Long-term changes in childhood malnutrition are associated with long-term changes in maternal BMI: evidence from Bangladesh, 1996–2011

• Published in: The American journal of clinical nutrition Vol. 104; no. 4; pp. 1121 - 1127
• Main Authors: Hasan, Md Tanvir, Soares Magalhães, Ricardo J, Williams, Gail M, Mamun, Abdullah A
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01-10-2016; American Society for Clinical Nutrition, Inc
• Subjects: Adolescent; Adult; Bangladesh; Body Mass Index; Child Nutrition Disorders - etiology; Child, Preschool; Children & youth; Correlation analysis; Growth Disorders - etiology; Humans; Malnutrition; Mothers; Nutrition; Nutrition research; Nutritional Status; Obesity - epidemiology; Overnutrition; Overweight; Prevalence; Thinness - complications; Thinness - epidemiology; Young Adult; Bangladesh; children under 5 years of age; malnutrition; Bangladesh; nutritional transition; maternal BMI
• DOI: 10.3945/ajcn.115.111773
• EISSN: 1938-3207
• ISSN: 0002-9165

ABSTRACT
Background: Nutritional transition (from under- to overnutrition) among women of reproductive age (15–49 y) is becoming increasingly common in many developing countries, including Bangladesh. However, the influence of this transition on the nutritional status of children <5 y of age (U5s) is unknown.
Objectives: The aim was to determine whether a nutritional transition has taken place in the past 15 y (1996–2011) among U5s and their mothers in Bangladesh and to examine how the association between maternal body mass index (BMI) and malnutrition in U5s has changed over time.
Design: We analyzed data assembled from 5 Demographic and Health Surveys conducted between 1996 and 2011 in Bangladesh to describe the nutritional status of 28,941 U5s and their mothers. A Poisson regression model was used to examine the associations between maternal BMI and stunting, underweight, and wasting in U5s over time.
Results: A nutritional transition among mothers of U5s was observed between 1996 and 2011. The height- or length-for-age and weight-for-age z score distributions of U5s showed consistent improvement; however, there was no indication of a nutritional transition. An interaction was found between maternal BMI categorized as underweight [BMI (kg/m2) <18.5], healthy BMI (BMI: 18.5–24.9), and overweight or obese (BMI ≥25) and year of survey on the risks of stunting and underweight in children. In 1996, children of underweight mothers had a 5% higher risk of being stunted than those born to healthy-BMI mothers (RR: 1.05; 95% CI: 1.00, 1.10); in 2011, children of underweight mothers had a 21% higher risk of being stunted (RR: 1.21; 95% CI: 1.13, 1.30). Maternal overweight or obesity was associated with a reduced risk of malnutrition in children.
Conclusions: A nutritional transition among U5s has yet to occur in Bangladesh. However, our results indicate that improvement in maternal BMI in the past 15 y was accompanied by a reduction in malnutrition in U5s.