Burden of abnormal nutritional indices among women aged 15-24 years in 40 low-income and middle-income countries: a multilevel multinomial logistic regression analysis.

BACKGROUND: Despite global efforts to improve nutrition, young women aged 15-24 years in low-income and middle-income countries (LMICs) face persistent dual burdens of malnutrition, marked by high rates of underweight and emerging issues of overnutrition, such as overweight and obesity. Current research often emphasises individual-level factors, potentially overlooking broader regional influences. OBJECTIVE: To examine the burden of abnormal nutritional indices among women aged 15-24 years in 40 LMICs using the most recent Demographic and Health Survey conducted between 2015 and 2023. DESIGN: Cross-sectional study design. SETTING: 40 LMICs. PARTICIPANTS: 357 587 young women aged 15-24 years. PRIMARY AND SECONDARY OUTCOME MEASURES: A multilevel mixed-effect multinomial analysis was conducted to identify determinants of underweight, overweight and obesity. The adjusted relative risk ratio with 95% CI was used to declare the statistical significance of the association. RESULTS: Our analysis found that among young women aged 15-24 years in LMICs, the pooled prevalence of underweight was 25.7% (95% CI 25.6% to 25.8%), with substantial country-level variation. The highest prevalence was in Timor-Leste (35.4%) and India (31.6%), while Jordan (2.9%) and Zambia (5.5%) had the lowest rates. Overweight and obesity prevalence was 17.7% (95% CI 15.7% to 19.7%), with the highest rates in Jordan (48.9%) and Zambia (40.9%) and the lowest in Timor-Leste (3.9%) and Ethiopia (4.5%). Furthermore, factors such as household wealth, age at marriage, age, education status, access to media, employment status, parity, contraceptive use, toilet facility, region and place of residence were statistically associated with being underweight, overweight and obese. CONCLUSIONS: Our study highlights significant variations in nutritional status among young women aged 15-24 years in LMICs, with a notable prevalence of underweight and emerging challenges of overweight and obesity. Country-specific strategies addressing socioeconomic disparities and regional differences are crucial for effective public health interventions to improve nutritional outcomes among this vulnerable population.