Adolescent Undernutrition: Global Burden, Physiology, and Nutritional Risks

Christian P, Smith ER.


This paper reviews the current state of nutrition in adolescent populations, starting at 10 years of age. It highlights that adolescents, comprised of 10–19-year-olds, form the largest generation of young people in our history, and that of the estimated 1.8 billion adolescents in the world, 90% reside in low- and middle-income countries. The burden of disease among adolescents has its origins in infectious and injury-related causes, but nutritional deficiencies, suboptimal linear growth, and undernutrition are major public health problems, even as overweight may be on the rise in many contexts. The paper reviews and focuses particularly on the factors that influence health and nutritional burdens in adolescent girls, including poor dietary patterns and physical activity, schooling and countervailing social norms for early marriage, and the physiologic processes that can compound them. Specific nutrient requirements (including energy, protein, iron, calcium), suboptimal intakes, anaemia and micronutrient deficiencies, and endocrine factors sensitive to undernutrition are reviewed. They note that growth velocity increases during puberty when peak height velocity occurs and catch-up is possible. In girls, about 15–25% of adult height is attained at this time, a premature pregnancy can halt linear growth and increase the risk of adverse birth outcomes. Finally, they highlight the major data gaps that exist related to nutrition and growth during adolescence, as well as evidence on potential interventions during this second window of opportunity to enhance growth and development, improve human capital, and end the intergenerational cycle of growth failure.

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Source: Christian P, Smith ER. Adolescent Undernutrition: Global Burden, Physiology, and Nutritional Risks. Ann NutrMetab. 2018;72(4):316-328. doi: 10.1159/000488865. Epub2018 May 4. PMID: 29730657.