Underweight and overweight/obesity among adults in Afghanistan: prevalence and correlates from a national survey in 2018

Background The study aimed to estimate the prevalence and correlates of underweight and overweight/obesity among adults in Afghanistan. Methods National cross-sectional survey data of 3779 persons aged 18-69 years were analysed. Multinomial logistic regression was used to estimate factors associated with underweight and overweight/obesity relative to normal weight. Results In all, 7.8% of the study sample was underweight (BMI < 18.5 kg/m(2)), 49.5% had normal weight (BMI 18.5-24.9 kg/m(2)), 25.5% overweight (25.0-29.9 kg/m(2)), and 17.2% obesity. In adjusted multinomial logistic regression, factors negatively associated with underweight were male sex (adjusted relative risk ratio (ARRR): 0.30, 95% confidence interval (CI): 0.15-0.58) and hypertension (ARRR: 0.51, 95% CI: 0.27-0.95) and factors positively associated with underweight were sedentary behaviour (ARRR: 1.85, 95% CI: 1.11-3.10) and current tobacco use (ARRR: 2.58, 95% CI: 1.08-6.16). Factors positively associated with overweight/obesity were aged 30-44 years (ARRR: 2.00, CI: 1.51-2.66) and aged 45-69 years (ARRR: 1.58, CI: 1.09-2.31) (compared to 18-29 years) (ARRR: 1.28, CI: 1.14-2.18), hypertension (ARRR: 2.74, CI: 1.89-3.96), and type 2 diabetes (ARRR: 1.82, CI: 1.13-2.94), and high physical activity (ARRR: 0.70, CI: 0.50-0.98) was negatively associated with overweight/obesity. Conclusion Almost one in ten adult respondents were underweight and more than two in five were overweight/obese, confirming a dual burden of malnutrition in Afghanistan.