Household Food Security and the Nutritional Status of Rural Tanzanian Adolescents

Household food insecurity contributes to poor nutritional health, with negative consequences on growth and development across childhood. While the nutritional status of children under five years is a priority due to vulnerability and child survival concerns, once beyond that critical age, adolescence is the next important nutritional phase – a time when adult bodies, minds, and social behaviors are formed. This study investigates the association between household food insecurity and undernutrition (BMI for Age <5th percentile of the WHO/NCHS reference) among a sample of never-married adolescents ages 10-19 years (n=670) from 28 villages in Kilosa District, Tanzania. This study is unique in examining these issues in the context of a developing country, Tanzania, that is deeply affected by HIV/AIDS and where chronic undernutrition is highly prevalent. The prevalence of undernutrition among adolescents in this sample was 21%. Logistic regression analyses tested for associations between undernutrition and three distinct measures of household food insecurity (i.e. household caloric adequacy, household dietary diversity score, and coping strategies index), after adjusting potential confounders. Household Dietary Diversity Score emerged the most interesting indicator of food insecurity: every one additional food group added to the household diet increased the odds of being well-nourished by 24.3 percentage points. Similarly, for every unit increase in household caloric adequacy, the odds of being well-nourished increased by 10.4 percentage points. These findings support a growing body of research on adolescent health, suggesting detrimental effects of household food insecurity on nutritional status. We conclude that household dietary diversity is a practical indicator of food security and recommend its use in studies on adolescents living in developing countries.