Socio Demographic Factors Attributing to the Double Burden of Malnutrition in Urban Bangladesh

Background The double burden of malnutrition (DBM) is high in children and adolescents in South Asia, albeit factors attributed to DBM are unknown. This research aims to explore which socio demographic factors attribute to DBM in urban Bangladesh. Methods We conducted secondary analyses of data obtained from the national survey of child-hood obesity among school age children in Bangladesh 2012-2013. The sample includes 4,140 children (aged 5–9 years) and adolescents (10-19 years) randomly recruited from the city corporation (urban) areas in all administrative divisions. DBM was estimated as coexistence of underweight and overweight/obesity among children at population level and among mother-child pair at household level. Multivariable logistic regression model was fitted to estimate odds ratio and 95% confidence interval. A rapid policy re-view was conducted to understand the implication of results obtained from the analy-sis. Results The prevalence of DBM at the population level was 44.0% (95% CI: 42.5–45.5%), ranging between 40.0% and 47.6% across seven divisions (P < 0.001). At the household level, DBM prevalence was 15.6% (95% CI: 14.5–16.7%), ranging between 14.0% and 19.0% across seven divisions (P=0.015). At the population level, DBM odds were 56% higher among younger children (5–9 years) than adolescents (OR: 1.56; 95% CI: 1.37–1.78) and independently observed in four divisions. At the household level (mother-child pairs), DBM odds were 64% higher in younger children than adolescents (OR: 1.64; 95% CI:1.38-1.95); children living in lower-middle socio economic status (SES) (OR: 1.41, 95% CI: 1.03-1.93) and middle SES (OR: 1.49; 95% CI: 1.10-2.03) than upper SES. The policy review revealed that Bangladesh has made substantial commitments to improve nutri-tion, however, reference to DBM is absent from policy documents. Conclusion The prevalence of DBM is high among children in urban areas in Bangladesh disproportionately affecting younger children and households with low SES. There is a dire need of recognizing DBM to be a public health problem in policy and identifying region sensitive strategies to prevent DBM among school age children in Bangladesh.