The study explored the spatial differences in diet quality and economic vulnerability to food insecurity with the association of sociodemographic characteristics at the household level in Bangladesh. This study was a secondary data analysis of Household Income and Expenditure Survey (HIES) data of 2016. Both statistical and spatial analyses were applied while assessing diet qualities in terms of the household dietary diversity score (HDDS), percentage of food energy from staples (PFES), and percentage of expenditure on food (PEF) as an indicator of the economic vulnerability to food insecurity (EVFI). The study’s findings revealed that the quality of people’s diets worsened as they moved from urban to rural area, and EVFI increased as they moved from the center to the periphery of the country. Nationally, the average HDDS was about 6.3, and the average PFES per household per day was about 70.4%. The spatial distribution of HDDS and PFES showed that rural regions in terms of settlements and the north, northwest and southeast regions had mostly low diet diversity. Besides, the average PEF per household per day was about 54%, with the highest in Mymensingh (57.4%) and the lowest in Dhaka division (50.2%). The average PEF in the households illustrated was highest in rural (55.2%) and lowest in the city (45.7%). Overall, based on the PEF at the sub-district level, the medium level of vulnerability comprised the highest share (69%) in Bangladesh. Age, gender, literacy, educational qualification and religion of the household’s head along with the number of earners, monthly income, area of settlements and divisions were significantly correlated with HDDS, PFES and EVFI. The study findings suggest that targeted interventions, including access to education, women empowerment and employment generation programs should be implemented in peripheral areas (north, northwest and southeast) to increase diet quality and minimize economic vulnerability to achieve sustainable food and nutrition security in Bangladesh.

South Asia is observing an epidemiological transition from communicable to non-communicable diseases where diabetes is an important marker. In this study,

We investigated the change of the prevalence of noncommunicable diseases (NCDs) in Bangladesh from 2011 to 2018 across different socioeconomic groups as well as the factors associated with the changes in prevalence. We used the two waves of the Bangladesh Demographic and Health Surveys conducted in 2011 and 2017–2018. Modified Poisson regression model was used to estimate the prevalence rate and ratio of NCDs and to test the association with different demographic and socioeconomic variables. The study found an upward trend of NCDs from 2011 to 2017 in which overweight and obesity, hypertension, and diabetes increased by 1.8, 1.5, and 1.1 times, respectively. In 2011, people from the richest households had 5.6 higher odds of being overweight compared to the poorest, which was reduced to 3.0 in 2017. However, the increment for overweight and hypertension was the highest among the poor and manual workers from 2011 to 2017. The age‐adjusted prevalence ratio of overweight increased 4.4 times for the poorest, compared to 1.7 times for the richest. For manual workers, overweight increased 3.8 times, whereas hypertension increased by 2.4 times. The pooled analysis revealed that participants from the richest households have the highest risk of NCDs, with 3.3 times for overweight, 2.3 times for diabetes, and 1.3 times for hypertension, compared to the poorest. However, the prevalence of NCDs is rising quickly among the low socioeconomic groups in Bangladesh, narrowing the gap with higher socioeconomic groups. Our findings call for immediate policy interventions and targeted programs to curb NCD escalation in Bangladesh.

