200810 A descriptive study of undernutrition, gender and sexual maturation among adolescents in Kilosa District, Tanzania

Monday, November 9, 2009: 9:20 AM

Lorraine Cordeiro, PhD, MPH , Wellesley Centers for Women, Wellesley, MA
Parke Wilde, PhD , Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
Ellen Pinderhughes, PhD , Child Development, Tufts University Arts, Sciences and Engineering, Medford, MA
F. James Levinson, PhD , Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
OBJECTIVE: Undernutrition is a major public health concern and afflicts between 15-30% of adolescents in Sub Saharan Africa. A significant gender difference in adolescent nutritional status has been observed in several developing country studies, with boys appearing to be twice as undernourished as girls. We sought to examine the associations among undernutrition, gender, and sexual maturation in a sample of adolescents from Tanzania.

METHODS: This cross-sectional study examined the nutritional status of 670 individuals aged 10-19 years from 28 villages in Kilosa District, Tanzania. Undernutrition was defined as BMI for Age <5th percentile of the NCHS/WHO reference. Logistic regression models tested associations between gender, sexual maturation, and the outcome variable, undernutrition. We also included an interaction term to represent the cross-product of male and mid-adolescence, a period associated with peak linear growth.

RESULTS: The prevalence of undernutrition in this sample was 25.4% among boys and 15.7% among girls. Undernutrition appeared to be transient during adolescence, with marked improvement in nutritional status after mid-adolescence. Multivariate analyses indicated a moderating effect of mid-adolescence on the nutritional status of males but not females. The odds of being undernourished were significantly greater for mid-adolescent males relative to all other groups.

CONCLUSION: Our findings suggest that undernutrition among adolescent males in this sample might be a function of the rapid growth, physiological changes, and increased nutrient demands associated with sexual maturation. Longitudinal studies are needed to determine whether the gender differential observed in adolescent nutritional status in developing countries has a physiological explanation.

Learning Objectives:
1. Understand adolescent growth in a developing country context 2. Describe gender disparities in adolescent health and nutrion 3. List concerns regarding reference data for adolescent nutritional status 4. Understand the complexity of assessing adolescent nutritional status due to stages of sexual maturation

Keywords: Adolescent Health, Adolescents, International

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Ph.D. Nutrition M.P.H. International Health and Development UNICEF/Tanzania - research on adolescent health and growth Dr. Cordeiro has worked extensively on behalf of children in underserved populations – from Lowell, Massachusetts to Tanzania to Cambodia. Her research encompasses a public health approach to addressing adolescent health outcomes and risk behavior. Integral to her research agenda is her commitment to strengthening scientific infrastructure, both domestically and internationally, using a capacity building model for research. Dr. Cordeiro’s doctoral research on health, nutrition, and risk behavior among adolescents in Tanzania has been published in the 2007 World Hunger Series, a publication of the United Nations. Dr. Cordeiro’s current research examines the association between household food insecurity and behavioral outcomes among adolescents.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.