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Adolescent nutrition mapping study: A global stakeholder survey of policies, research, interventions and data gaps

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Summary of research1

Nutrition in school-aged children and adolescents can significantly impact lifelong health and wellbeing as well as the growth, development and long-term health of future generations. Considerable evidence exists for the importance of nutrition in the first 1,000 days, however less focus has been placed on understanding or improving the nutritional status of older children and adolescents.

While evidence and programme experience in this area have been growing, we need greater consensus and information-sharing on the burden, indicators and successful interventions to tackle malnutrition in adolescents and school-age children (5-19 years). Using an online survey, this research mapped the activities and experiences of stakeholders across 1) research and data, 2) policies, strategies and guidelines and 3) interventions and programmes. Questions focused on micronutrient deficiencies, undernutrition (including wasting, thinness and stunting), overweight and obesity and dietary behaviours. The analysis included 133 responses with representation from 42 countries. Most of the work described by the respondents was conducted in low- and middle-income countries (LMICs) in Africa and Asia.

The results showed that research efforts have predominantly focused on the burden of malnutrition with nutrition indicators and the consequences of malnutrition during the adolescent period receiving less attention. More studies were reported on undernutrition, micronutrient deficiencies and diets in this age group than on overweight and obesity. This is a worrying omission considering the rising tide of overnutrition globally. The majority of adolescent nutrition programmes and interventions described by the respondents were provided through the health, nutrition and education sectors. Many of the large-scale and successful programmes described target micronutrient deficiencies, especially iron-deficiency anaemia. Other large-scale programmes described included social media campaigns and school-based peer education programmes to influence dietary practices.

The survey also identified a lack of agreement as to how the adolescent period is defined leading to difficulties in providing representative and comparable data. Other important data and policy gaps identified include the lack of national and international nutrition targets for this age group, lack of standardised definitions of malnutrition, lack of data on current and optimal diets, lack of inclusion and/or disaggregation of adolescent data within national surveys, lack of data on adolescent sub-groups (e.g., males, refugees, out-of-school adolescents), lack of evidence on effective interventions and the lack of inclusion of adolescent voices within research.

Given these findings, the authors recommend:

• Adoption of a universal definition of adolescence. To date, the most commonly used definition is 10-19 years.

• Adolescent-specific nutrition targets that go beyond anaemia in women of reproductive age are needed, both nationally and internationally.

• Routine national surveys are age-disaggregated to represent the adolescent population.

• More research and agreement on effective interventions, particularly for dietary patterns and overweight/obesity, the nutritional needs of particular sub-groups (male adolescents, those out-of-school and adolescents in humanitarian contexts), the most useful indicators to identify and classify malnutrition and how best to reach adolescents (e.g., using social media platforms).

• Greater attention and funding from donor agencies to address the research and programmatic gaps identified in this review and to ultimately improve adolescent outcomes.

 

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Endnotes

1 Zakari Ali, Natasha Lelijveld, Stephanie Wrottesley and Emily Mates (2020). Adolescent nutrition mapping study: A global stakeholder survey of policies, research, interventions and data gaps. www.ennonline.net/adolescentnutritionmappingstudy

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Adolescent nutrition mapping study: A global stakeholder survey of policies, research, interventions and data gaps. Field Exchange 64, January 2021. p76. www.ennonline.net/fex/64/adonutritionmappingsurvey

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