesity should be a top focus.

Obesity among non-pregnant women in the 36 States and federal capital territory of Nigeria; sub-national variation of a national epidemic

“…These ndings corroborate the ndings of previous studies among women of reproductive age in Nigeria. [11,16,21,22,25,26] In the present study, the associations were such that women who were older, more educated, Christians, with more children, from richer households and who had more educated spouses had higher odds of being obese. This pattern of relationship has also been previously reported by studies among women of reproductive of age within and outside Nigeria.…”

“…This study showed that sub-national variations exist in the prevalence of obesity among non-pregnant women of reproductive age in the different states of Nigeria, even after adjusting for a wide range of commonly reported individual, household and community level predictors. Such variations have been observed in studies carried out in the United States, [15] Bangladesh, [21,22] Cambodia, [23] China, [24] and particularly in Africa. [11,14,[25][26][27] The nding of this study is important because it highlights the role of the contextual unit or the environment in which a woman lives in the prevalence of obesity.…”

“…[11,14,16, 27] However, the nding of this study showed that these factors alone did not explain the sub-national variation of obesity among this category of women in Nigeria. There may be need to explore other methodological approaches including qualitative studies, [28-30] mixed methods,[31] and multi-level analysis, [15,18,22] to explain the sub-national variation in the prevalence of obesity among nonpregnant women of reproductive age in Nigeria.…”

Association between dietary protein intake, diet quality and diversity, and obesity among women of reproductive age in Kersa, Ethiopia

“…Notably, reports indicate a consistent rise in the prevalence of overweight and obesity in this age group, increasing from 3% in 2000 to 8% in 2016 in Ethiopia ( 44 ). The prevalence of overweight and obesity reached an alarming level in some developing countries such as 50.4% in Tanzania ( 45 ), 35.2% in Bangladesh ( 46 ), and 55.20% in Brazil ( 47 ). This shows the urgent need for targeted interventions and policies to address this growing issue and improve the health outcomes of women and their children.…”