Determinants of Double Burden of Malnutrition Among School Children and Adolescents in Urban Dhaka: A Multi-Level Analyses

BackgroundBangladesh faces a double burden of malnutrition, with a rising prevalence of overweight and obesity among children parallel to existing undernutrition. ObjectiveThe current study was designed to assess the determinants of double burden of malnutrition among urban school children from Dhaka, Bangladesh. MethodsA cross-sectional survey was conducted among 2,690 students from 14 schools in Dhaka city from January to June 2018. Anthropometric measurements were taken during school hours, and self-administered questionnaires were sent to the parents. We performed multi-level multiple logistic regression analyses to assess the determinants of underweight, overweight, and obesity. FindingsThe prevalence of overweight (33%) and obesity (23%) was highest among children and adolescents from high tuition schools but the prevalence of underweight (4%) was lowest compared to those from low (underweight 19%, overweight 17%, and obesity 6%) and medium (underweight 18%, overweight 15%, and obesity 6%) tuition schools. Children from high-tuition schools had higher odds of being overweight/ obese (AOR: 2.92; 95% CI: 1.90, 4.49). Parental NCDs and overweight were negatively associated with underweight but positively associated with overweight and obesity among children. Lack of physical activity inside schools was positively associated (AOR: 1.26; 95% CI: 1.02, 1.55) with overweight and obesity among school children. ConclusionOur results point to opportunities in and outside schools to address the rising prevalence of underweight, overweight, and obesity among urban school children.