Early detection of diabetes and hypertension is helpful to prevent and/or delay the onset of these diseases through proper interventions. Therefore, it is a prerequisite to know the prevalence of prediabetes and prehypertension and the factors associated with these conditions but people from developing countries including Bangladesh often remain undiagnosed and unaware of these conditions. In this study we investigate the prevalence of prediabetes and prehypertension and their associated factors in Bangladesh using nationally representative data. We used nationally representative Bangladesh Demographic and Health Survey (BDHS) 2017–18 survey data, which included a total sample of 14,704 adults aged 18 years and more from whom blood pressure and fasting plasma glucose were collected. Chi-square test was used to examine the differences between sociodemographic and outcome variables. The univariate and multivariate logistic regression was performed to identify the factors associated with prediabetes and prehypertension. Overall, the prevalence of prediabetes and prehypertension was 8.6% with 14% of the sampled population having from prediabetes and prehypertension separately. Among the prediabetic and prehypertensive participants, one-fourth of the participant were from the richest families and around one-third were overweight/obese, while more than fifty percent had normal Body Mass Index (BMI) and completed secondary and higher education. In the univariate analysis, the richest wealth status (UOR 3.3, 95% CI: 2.46 -4.35) and overweight/obesity (UOR 3.2, 95% CI: 2.62–3.85) are the highest predictors for prediabetes and prehypertension. After adjusting the other variables, overweight/obesity remains the largest predictor for prediabetes and prehypertension (AOR:2.5, 95% CI:2.05–3.05). Further, people aged 31 and above and from the richest family had around 2 times and 1.8 times higher risk of being prediabetic and prehypertensive compared to the younger age people (18–30 years) and the poorest family (respectively). The coexistence of prediabetes and prehypertension is an early sign of a greater burden of noncommunicable diseases (NCDs) in the near future for Bangladesh. To reduce the higher burden of NCDs, our findings call for a multisectoral approach to identify the precondition of NCDs with particular attention to maintaining body weight.

Heart disease is a significant public health threat, and its burden is increasing worldwide. Recent evidence suggests that dietary pattern is a key modifiable factor for heart disease. Research regarding dietary patterns and heart disease in Bangladesh with their spatial variability is limited. In this study, the spatial variation and relationship between dietary patterns and heart disease among Bangladeshi people was investigated. The country-representative Household Income and Expenditure Survey 2016 dataset was used, and a total of 77,207 participants aged 30 years and over were included. A principal component analysis was conducted to derive the dietary patterns. Both statistical and spatial analyses were performed. The overall prevalence of heart disease was 3.6%, with a variation of 0.6% to 10.4% across districts of Bangladesh. Three major dietary patterns, named “festival pattern”, “pickles and fast foods pattern”, and “rice and vegetable pattern” were identified, accounting for 25.2% of the total dietary variance. Both the dietary pattern and heart disease rate varied across the region. A higher risk of heart disease was persistent in the western-south, southern, central, and eastern regions, as was greater adherence to the “festival pattern” and “pickles and fast foods pattern.” After adjusting for confounders, participants with the highest adherence to the "rice and vegetable pattern" were associated with a lower likelihood of developing heart disease (AOR: 0.78, 95% CI: 0.64–0.95, p <0.05), while the highest adherence to the "pickles and fast foods pattern" was associated with a higher likelihood of developing heart disease (AOR: 1.50, 95% CI: 1.27–1.76, p <0.001). The spatial disparities in the prevalence of heart disease and dietary patterns underscore the significance of prioritizing intervention at the district level, especially in the western-south, southern, central, and eastern regions, to control the rising heart disease trends in Bangladesh.

Homegardening has the potential to improve access to nutrient-dense foods. We evaluate the impact of a large Homestead Food Production intervention on crop species richness and homegarden management as pathway outcomes of the ‘Food and Agricultural Approaches to Reducing Malnutrition’ (FAARM) cluster-randomized trial (NCT02505711) in rural North-eastern Bangladesh. Ninety-six settlements were allocated 1:1 to intervention (1337 women) and control arm (1368 women). During the three-year intervention (2015–2018) women received vegetable seeds and training in homegardening, poultry rearing, and nutrition. We assessed number and type of harvested garden crop species at baseline and every four months during and after the intervention, totalling 12 survey rounds. Impacts were measured overall and by year using mixed-effects linear regression. In its final year, the intervention increased the number of harvested vegetable species by 4.3 and total crop species by 6.4, more than double over control. We also saw sizable changes in production practices. Impacts were present in all seasons, consistent across gradients of wealth and education and maintained up to 2.5 years post-intervention when they seemed to spill over to controls. This study provides rigorous evidence that homegardening can have sustained positive impacts on year-round diversity of nutrient-rich garden crops produced by households.