Trends and Inequities in Adequacy of Micronutrient Intakes in Rural Bangladesh.

Abstract

Background: Micronutrient deficiencies pose a significant public health challenge, yet limited evidence exists on micronutrient intakes over time in Bangladesh.

Objectives: We assessed trends and adequacies in micronutrient intakes and examined the changes in inequities by age group, sex, and expenditure quintile.

Methods: We used panel data from the 2011 and 2018 Bangladesh Integrated Household Survey (n = 21,475 and 21,589 household members aged 2 y or older, respectively). Food consumption data were collected using a household dietary recall. Changes in micronutrient intakes were assessed using nonparametric Mann-Whitney-Wilcoxon rank sum test. Inequities in outcomes were examined using the slope index of inequality and concentration index.

Results: Micronutrient intakes remained suboptimal across 2011 and 2018, with low adequacy (<0.50) for all nutrients except niacin. While vitamin A intake increased across various demographics, trends for other micronutrient intakes differed by age. Intakes improved for 10 micronutrients among children aged 2 to <5 y but increased for only half of the examined micronutrients among children aged 5-9 y. For adolescents and adults, most micronutrient intakes slightly declined, with greater inadequacies observed among females than those among males. Pregnant women experienced sharper declines in adequacy of micronutrient intakes than lactating women. The mean probability of adequacy (MPA) was low (around one-third) for all age groups with lower MPA among poorer than that among richer households across age, sex, and survey years. Inequity gaps in MPA mostly declined, except for females aged 50 y or older and pregnant women.

Conclusions: Micronutrient intakes and adequacies remain suboptimal and have decreased marginally over time for many nutrients and MPA across most age groups. Inequities in micronutrient intakes persist by age, sex, and income levels, disproportionately affecting the poor, adults, and women. Our study calls for evidence-based policies and programs that incorporate a range of proven approaches and tailored solutions to effectively tackle persisting inequities and ensure access to healthy diets for all.