Abstract
In many low- and middle-income countries (LMICs) the double burden of malnutrition is high among adolescent girls, leading to poor health outcomes for the adolescent herself and sustained intergenerational effects. This underpins the importance of adequate dietary intake during this period of rapid biological development. The aim of this systematic review was to summarize the current dietary intake and practices among adolescent girls (10–19 years) in LMICs. We searched relevant databases and grey literature using MeSH terms and keywords. After applying specified inclusion and exclusion criteria, 227 articles were selected for data extraction, synthesis, and quality assessment. Of the included studies, 59% were conducted in urban populations, 78% in school settings, and dietary measures and indicators were inconsistent. Mean energy intake was lower in rural settings (1621 ± 312 kcal/day) compared to urban settings (1906 ± 507 kcal/day). Self-reported daily consumption of nutritious foods was low; on average, 16% of girls consumed dairy, 46% consumed meats, 44% consumed fruits, and 37% consumed vegetables. In contrast, energy-dense and nutrient-poor foods, like sweet snacks, salty snacks, fast foods, and sugar-sweetened beverages, were consumed four to six times per week by an average of 63%, 78%, 23%, and 49% of adolescent girls, respectively. 40% of adolescent girls reported skipping breakfast. Along with highlighting the poor dietary habits of adolescent girls in LMIC, this review emphasizes the need for consistently measured and standardized indicators, and dietary intake data that are nationally representative.
Highlights
The adolescent cohort today (1.2 billion) represents the largest generation in history [1], and 90% of these adolescents reside in a low- or middle-income country (LMIC) [2]
From a total of 72,514 citations found through our database search, we screened 4455 full text articles and identified 288 studies for inclusion (Figure 1) after application of our specified inclusion and exclusion criteria
Several studies were excluded from analysis (N = 61) because of incomplete data or data that was in a form that was unable to be pooled based on our outcomes of interest
Summary
The adolescent cohort (aged 10–19 years) today (1.2 billion) represents the largest generation in history [1], and 90% of these adolescents reside in a low- or middle-income country (LMIC) [2]. While some populations have stabilized, projections estimate a 42% growth of youth (15–24 years) in Africa alone from 2015 to 2030 [3], underpinning the importance of this group, and especially girls and young women, in driving global health and development. We know that the nutrient needs of this group are high and, in LMICs adolescents are at risk of malnutrition (underweight, overweight, micronutrient deficiencies) [5,6,7,8]. In 2016, the global prevalence of underweight was 8%, while overweight and obesity reached over 5% of young girls [9].
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