Adolescents account for nearly one-third of the global population. With the incredible amount of physical, cognitive, and psychosocial growth and development occurring during this time, ensuring adolescents’ access to a nutritious diet has life-long benefits. For girls, the impact will echo on much longer, through the survival, health, and well-being of their children.
Despite this critical stage in development, information about diets and nutritional status of adolescents in low and middle-income countries is surprisingly scant. In a study funded by the New York Academy of Sciences and A4NH, Leroy and colleagues used the 2011-2012 Bangladesh Integrated Household Survey (BIHS) to delve into these issues. Their main conclusion: investing into ensuring adequate access to nutrition during this vulnerable, critical period or life, is essential.
Bangladesh faces significant challenges in malnutrition: in rural parts of the country, rice makes up the vast majority of the diet, accounting for approximately three-quarters of the energy adolescents consume, while animal source foods account for less than five percent.
The BIHS revealed the extent to which adolescents in rural Bangladesh are at risk of the negative effects of malnutrition: one-sixth of the adolescent girls and one-fifth of the adolescent boys were too thin, virtually all adolescents in the sample had deficient Vitamin A intakes, and a large proportion had inadequate energy, iron, and zinc intakes. Differences between boys and girls were not very large, but adolescent boys tended to be thinner and were more likely to have low intakes of zinc, whereas girls were less likely to meet their energy and iron requirements.
Surprisingly, the level of women’s education or empowerment in the home did not improve the diets or nutritional status of adolescents, nor did it impact the nutrient gaps between boys and girls to any significant degree. This came as a surprise given that maternal education is usually a strong determinant of children’s diets and nutritional well-being. The absence of an impact here hints at other, underlying causes.
One thing that did seem to improve nutrition for adolescents is the amount of money available to spend on food within the household. When additional resources were available, intake of energy, iron, and zinc improved for both boys and girls.
These mixed results create a challenge for policymakers and stakeholders looking to target investments to improve adolescent nutrition, but highlight the urgent need to improve the quality of adolescent diets in rural Bangladesh. Several avenues for doing so could be considered, but all of them will require additional research.
· Social protection programs: Bangladesh has a wealth of experience in designing and implementing large social protection programs that effectively reach the poorest and most vulnerable population groups in the country. It is not known, however, to what extent these programs can be leveraged to reach adolescents.
· School feeding programs: BIHS results showed that the vast majority of adolescents up to age 14 were still in school. Expanding traditional school feeding programs, which have successfully targeted primary school students, to secondary schools could improve nutrition and may keep adolescents in school longer. Studies should explore if combining these programs with conditional transfers or dietary supplements can increase their effectiveness at improving adolescent nutritional status.
· Consideration of social norms: Views on adolescents, and on differences between girls and boys, may play a part in the overall nutritional wellbeing of this group. Better understanding these beliefs and norms, and a careful analysis of what interventions might shift these opinions among adults, are possible avenues for affecting change.
This study makes clear there are still many unknowns when it comes to adolescent nutrition. This is a critical stage of life for a group in a vulnerable social position. Finding ways to ensure their nutritional health and well-being will improve their lives now and through adulthood, and set their children up for better nutrition and health, as well.
This post was written by Janet Hodur, A4NH Communications Specialist.