Socioeconomic inequalities are driving both underweight and overweigth malnutrition in women from low and middle-income countries in South East Asia, presenting a major public health challenge that requires urgent and targeted nutrition monitoring and programs.
This is a key finding of a new study led by Life Course Centre researchers at the Institute for Social Science Research at The University Queensland using nationally-representative Demographic and Health Surveys data on 933,836 women from 2000 to 2017 in seven South East Asia countries – Bangladesh, India, Nepal, Pakistan, Timor-Leste, Maldives, Myanmar, and Cambodia. It found a significant prevalence of the double burden of malnutrition (co-existence of underweight and overweight in a population) as well as strong associations with socioeconomic status.
The total pooled prevalence of women who were underweight and overweight was 20% and 29% respectively. There was wide variation between and within countries, with rates of underweight ranging from 7.0% to 33%, and overweight from 19% to 67%.
Lead author Dr Tuhin Biswas said the study showed a sizeable concentration of both underweight and overweight women in all countries studied. The overall prevalence of overweight women in the region had gradually increased overtime, and now exceeded the prevalence of underweight women. In almost all countries, underweight disproportionately affected the poorest populations, while overweight was a greater problem in the more affluent.
“This is the first comprehensive study evaluating sub-national level change in the prevalence of underweight, overweight, and socioeconomic inequalities in South East Asia,” Dr Biswas said.
“It provides valuable insights on geographical variations over time, and socioeconomic associations, to inform the planning, implementation and evaluation of nutrition programs and the targeting of high-risk populations in the region.”
Tuhin Biswas
Associate Professor Abdullah Mamun, a Life Course Centre Chief Investigator, said further data collection and longitudinal research was needed to address the double burden of malnutrition in women, which presents long-term adverse health consequences including on pregnancy outcomes.
“The degree and patterns of socioeconomic inequality in the double burden of malnutrition should be of concern in setting health policies for South East Asia. Our analysis shows that concerted action on nutrition interventions is urgently needed in the region,” Associate Professor Mamun said.
“Nutrition monitoring with an equity lens should become an integral component of tracking progress towards optimal nutrition at a population level. In addition, sub-national level strategic nutrition programs are also needed to combat the double burden of malnutrition.”
Abdullah Mamun
The study was authored by Dr Biswas, Associate Professor Mamun and Md Mehedi Hasan from ISSR and Dr Nick Townsend from University of Bath, and Associate Professor Ricardo Magalhaes of UQ.
Contact: Tuhin Biswas, Phone: +61 7 334 69302, Email: t.biswas@uq.edu.au
Go to full article: ‘Geographical and socioeconomic inequalities in the double burden of malnutrition among women in Southeast Asia: A population-based study’ The Lancet Regional Health – Southeast Asia.