Globally about 10 percent of children between five to 19 years of age are underweight and 18 percent are overweight 4. Ten percent of school-going adolescents 12 to 15 years of age primarily from low- and middle-income countries are stunted 5. Micronutrient deficiencies and anaemia are widespread, especially in low- and middle-income countries, where up to half of adolescent girls in regions such as South and Southeast Asia may suffer from anaemia 3. This is in part the result of lack of access to adequate, diverse, and nutritious diets. In addition to contributing to micronutrient deficiencies, inadequate diets, combined with lower physical activity, are increasingly contributing to higher rates of overweight/obesity among adolescents 6.
1. Black, R. E. et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet 382, 427–451 (2013).
2. Victora, C. G. et al. Maternal and child undernutrition: consequences for adult health and human capital. The Lancet 371, 340–357 (2008).
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4. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet Lond. Engl. 390, 2627–2642 (2017).
5. Caleyachetty, R., Thomas, G. N., Kengne, A. P., Echouffo-Tcheugui, J. B., Schilsky, S., Khodabocus, J., & Uauy, R. (2018). The double burden of malnutrition among adolescents: analysis of data from the Global School-Based Student Health and Health Behavior in School-Aged Children surveys in 57 low-and middle-income countries. The American journal of clinical nutrition, 108(2), 414-424.
6. Akseer, N., Al-Gashm, S., Mehta, S., Mokdad, A. & Bhutta, Z. A. Global and regional trends in the nutritional status of young people: a critical and neglected age group. Ann. N. Y. Acad. Sci. 1393, 3–20 (2017).
The Global Alliance for Improved Nutrition (GAIN) will focus on improving adolescent diets by identifying suitable interventions that can be practically implemented and scaled up. An initial step in this process will be identifying the primary nutritional and dietary issues adolescents face in each country, including trends over time, geography, and subpopulations. Adolescents will be involved in the design process and help shape the narrative around why adolescents should care about healthy diets. Empowering adolescents by making sure they are involved in building this program will help inspire other young people to join and request better and more affordable foods.
The program methods adopted will be similar in each focus country in terms of building relationships with partners and involving adolescents in the design process. However, due to the unique contexts and nutritional issues, specific diet quality outcomes and interventions will vary. In Bangladesh, GAIN’s efforts will build on the strength of the Shornokishoree Network Foundation (SKNF), which reaches adolescents through girls and boys clubs as well as television programs. In Mozambique, GAIN is developing and testing interventions that could be integrated into an established sexual and reproductive health program, “Action for Girls”, which predominantly employs peer counselling and mentorship and is implemented by the United Nations agencies, the government and civil society. In Pakistan, GAIN is conducting in-depth situational assessment, establishing a national platform to synergize the actions of government and other key stakeholders and identifying next steps for policies and interventions. In Indonesia, based on GAIN’s previous research on the use of social media as a channel to reach adolescents and working in collaboration with adolescent-led associations, GAIN is developing a narrative with potential to reach a large number of adolescents with key messages about the importance of making healthier food choices.