Report executive summary

Adolescent girls are an important target group for nutrition interventions. Not only are their nutritional requirements increased due to rapid growth and development, but many girls in Asia give birth before they themselves have fully grown, increasing the importance of adequate nutrition. Many lifestyle habits are formed in adolescence, making this an important period in which to establish healthy habits. A sedentary lifestyle combined with unhealthy food choices will most likely lead to overweight and non-communicable diseases (NCDs). Addressing nutrition issues in adolescent girls has the potential to break the intergenerational cycle of malnutrition and poverty and prevent many health problems in the future, both for themselves and for future generations. Malnourished mothers tend to deliver babies that are small-for-gestational age, and these children not only suffer the consequences of undernutrition, such as stunting, but are also more prone to becoming overweight or obese and of developing NCDs in later life, including but not limited to cardiovascular disease and type 2 diabetes and obesity. Additionally, girls that were born small for gestational age are more likely to continue the vicious cycle of malnutrition by giving birth to babies that are small for gestational age.

However, the nutritional needs of adolescent girls have been largely neglected, especially in underdeveloped regions of the world where other demographic groups, most notably children under 5 or pregnant and lactating women, have been prioritised. This has largely been the case across Asia, the Western Pacific and the Middle East. The purpose of this document is to draw attention to the fact that adolescent girls need special attention as their nutritional requirements differ from boys, in particular with regard to iron in the wake of menstruation. Not only do the changes that come with puberty pose nutritional challenges, but barriers related to insufficient hygiene and sanitation conditions at schools threaten girls’ education. Many Asian girls still get married very young and get pregnant when their own bodies are still growing, which leads to competition for nutrients between the young mother-to-be and her own foetus, threatening the health and survival of both. It is becoming increasingly clear how malnutrition and poverty form a vicious cycle that spreads over multiple generations. Targeting adolescent girls is a promising way to break this cycle, especially because it provides the opportunity to influence the formation and establishment of healthy lifestyle habits that will stay with them for the rest of their lives and will be taught to future generations.

While undernutrition and deficiencies in vitamins and minerals are still prevalent, many countries have seen large successes in decreasing rates of undernutrition. However, a combination of the long-term impact of suboptimal nutrition of previous generations, urbanisation and related changes in lifestyle, leads to a rapid increase in overweight and obesity rates among young people. This increases the risk of developing NCDs, particularly in individuals who were undernourished early in life.

This report describes some of the underlying causes and the impact of these problems on the long-term health and well-being of the individual adolescent girl and her future offspring. It provides a snapshot of some programmes and interventions in Asia that aim to address these issues. The report ends with a list of recommendations to the Asian public health and nutrition community on how to continue to move forward and expand programming for this important target group.

Why adolescent girls?

  1. Girls face specific nutritional needs due to the onset of menstruation, which increases their iron requirements relative to boys.

  2. When adolescent girls get pregnant, the nutritional needs of the foetus and those of its still developing young mother compete for nutrients in the mother’s body; adolescent pregnancies are still common in parts of
    Asia, contributing to the intergenerational cycle of malnutrition.

  3. Adolescence is when many lifestyle habits (both healthy and unhealthy) are formed that will stay with the person for life.

  4. Malnutrition and poverty act in synergy to perpetuate and reinforce such conditions across generations. Effective interventions targeting adolescent girls are needed to break this vicious cycle as they are the key to ensuring a strong nutritional foundation for mother and focus during the critical first 1,000 days of life. 

View and download the full report: Improving Nutrition for Adolescent Girls in Asia and the Middle East:  Innovations are Needed