Correlates and inequality of underweight and overweight among women of reproductive age: Evidence from the 2016 Nepal Demographic Health Survey

Anjana Rai, Swadesh Gurung, Subash Thapa, Naomi Saville

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Resumé

INTRODUCTION: Understanding socio-economic correlates and inequality of underweight and overweight is crucial to develop interventions to prevent adverse health outcomes.

MATERIALS AND METHODS: We analysed Nepal Demographic and Health Survey 2016 data from 6,069 women aged 15-49 years. WHO cut-offs for Body Mass Index categorised as: underweight (<18.5 kg/m2), normal weight (18.5kg/m2 to 24.9kg/m2) and overweight/ obesity (> = 25.0 kg/m2) were used. We used multinomial logistic regression to explore associations of factors with Body Mass Index and concentration indices to estimate socio-economic inequalities.

RESULTS: Higher risk of underweight was found in age group 15-19 (RRR 3.08, 95% CI: 2.29-4.15), 20-29 (RRR 1.64, 95% CI: 1.29-2.08) and in lowest (RRR 1.60, 95% CI: 1.03-2.47) and second wealth quintiles (RRR 1.77 (95% CI: 1.18-2.64). Education, occupation, urban/rural residence and food security were not associated with underweight (p>0.05). Lower risk of overweight/obesity was found in age group 15-19 (RRR 0.07, 95% CI: 0.05-0.10), 20-29 (RRR 0.40, 95% CI: 0.32-0.51), in manual occupation (RRR 0.58, 95% CI: 0.46-0.74) and in lower quintiles. Women with primary (RRR 1.91, 95% CI: 1.36-2.67), secondary education (RRR 1.42, 95% CI 1.00, 2.01) were at increased risk of overweight/obesity. Household food security and urban/rural residence were not associated with overweight/obesity (p>0.05). Socioeconomic inequalities were detected, with overweight/obesity strongly concentrated (concentration index: 0.380) amongst the higher quintiles and underweight concentrated (concentration index: -0.052) amongst the poorest.

CONCLUSION: Nutrition programmes should target younger and poor women to address undernutrition and higher wealth group women to address overnutrition. Equity based nutrition interventions improving socio-economic status of poor households may benefit undernourished women. Interventions to encourage physical activity as women age and among wealthier women as well as healthy eating for prevention of under- and over-nutrition are needed.

OriginalsprogEngelsk
Artikelnummere0216644
TidsskriftPLOS ONE
Vol/bind14
Udgave nummer5
Antal sider16
ISSN1932-6203
DOI
StatusUdgivet - maj 2019

Fingeraftryk

Nepal
underweight
Nutrition
demographic statistics
obesity
Economics
Education
socioeconomics
Food Supply
Occupations
food security
malnutrition
body mass index
households
Body Mass Index
Age Groups
Logistics
secondary education
Health
nutritional intervention

Citer dette

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title = "Correlates and inequality of underweight and overweight among women of reproductive age: Evidence from the 2016 Nepal Demographic Health Survey",
abstract = "INTRODUCTION: Understanding socio-economic correlates and inequality of underweight and overweight is crucial to develop interventions to prevent adverse health outcomes.MATERIALS AND METHODS: We analysed Nepal Demographic and Health Survey 2016 data from 6,069 women aged 15-49 years. WHO cut-offs for Body Mass Index categorised as: underweight (<18.5 kg/m2), normal weight (18.5kg/m2 to 24.9kg/m2) and overweight/ obesity (> = 25.0 kg/m2) were used. We used multinomial logistic regression to explore associations of factors with Body Mass Index and concentration indices to estimate socio-economic inequalities.RESULTS: Higher risk of underweight was found in age group 15-19 (RRR 3.08, 95{\%} CI: 2.29-4.15), 20-29 (RRR 1.64, 95{\%} CI: 1.29-2.08) and in lowest (RRR 1.60, 95{\%} CI: 1.03-2.47) and second wealth quintiles (RRR 1.77 (95{\%} CI: 1.18-2.64). Education, occupation, urban/rural residence and food security were not associated with underweight (p>0.05). Lower risk of overweight/obesity was found in age group 15-19 (RRR 0.07, 95{\%} CI: 0.05-0.10), 20-29 (RRR 0.40, 95{\%} CI: 0.32-0.51), in manual occupation (RRR 0.58, 95{\%} CI: 0.46-0.74) and in lower quintiles. Women with primary (RRR 1.91, 95{\%} CI: 1.36-2.67), secondary education (RRR 1.42, 95{\%} CI 1.00, 2.01) were at increased risk of overweight/obesity. Household food security and urban/rural residence were not associated with overweight/obesity (p>0.05). Socioeconomic inequalities were detected, with overweight/obesity strongly concentrated (concentration index: 0.380) amongst the higher quintiles and underweight concentrated (concentration index: -0.052) amongst the poorest.CONCLUSION: Nutrition programmes should target younger and poor women to address undernutrition and higher wealth group women to address overnutrition. Equity based nutrition interventions improving socio-economic status of poor households may benefit undernourished women. Interventions to encourage physical activity as women age and among wealthier women as well as healthy eating for prevention of under- and over-nutrition are needed.",
author = "Anjana Rai and Swadesh Gurung and Subash Thapa and Naomi Saville",
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Correlates and inequality of underweight and overweight among women of reproductive age : Evidence from the 2016 Nepal Demographic Health Survey. / Rai, Anjana; Gurung, Swadesh; Thapa, Subash; Saville, Naomi.

