PROMOTING GIRLS' NUTRITION IN EARLY ADOLESCENCE * 0 AN= Why does adolescent nutrition matter? Adolescence is the second most crucial It is also a last opportunity to In Bangladesh, good health and nutrition period of a child's life in terms of physical reverse growth faltering during this period is key to breaking the growth and cognitive development. experienced during childhood. inter-generational cycle of undernutrition, and ensuring later adult health and productivity. How are adolescent girls doing?* In Bangladesh, one-fourth of Adolescents living in rural areas are Girls are 5 percentage points adolescent girls (15-19 years) fail to more likely to suffer from stunting more likely to be stunted achieve their optimal growth, as and thinness compared to those in than boys over the assessed by optimal height for age urban areas. adolescent period or stunting. Adolescent Growth Dynamics (HAZ score) HAZ scores by girls' age -.8 Steep growth faltering .rela tiveto healthy norm during -1.2 -early years 95% Cl 1.4 Predicted value -1.6 II -1.8- 10 11 12 13 14 15 16 17 18 19 Over the early adolescence Age of girl (years) period, rates of stunting double Girls' height increases until As this graph shows, there is a steep decline in height for from -11% to -22% percent. age 14, but well below the age compared to a healthy norm during the early adolescent healthy norm. period. This begins to level off around age 15 years. Stunting by girls' age 50 Rapid rise in stunting 40 during early years F- 30 # 20 95% Cl 11 Predicted value Growth faltering relative to the Girls continue to gain weight 10 11 12 13 14 15 16 17 18 19 healthy norm is much greater in through the later adolescent period Age of girl (years) the early adolescent period leading to a possible risk of This graph shows steep gradient in the rate of stunting in (age 10-14) compared to late overweight and ohesity in the early adolescent period. The slope is less steep in the adolescence (15-19). adulthood. later adolescent period hut rates of stunting are very high What are the trends in adolescent malnutrition? M IV i Ig Overnutrition, or overweight Changes in the prevalence of Undernutrition declined in early (10-14 and obesity increased among undernutrition and overnutrition from 2012 years) and late adolescent (15-19 years) older adolescents from 2012 to 2014 varied substantially by division and age groups comparing 2012 and 2014 to 2014 between rural and urban areas. Changes nutritional status (2012-2014) Early adolescents (10-14 years) Late adolescents (15-19 years) Division Undernutrition Overweight Undernutrition Overweight Rajshahi Decreased No change Decreased Khulna No change No change Decreased No change Barisal No change No change Decreased Dhaka Decreased No change Decreased Sylhet No change No change No change No change Chittagong No change Rangpur No change No change Decreased Rural Decreased Decreased Urban Decreased Inconsistent Decreased Why? X Q Almost one-third of Household food security is Throughout the adolescence Maternal education is adolescents are already associated with the linear period, girls from the poorest consistently associated with mothers or pregnant with growth of adolescent girls. households experience the stunting in both early and their first child highest rate of stunting. late adolescent age groups. The quality or diet is poor. Dietary Adolescents, especially girls Overweight or obesity are associated with inadequacy (eating 4 or less number living in urban areas adolescents spending more than 4 hours every of food groups) increased among increases the risk of day on sedentary activities such as watching both early and late adolescent overweight in both early and television, computer games and not having periods from 2012 to 2014 late adolescent periods. access to sports and physical activity. Key actions and Policy recommendations Adolescence is a window of opportunity for lifelong health and well-being. It is a time to build on early investments, and offer a second chance for those who have not fared well in early childhood. * Focus on the early adolescent period when nutritional needs are greatest! * Adequate nutrient intake during the early adolescent period is foundational to achieving full developmental potential, and optimizing later adult health and productivity. * Use schools as platform. Healthy school meals, physical education and sports hold promise as most children between 10-13 are still in school * Use social media and adolescent clubs to promote better dietary habits and physical activity * Educate young people about sexual and reproductive health and prevent child marriage and early pregnancy To sustain Bangladesh's positive trajectory in health and economic development, now is the time to invest in the nutritional entitlements of the country's almost 36 million adolescents. *An analysis of pooled nationally representative data on over 18,000 girls aged 10-19 over the period 2011-14 taken from the Food Security Nutritional Surveillance Project (FSNSP), HKI and JPGSPH/BRAC University ,NBRAC SOLtic THE WORLD BANK BEALTH I WORLDBANKGROUP