Trends and Correlates of Overweight among Pre-School Age Children, Adolescent Girls, and Adult Women in South Asia: An Analysis of Data from Twelve National Surveys in Six Countries over Twenty Years.

Kassandra L Harding,Victor M Aguayo,Patrick Webb

doi:10.3390/nu11081899

Abstract

Overweight has become a global pandemic and is associated with a rise in diet-related non-communicable diseases and associated co-morbidities. Most of the world’s undernourished people live in South Asia, yet the number of overweight and obese individuals in this region is growing. This study explores trends and correlates of overweight among pre-school age children, adolescent girls, and adult women in South Asia. Using pooled data from 12 national surveys in six countries, generalized linear mixed models were run to analyze relationships. Overweight children had significantly higher odds than non-overweight children of having an overweight mother (Adjusted Odds Ratio: 1.34, p < 0.01). Overweight adolescent girls were more likely to come from a wealthier household (Adjusted Prevalence Ratio (APR): 2.46, p < 0.01) in an urban area (1.74, p < 0.01), and have formal education (1.22, p < 0.01), compared to non-overweight girls. Similar relationships were seen among overweight vs. non-overweight adult women. In Bangladesh, India, and Nepal, overweight among girls and women increased over time, while differentials associated with household wealth, urban residence, and formal education attenuated over time. Overweight and obesity are becoming more prevalent across South Asia in a context of persisting undernutrition. Once a condition of the wealthier, more educated and urban, rates of overweight are increasing among poorer, less educated, and rural women. This requires immediate attention to ‘multi-use’ policies and programmes.

Highlights

Overweight is a growing pandemic that increasingly affects low- and middle-income countries (LMICs)
We report the prevalence of underweight, overweight, and obesity based on International Classifications as well as those proposed by the International Obesity Task Force (IOTF) sex and age-adjusted values for adolescent girls [34]
Across our sample as a whole we found that formal education was not significantly associated with overweight among adolescent girls once stratified by country, despite the fact that higher education tends to be associated with more overweight and obesity elsewhere [14]

Summary

Introduction

Overweight is a growing pandemic that increasingly affects low- and middle-income countries (LMICs). Two-thirds of the globe’s obese people reside in LMICs. Currently, two-thirds of the globe’s obese people reside in LMICs Governments in these countries are challenged to design and implement effective policies, strategies and programmes that respond to the co-existing threats of undernutrition—including micronutrient deficiencies as well as overweight and obesity [1,2]. South Asia is home to an estimated 58.7 million stunted preschoolers, which represents approximately 2 in 5 of all stunted preschoolers worldwide, and to. 5.2 million children aged 0 to 59 months who are overweight (3.1%)—representing 14% of the global burden of overweight among preschoolers [3]. The number of preschool-age children in South Asia classified as overweight has risen from 4.4 million in 2000 to 5.2 million in 2018 [3]. The age-standardized prevalence of overweight was 22.5% in 2013 [1]

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