Recent trends in the prevalence of under- and overweight among adolescent girls in low- and middle-income countries

Background: Most studies of childhood malnutrition in low- and middle-income countries (LMICs) focus on children <5 years, with few focusing on adolescence, a critical stage in development.

Objective: This study aimed to evaluate recent trends in the prevalence of under- and overweight among girls (15-18 years) in LMICs.

Methods: Data are from Demographic and Health Surveys (53 countries) and national surveys conducted in Indonesia, China, Vietnam, Brazil and Mexico. The most recent surveys with sample sizes ≥50 when stratified by rural-urban status were included: 46.6% of countries had a survey conducted in the past 5 years, while the most recent survey for 10.3% of countries was over 10 years old. The overall rural sample size was 94,857 and urban sample size was 81,025. Under- and overweight were defined using the International Obesity Task Force (IOTF) sex- and age-specific body mass index cut points.

Results: South Asia had the highest prevalence of underweight; nearly double that of East Asia and the Pacific and sub-Saharan Africa, and increasing annually by 0.66% in rural areas. Latin America and the Caribbean had the highest regional prevalence of overweight in both rural and urban settings, and this prevalence is increasing annually by about 0.50%. In urban areas, 38% of countries had both an under- and overweight prevalence ≥10%.

Conclusions: There is substantial variation across and within regions in the burden of under- and overweight, with increasing dual burdens in urban areas. Innovative public health interventions capable of addressing both ends of the malnutrition spectrum are urgently needed.