I: PLOS ONE, Bind 14, Nr. 5, e0216644, 05.2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Correlates and inequality of underweight and overweight among women of reproductive age

T2 - Evidence from the 2016 Nepal Demographic Health Survey

AU - Rai, Anjana

AU - Gurung, Swadesh

AU - Thapa, Subash

AU - Saville, Naomi

PY - 2019/5

Y1 - 2019/5

N2 - INTRODUCTION: Understanding socio-economic correlates and inequality of underweight and overweight is crucial to develop interventions to prevent adverse health outcomes.MATERIALS AND METHODS: We analysed Nepal Demographic and Health Survey 2016 data from 6,069 women aged 15-49 years. WHO cut-offs for Body Mass Index categorised as: underweight (<18.5 kg/m2), normal weight (18.5kg/m2 to 24.9kg/m2) and overweight/ obesity (> = 25.0 kg/m2) were used. We used multinomial logistic regression to explore associations of factors with Body Mass Index and concentration indices to estimate socio-economic inequalities.RESULTS: Higher risk of underweight was found in age group 15-19 (RRR 3.08, 95% CI: 2.29-4.15), 20-29 (RRR 1.64, 95% CI: 1.29-2.08) and in lowest (RRR 1.60, 95% CI: 1.03-2.47) and second wealth quintiles (RRR 1.77 (95% CI: 1.18-2.64). Education, occupation, urban/rural residence and food security were not associated with underweight (p>0.05). Lower risk of overweight/obesity was found in age group 15-19 (RRR 0.07, 95% CI: 0.05-0.10), 20-29 (RRR 0.40, 95% CI: 0.32-0.51), in manual occupation (RRR 0.58, 95% CI: 0.46-0.74) and in lower quintiles. Women with primary (RRR 1.91, 95% CI: 1.36-2.67), secondary education (RRR 1.42, 95% CI 1.00, 2.01) were at increased risk of overweight/obesity. Household food security and urban/rural residence were not associated with overweight/obesity (p>0.05). Socioeconomic inequalities were detected, with overweight/obesity strongly concentrated (concentration index: 0.380) amongst the higher quintiles and underweight concentrated (concentration index: -0.052) amongst the poorest.CONCLUSION: Nutrition programmes should target younger and poor women to address undernutrition and higher wealth group women to address overnutrition. Equity based nutrition interventions improving socio-economic status of poor households may benefit undernourished women. Interventions to encourage physical activity as women age and among wealthier women as well as healthy eating for prevention of under- and over-nutrition are needed.

AB - INTRODUCTION: Understanding socio-economic correlates and inequality of underweight and overweight is crucial to develop interventions to prevent adverse health outcomes.MATERIALS AND METHODS: We analysed Nepal Demographic and Health Survey 2016 data from 6,069 women aged 15-49 years. WHO cut-offs for Body Mass Index categorised as: underweight (<18.5 kg/m2), normal weight (18.5kg/m2 to 24.9kg/m2) and overweight/ obesity (> = 25.0 kg/m2) were used. We used multinomial logistic regression to explore associations of factors with Body Mass Index and concentration indices to estimate socio-economic inequalities.RESULTS: Higher risk of underweight was found in age group 15-19 (RRR 3.08, 95% CI: 2.29-4.15), 20-29 (RRR 1.64, 95% CI: 1.29-2.08) and in lowest (RRR 1.60, 95% CI: 1.03-2.47) and second wealth quintiles (RRR 1.77 (95% CI: 1.18-2.64). Education, occupation, urban/rural residence and food security were not associated with underweight (p>0.05). Lower risk of overweight/obesity was found in age group 15-19 (RRR 0.07, 95% CI: 0.05-0.10), 20-29 (RRR 0.40, 95% CI: 0.32-0.51), in manual occupation (RRR 0.58, 95% CI: 0.46-0.74) and in lower quintiles. Women with primary (RRR 1.91, 95% CI: 1.36-2.67), secondary education (RRR 1.42, 95% CI 1.00, 2.01) were at increased risk of overweight/obesity. Household food security and urban/rural residence were not associated with overweight/obesity (p>0.05). Socioeconomic inequalities were detected, with overweight/obesity strongly concentrated (concentration index: 0.380) amongst the higher quintiles and underweight concentrated (concentration index: -0.052) amongst the poorest.CONCLUSION: Nutrition programmes should target younger and poor women to address undernutrition and higher wealth group women to address overnutrition. Equity based nutrition interventions improving socio-economic status of poor households may benefit undernourished women. Interventions to encourage physical activity as women age and among wealthier women as well as healthy eating for prevention of under- and over-nutrition are needed.

U2 - 10.1371/journal.pone.0216644

DO - 10.1371/journal.pone.0216644

M3 - Journal article

C2 - 31075139

VL - 14

JO - P L o S One

JF - P L o S One

SN - 1932-6203

IS - 5

M1 - e0216644

ER -