Recent underweight and overweight trends by rural-urban residence among women in low- and middle-income countries

Abstract

Background: Long-term trends mask critical recent dynamics in the prevalence of under- and overweight.

Objective: The objective of this study was to compare annualized prevalence rates of both under- and overweight among nonpregnant women aged 19-49 y during the periods covering 1) the 1990s-the early 2000s and 2) the early 2000s-the late 2000s or early 2010s, by rural-urban residence.

Methods: Data are from nationally representative surveys (29 Demographic and Health Surveys and 4 national surveys). Standardized protocols were used to measure weight and height. Underweight was defined as body mass index (BMI) < 18.5 kg/m(2) and overweight as BMI ≥ 25 kg/m(2).

Results: From the 1990s to the early 2000s, most countries were making progress on decreasing the prevalence of underweight, especially in rural areas. Although many countries continued to make progress more recently, several countries in Sub-Saharan Africa that previously had a decreasing prevalence of underweight now have an increasing prevalence of underweight. For example, in rural areas of Senegal, the prevalence of underweight decreased 0.23% annually between 1992 and 2005, then increased 1.60% annually between 2005 and 2010. Meanwhile, the prevalence of overweight is increasing in nearly all countries, and in approximately half of all countries, the rate of increase is greater in rural areas than in urban areas. Although underweight persists as more prevalent than overweight in rural areas of many East Asian, South Asian, and Sub-Saharan African countries, the ratio of underweight to overweight in many countries has decreased over time, indicating that this trend is reversing.

Conclusions: Select countries in Sub-Saharan Africa may be more susceptible to food crises and should be targets for intervention. At the same time, global health efforts need to focus on preventing overweight, particularly in rural areas, which are quickly catching up to their urban counterparts.

Keywords: developing countries; dual burden; overweight; rural health; underweight.

FIGURE 1

National annualized change in the prevalence of underweight among nonpregnant women aged 19–49 y by rural–urban residence, sorted by region and 2010 per capita gross domestic product within region. Underweight was defined according to the WHO's recommendation as BMI < 18.5 kg/m².

FIGURE 2

National annualized change in the prevalence of overweight among nonpregnant women aged 19–49 y by rural–urban residence, sorted by region and 2010 per capita gross domestic product within region. Overweight was defined according to the WHO's recommendation as BMI ≥ 25 kg/m².