Underweight, overweight or obesity, diabetes, and hypertension in Bangladesh, 2004 to 2018

Abstract

Background and objectives Bangladesh is experiencing a nutrition transition with an increase in the double burden of malnutrition and non-communicable diseases (NCDs). This study sought to: 1) examine trends and differences in underweight, overweight/obesity, hypertension and diabetes by gender, area of residence, and wealth in Bangladesh from 2004 to 2018, 2) assess what factors contributed to changes in these outcomes. Methods We used data from five rounds of the Bangladesh Demographic and Health Surveys (n = 76,758 women 15-49y and 10,900 men 18-95y in total). We calculated differences, slope index of inequality (SII) and concentration index (CIX) to examine trends over time and differences in outcomes by wealth and residence. We identified determinants and estimated drivers of changes in outcomes using regression-based decomposition. Results Between 2004 and 2018, underweight prevalence decreased in both women (33% to 12%) and men (26% to 18%), whereas overweight/obesity increased (17% to 49% in women and 21% to 34% in men). Hypertension also increased in both women (31% to 44%) and men (19% to 33%) while diabetes changed marginally (11% to 14%). In all years, underweight was concentrated in poorer and rural households while overweight/obesity, diabetes and hypertension were concentrated in wealthier and urban households. Wealth inequity decreased over time for underweight, changed little for overweight/obesity, and increased for hypertension and diabetes among men. Increases in wealth explained 35% to 50% of the reduction in underweight and 30% to 57% of the increase in overweight/obesity. Conclusion Our findings imply that double duty actions are required to sustain the decrease in undernutrition and slow the increase in overweight/obesity and NCDs across diverse socioeconomic sections of the population in Bangladesh.

Socio-economic, environmental and health trade-offs in Bangladesh’s food system transformation

“…Over the last decades, Bangladesh has experienced strong economic growth and impressive poverty reduction. As a result, the country has made major progress in reducing malnutrition (Nguyen et al, 2022). Like in other Asian countries (Pingali et al, 2022;Reardon et al, 2014), growing household income has led to an increasingly diverse diet (Figure 1) with lower shares in starches in combination with an increase in meat, fruit and beverages consumption (Waid et al, 2018).…”

“…This overconsumption has resulted in an increase in the incidence of non-communicable diseases like hypertension and diabetes over the last decades (Ahsan et al, 2022;Nguyen et al, 2022). The prevalence of overweight, obesity, hypertension and diabetes were highest in wealthier households, as in other lowand middle-income countries (Nguyen et al, 2022). Changing food consumption patterns, combined with population growth, affect land use activities by agriculture and have a significant impact on habitat loss and environmental degradation.…”

“…The majority of the population consumes less than 75% of the recommended dietary intake for all food groups, with the exception of starches. Simultaneously, 22%, 17% and 14% of the population consume more than the recommended intake of sweets, oils and meat, respectively (de Brauw et al, 2020), which has led to a sharp increase in the prevalence of overweight and obesity (Nguyen et al, 2022). This overconsumption has resulted in an increase in the incidence of non-communicable diseases like hypertension and diabetes over the last decades (Ahsan et al, 2022;Nguyen et al, 2022).…”

Association of Triglyceride-Glucose Index and Liver Function Parameters Among Healthy Obese Civil Servants: A Center-Based Study

“…Metabolic syndrome (MetS) and its associated comorbidities, such as type 2 diabetes mellitus (T2DM), nonalcoholic fatty liver disease (NAFLD), hypertension, hyperlipidemia, chronic renal disease, and cardiovascular disease (CVD), are brought on by obesity. 2,3 Nearly a quarter of the world's population now suffers with NAFLD, making it the most prevalent chronic liver disease. Obese people have a 25-30% greater prevalence of NAFLD than the overall population.…”

Rapidly Rising Diabetes and Increasing Body Weight: A Counterfactual Analysis in Repeated Cross-sectional Nationally Representative Data from Bangladesh

“…Recent studies using this data find that the region is experiencing one of the fastest increases in diabetes prevalence globally. 6,7 Building on these analyses, there are two important research gaps regarding this rapid rise in diabetes. First, it is unclear which risk factors are the main drivers of changes in diabetes prevalence at the national level.…”