Trends and Inequities in Food, Energy, Protein, Fat, and Carbohydrate Intakes in Rural Bangladesh

Abstract

Background Tracking dietary changes can inform strategies to improve nutrition, yet there is limited evidence on food consumption patterns and how disparities in food and nutrient intakes have changed in Bangladesh. Objectives We assessed trends and adequacies in energy and macronutrient intakes and evaluated changes in inequities by age group, sex, and expenditure quintile. Methods We used panel data from the 2011 and 2018 Bangladesh Integrated Household Survey (n = 20,339 and 19,818 household members ≥ 2 years, respectively). Dietary intakes were collected using 24-hour recall and food-weighing methods. Changes in energy and macronutrient intakes were assessed using generalized linear models and adjusted Wald tests. Inequities in outcomes were examined by age group, sex, and expenditure quintile using the Slope Index of Inequality and Concentration Index. Results Between 2011 and 2018, dietary diversity improved across sex and age groups (30–46% in children, 60–65% in adolescents, 37–87% in adults), but diets remain imbalanced with around 70% of energy coming from carbohydrates. There were declines in intakes of energy (3–8%), protein (3–9%), and carbohydrate (9–16%) for all age groups (except children 2–5 years), but an increase in fat intake (57–68% in children and 22–40% in adults). Insufficient intake remained high for protein (>50% among adults) and fat (>80%) while excessive carbohydrate intake was > 70%. Insufficient energy, protein, and fat intakes, and excessive carbohydrate intakes were more prevalent among poor households across survey years. Inequity gaps reduced for insufficient energy intake in most age groups, remained stable for insufficient protein intake, and increased for insufficient fat and excessive carbohydrate intakes. Conclusions Despite improvements in dietary diversity, diets remain imbalanced and inequities in insufficient energy, protein, and fat intakes persist. Our findings call for coherent sets of policies and investments toward a well-functioning food system and social protection to promote healthier, more equitable diets in rural Bangladesh.

Impact of COVID-19 on Micronutrient Adequacy and Dietary Diversity among Women of Reproductive Age from Selected Households in Bangladesh

“…This again potentially indicates that, while many people may have consumed meals from those categories, the quantity ingested was most likely insufficient, as previously noted by Arsenault et al [ 8 ]. Interestingly, the estimated values of calories and protein consumption from the sample of the present study appear to be lower than the reported values for women aged 19–40 in the 2018 Bangladesh Integrated Household Survey (BIHS) [ 32 ]. This suggests that the COVID-19 pandemic affected the WRA’s total food intake in Bangladesh, increasing their risk of nutritional deficiency, irrespective of the number of food groups consumed.…”

“…The present study demonstrated inadequate NARs for vitamin A, pyridoxine, folate, and iron among women irrespective of their dietary diversity situation. An analysis of the 2018 Bangladesh Integrated Household Survey (BIHS) panel data on food consumption revealed that despite the addition of legumes, eggs, milk, and dairy products to people’s diets, the quantity consumed accounted for just about a third of the amount, and meat intake remains less than half of the requirement, although rice intake exceeds the necessary level [ 32 ]. This again potentially indicates that, while many people may have consumed meals from those categories, the quantity ingested was most likely insufficient, as previously noted by Arsenault et al [ 8 ].…”

A review of the dietary diversity and micronutrient adequacy among the women of reproductive age in low‐ and middle‐income countries

“…A recent study in four LMICs, Guatemala, India, Pakistan, and Congo also showed inadequately diversified dietary intake among pregnant women (Lander et al., 2019 ). However, evidence in Bangladesh showed that although dietary diversity has been improved in the last decade irrespective of age and sex, diets remain imbalanced with almost 70% energy come from carbohydrate (Ahmed et al., 2022 ). Literature suggests that in LMICs, several issues including low production (Harris‐Fry et al., 2015 ), poverty and food insecurity (Arimond, Wiesmann, Becquey, Daniels, et al., 2010 ; Brinkman et al., 2010 ; Harris‐Fry et al., 2015 ), and lack of nutritional knowledge contributed to inadequate dietary diversity and dependence to cereal‐based diets.…”

Nutritional Imbalance Can Affect the Human Body in Different Ways

“…Adequate meals and nutrient intakes are essential determinants of health, well-being, and survival [3]. The UNICEF conceptual framework highlights the influential position of age-appropriate, nutrient-wealthy meals on maternal and baby vitamins.…”