Association between childhood overweight/obesity and urbanization in developing countries: evidence from Bangladesh

Aim The association between urbanization and childhood overweight/obesity (OWOB) in lower- and middle-income countries (LMICs) is poorly understood. Therefore, this study aimed to explore the association between residential district-level urbanization and OWOB among children under 5 years of age in Bangladesh. Subjects and methods This study used data from a nationally representative sample of children under 5 years of age (N = 19,640) from the Bangladesh Multiple Indicator Cluster Survey 2012-13, including OWOB status of eligible children and other sociodemographic variables. District-level social and physical environmental features were used to create an urbanization index (low, medium, and high) using modified factor analysis. Individuals' data were linked to the district-level urbanization index, and design-based binary logistic regression was used to explore the association between urbanization and OWOB. Results Prevalence of childhood OWOB was 1.6%, and the average urbanization score was 37.4% (standard deviation: 8.7%). Childhood OWOB was higher in highly urbanized districts (2.0%) than in low urbanization districts (1.2%). The odds of OWOB was 53% higher in highly urbanized districts compared to low urbanization districts (adjusted odds ratio: 1.53; 95% CI: 1.01-2.31). Conclusions Residential area urbanization was associated with childhood OWOB. These results suggest the importance of formulating context-specific prevention programs and policies to mitigate the adverse impacts of urbanization on childhood overnutrition in LMICs like Bangladesh. Future studies are required to understand its causal relationship with OWOB.

Automated summary

The study found that childhood OWOB prevalence was higher in highly urbanized districts in Bangladesh, with a 53% increased risk of OWOB in highly urbanized areas compared to low urbanization areas. The results suggest the importance of developing context-specific prevention programs and policies to mitigate the adverse effects of urbanization on childhood overnutrition in LMICs like Bangladesh. Future research is needed to understand the causal relationship between urbanization and OWOB.