nutrition in adolescence is the foundation for adult health

around the world, there are an estimated  1.2 billion adolescents  between 10 and 19 years old. although adolescence lies between childhood and adulthood, adolescents are neither big children, nor little adults. they have increased food requirements to support their rapid physical growth and maturation.

the steep increase in issues such as anemia, overweight and obesity in this age group puts nutritional issues among the  greatest immediate threats to adolescent health . exposure to healthy nutrition from adolescence — ranging from actual food consumption to the food environment — can set the stage for a healthy life ahead and good dietary habits.

however,  poverty and socio-economic inequalities  remain important barriers to accessing diverse and nutritious foods. supporting adolescents’ health and well-being is necessary to ensure their  healthy development , but also offers lifelong and intergenerational benefits.

forms of malnutrition in adolescents

on the undernutrition side,  an estimated one in four adolescents experience anemia , a condition where someone does not have enough healthy red blood cells to carry adequate oxygen to their body’s tissues. linked to limited intake of required vitamins and minerals or malabsorption from the gut,  anemia can complicate growth and development.

anemia can also decrease productivity, which is particularly important considering most adolescents go to school and/or work. the number of adolescents who experience  undernutrition is disproportionately higher in low- and middle-income countries .

from an over-nutrition perspective,  one in five adolescents is overweight or obese , and the proportion is increasing worldwide. these conditions are associated with a  greater risk of developing a disease such as diabetes or cancer later in life , as well as chronic health issues such as hypertension.

making nutritious food choices

eating a balanced and diverse diet is key to meeting nutritional needs. making good food choices is complicated by  adolescents’ affinity for unhealthy foods , such as high-energy and ultra-processed foods like sugar-sweetened drinks and fast food. compared to children, they have a greater say in what they eat, when and where they eat it, and can be  increasingly influenced by social pressures .

food environments  are shaped by food availability, affordability, promotion, quality and safety. they impact food choices and are an important factor in what adolescents eat. adolescents can face multiple food environments daily between the different settings they encounter such as home, school and workplace.

food environments can be classified into three categories :

• traditional: limited food availability and accessibility, adolescent food autonomy is restricted.
• mixed: greater food availability and affordability, food autonomy is increased, role for social significance of food and advertising.
• modern: no concerns about food access, food autonomy is common, influenced by peers and advertising.

making good food choices is complicated by adolescents’ affinity for unhealthy foods, such as high-energy and ultra-processed items like sugar-sweetened drinks and fast food. getty

poverty’s effect on healthy food consumption

in resource-limited settings, found in both high- and low-income countries,  poverty is a key factor driving nutritional inequalities  — particularly micronutrient deficiencies. with the covid-19 pandemic, economically vulnerable households worldwide have experienced  increased food challenges and food insecurity . this presents yet another challenge to adolescent nutrition.

with colleagues in pakistan, my research looked at  social determinants of nutrition among late adolescent girls . one way we did this was using a  diet scoring tool  to assess the diversity of the food they ate. we found that the adolescent girls ate micronutrient-poor foods most of the time, and they commonly had highly sweetened tea, desserts and fried snacks.

1. strategies to reduce poverty to deal with the resource constraints that prevented them from accessing diverse and nutritious foods. these include social safety net programs such as cash transfers.
2. micronutrient intake strategies such as supplements and fortified foods.

interventions to improve adolescent nutrition

the world health organization recognizes several  evidence-informed interventions to improve nutrition during adolescence . these range from education to supplements, and vary depending on the setting, context and type of malnutrition.

for example, a nutrition intervention targeting adolescents in canada would look different from one in pakistan. however, interventions within either canada or pakistan could also differ, depending on geography (urban or rural) and resources. in settings with  socio-economic barriers  such as income and education, these must be addressed; intervening at the individual level alone does not get at the root cause of malnutrition.

a recent international study looked at the interventions in different countries to  improve adolescents’ food and nutrition environments and increase their ability to make choices about their nutrition . it showed a need for more data and research, and saw a role for engaging adolescents to generate solutions. but the greatest reach may come from establishing collaborations across multiple sectors. this means extending beyond the usual players in health and nutrition to engage those in education, food production and marketing (including social media), and agriculture.

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