Adolescent nutritional status in developing countries

In the last 10 years, interest in adolescence has increased worldwide. Much of the attention has been on adolescent health, in particular adolescent pregnancy and sexually transmitted diseases, including HIV infection, but adolescent nutrition has aroused little interest. 11 studies on nutritional status of boys and girls have recently been conducted in Benin, Cameroon, Ecuador, India, Jamaica, Mexico, Nepal, Guatemala, and the Philippines. The studies differed in protocol, sample size, and data collection methods. Anemia was the most important nutritional problem. Anemia prevalence was high in 4 studies (55% in India, 42% in Nepal, 32% in Cameroon, 48% in Guatemala) and significant in 2 others (17% in Ecuador and 16% in Jamaica). Slow growth was common in 9 studies (27-65%). Height in girls as well as in boys did not improve during the entire 8 years of adolescence. It approached the fifth percentile at age 10 and at age 18. Low body mass index (BMI) was high (23-53%) in only 3 studies. It was surprising that boys had a BMI 2 times lower than that of girls relative to sex-specific data. With the difference in growth in height, BMI increased substantially throughout the 8 years of adolescence among all girls for both low BMI or satisfactory BMI at age 10 but only for low BMI among boys age 10. At age 18, the median BMI for girls and boys was well below the fifth percentile. However, in 3 countries where the median BMI at age 10 was low, the boys did not reach the 50th percentile and were still growing, while girls had reached the 50th percentile and stopped growing. These results suggest that the iron status of adolescents needs to be improved, but it is necessary to be cautious when improving height when the BMI is adequate for age 18.