Background/Objectives: Adolescence is a critical life stage characterized by rapid growth, increased nutrient requirements, and the establishment of long-term healthy behaviors. Growing evidence suggests that nutritional inadequacies may persist even when conventional indicators such as body mass index (BMI) appear normal, reflecting hidden malnutrition, a condition characterized by micronutrient inadequacy despite adequate energy intake. This issue may be particularly relevant in structurally constrained environments. This study aimed to compare dietary intake and nutrient adequacy between adolescents residing in residential care institutions (RCIs) and those in the general population in Taiwan. Methods: A total of 248 adolescents were included in the analysis. Institutional data were collected in 2018 and compared with nationally representative data from the Nutrition and Health Survey in Taiwan (NAHSIT 2010–2012). To improve comparability, 1:1 propensity score matching (PSM) was applied based on age, sex, and geographic region. Nutrient intakes were evaluated according to the Taiwan Dietary Reference Intakes (DRIs). Results: Adolescents in RCIs demonstrated significantly lower energy and protein adequacy than their counterparts in the general population. Among boys aged 13–15 years, the proportion meeting protein adequacy was substantially lower in RCIs than in the general population (34.0% vs. 84.0%). Similarly, among girls aged 13–15 years, energy adequacy was markedly lower in RCIs (25.0% vs. 63.9%). In addition, inadequate intake of multiple micronutrients, particularly B vitamins and essential minerals, was observed. Despite these differences, BMI remained largely comparable between groups, indicating a mismatch between anthropometric status and underlying nutritional quality. Conclusions: These findings suggest that hidden nutritional vulnerability may persist even within structured institutional environments designed to ensure stable food provision. The results highlight the limitations of relying solely on anthropometric indicators to assess nutritional status and underscore the need for targeted nutritional strategies to improve dietary quality and reduce health inequalities in residential care settings.
Kao et al. (Sun,) studied this question.