A vast majority of women in Bangladesh suffer from a variety of nutritional deficiencies, which is compounded by rising obesity rates.
Both under-nutrition and over-nutrition increase the risk of communicable and non-communicable diseases, reduced productivity, and adverse pregnancy outcomes.
Too much and too little
Based on this, researchers at Bangladesh's BRAC University carried out a narrative review of existing literature on nationally representative data, which included English-language quantitative studies on the prevalence and risk factors of the double burden of malnutrition among Bangladeshi women published between 1 May 2007 and 30 April 2017.
The researchers observed that the prevalence of underweight women and stunting in Bangladesh had been "dramatically reduced" in the last decade, but still, almost 25% of the country’s women are underweight and 20% are stunted.
In addition, almost 50% of women in Bangladesh suffer from a range of micronutrient deficiencies, a great burden of under-nutrition made worse by the nearly 50% of the country's women being overweight or obese.
The researchers stated that factors such as women's age, area of residence, education status and wealth index influence to a considerable extent their nutritional status, adding that the double burden of malnutrition is "an inevitable reality" among Bangladeshi women.
Multi-faceted, multi-sectoral approach
They added that to combat the problem, there should be a multi-sectoral approach within government organisations and multi-stakeholder approach in terms of public-private partnerships and collaborations among civilians, academic institutes and development partners.
Furthermore, specific and targeted public health programmes were "immediately required". These included raising awareness, increasing nutritious food supply, promoting water, and ensuring sufficient nutrition-related logistic supply at healthcare facilities, and nutritional interventions in urban slums.
They wrote: "Further research is also warranted to identify implementation challenges that hinder the success of existing nutrition-related interventions in the context of Bangladesh.
"To address overweight and obesity, preventive programmes through modifying a social and behavioural aspect of obesity can be adopted. For instance, educating and encouraging affluent women to embrace a healthy lifestyle, and generating awareness among them regarding the health impact of obesity using mass media."
They also suggested that the government restrict the production, purchase and promotion of junk food, and make fruits and vegetables accessible and affordable to all socio-economic groups.
They wrote that the prevention and control of the double burden of malnutrition among women in Bangladesh had "the potential to bring significant health and economic paybacks for the country".
They added that women's nutritional status was a 'multi-faceted' issue with a variety of underlying socio-cultural and biological aspects, including age, education level, wealth status and area of residence, and as such, it was not possible to effectively tackle the problem "until it becomes everybody's business and responsibility".
In conclusion, they wrote: "The adverse health consequences of women's under-nutrition and over-nutrition have been well documented.
"As women's nutritional status is a multi-faceted issue, effective implementation of very specific and focused public health interventions with (highly organised and) inclusive multi-sectoral and multi-stakeholder approaches — along with continuous monitoring and evaluation — are indispensable to combat this problem."
"Double Burden of Malnutrition among Bangladeshi Women: A Literature Review"
Authors: Mehedi Hasan, et al.