Rapid shift toward overweight from double burden of underweight and overweight among Bangladeshi women: A systematic review and pooled analysis

Context: Studies show there is a double burden of underweight and overweight in Bangladesh amidst a global background of increasing rates of overweight in lowincome settings. Objective: The aim of this review was to determine the rates of change in the prevalence of underweight and of overweight among Bangladeshi women of reproductive age, to investigate whether there has been a shift from underweight to overweight in this population, and, if a shift was documented, to identify potential determinants. Data Sources: Data was obtained via electronic searches of the PubMed, CINAHL, and Embase databases. Study selection: Studies and survey reports were eligible for inclusion if they provided data on the prevalence of underweight and of overweight among women of reproductive age as well as sociodemographic information. Data Synthesis: A meta-analysis was performed by reviewing data extracted from the included studies. Using data from 5 successive national demographic and health surveys, the average annual rates of change in underweight and in overweight were calculated, along with their associations with potential determinants. Conclusions: In Bangladesh, the prevalence of overweight exceeded that of underweight in 2014. A higher average annual rate of reduction of underweight was found among wealthier, highly educated, urban-living women, while a higher average annual rate of increase of overweight was found among poorer, uneducated, rural-living women. The shift in body mass index from underweight to overweight was most positively associated with urban residence, age, higher socioeconomic status, and higher education attainment.