Improving Adolescent Nutrition in Bangladesh and Tanzania

While a great deal of research has been conducted on child and adult malnutrition in developing countries, there are only a handful of studies on adolescent malnutrition. James Levinson, PhD, faculty member at the Friedman School of Nutrition Science and Policy at Tufts University, and colleagues address problems of adolescent malnutrition in developing countries and assess seminal efforts undertaken by Bangladesh and Tanzania to improve the health of adolescents. In a peer-reviewed publication of the United Nations System Standing Committee on Nutrition, Levinson and colleagues recognize the positive effect that increased attention to adolescent malnutrition has had on these countries, but note that further research is needed, especially studies that focus on the cost-effectiveness of programmatic efforts in developing countries.

What little research there is indicates that "stunting is highly prevalent among adolescents, younger adolescents tend to be more undernourished than older adolescents, and, contrary to expectations, that boys are almost twice as undernourished as girls," write the authors. In addition, these few studies suggest that there are more undernourished adolescents in "South Asia than in South-East Asia or Sub-Saharan Africa, and a higher prevalence in rural than in urban areas."

Researchers face specific challenges when trying to determine the extent of underweight in the adolescent population. Nutritional assessments are particularly difficult due to differences in adolescent growth patterns and variations in the onset of puberty among different populations, both of which are partially attributable to differences in nutritional status. According to Levinson and colleagues, "due to the wide range of variations in the onset of puberty and the resulting growth spurt, determining adolescent nutrient requirements should be based on physiological or maturation age, as opposed to chronological age."

"Adolescence is the only time in a person's life where their rate of growth will increase," says Levinson, corresponding author on the paper. "Adolescents can gain 15 percent of their ultimate adult height and 50 percent of their adult weight in this time period. They simply need more nutrients to support that growth and to become healthy adults."

The authors highlight findings from programs in Bangladesh that illustrate the potential for government-driven solutions. The government of Bangladesh, along with multiple non-governmental organizations (NGOs) and international partners, created and operated the Bangladesh Integrated Nutrition Project (BINP) between 1996 and 2003. BINP developed programs such as the Adolescent Girls Forum, which focused on teaching young women about healthy diets, reproductive health, delaying pregnancy, and women's rights; and the Newly Married Couples initiative to help young women through their first pregnancy. According to the authors, it is highly desirable for adolescent girls to attain full growth prior to their first pregnancy due to severe nutritional demands that pregnancy places on a female's body.