Shifting of undernutrition to overnutrition and its determinants among women of reproductive ages in the 36 low to medium income countries

Abstract

Objectives are to examine the shift away from undernutrition towards overnutrition for low to medium income countries (LMIC) and investigate the potential determinants of this shift using the nationally representative survey data. We analysed cross-sectional, representative samples of 540,290 women aged 20-49 years drawn from the Demographic and Health Surveys (DHS) at two time points in 36 LMIC. The ratio of overweight-to-underweight at earliest and latest survey was calculated for each country to illustrate the relative magnitude of the shifting of underweight to overweight. Potential determinants of underweight (BMI < 18.5) and overweight (BMI ≥ 25) were examined. In the latest DHS compared to the earliest DHS (mean duration 10 years), the prevalence of underweight significantly declined for one in two countries and the prevalence of overweight significantly increased for 80% of the listed countries. The annual increase of overweight was two folds higher than annual decline of underweight (6.4% vs. 3.3%). Although higher socio-demographic factors were associated with shifting of underweight towards overweight, over time, the risk of the highly educated, wealthy, and urban women being overweight was weakening. Findings of this study suggest that among women of child-bearing age there was a large shift away from undernutrition to overnutrition for most of the LMIC. Overtime, the contribution of higher education, wealth and urbanisation to being overweight was decreasing in the LMIC.