New achievements in nutrition? Not without adolescents
The growing momentum for improving adolescent nutrition excites the advocate in me. For reasons that go well beyond the future childbearing potential of adolescent girls, there are clear socio-demographic, economic, and moral needs to complement nutrition efforts focused on the early years of life, with those towards adolescents of both genders. For too long this crucial transition stage between childhood and adulthood has fallen through the cracks in our focus on malnutrition, despite being a second window of opportunity to shape human health, capital and potential.
Today, 1 in 6 of the world’s population are adolescents (10–19 years), and we can no longer afford to leave them behind
Last week at the ‘Adolescents: agents of change for a well-nourished world’ conference co-convened by the Global Alliance for Improved Nutrition (GAIN) and the World Health Organisation (WHO), many enriching discussions were had across a wide array of issues relevant to adolescent nutrition and health. However, the most rewarding feature of the conference was the presence and active participation of a group of confident, inspiring, and assertive adolescents from Zambia, Pakistan, Indonesia, Bangladesh, UK, and Ireland. Their enthusiasm in working with others to find solutions to their nutrition and wellbeing was impressive, and their unified ‘not for us without us’ position was categorically clear — if they do not get a say in how we address their problems, how useful will our solutions be?
Iron deficiency is a leading cause of death and disability in adolescents, and at the same time 340 million children and adolescents 5–19 years are overweight or obese (disaggregated data only on adolescents is not readily available). In addition, 11 per cent of all births are to girls 15–19 years, and this as we know, is a threat to their own nutrition, health, and survival but also to that of their children. The only sure path to addressing the spectrum of malnutrition in adolescents is a responsive, flexible, and inclusive system that addresses the breadth of socio-economic, health and gender determinants of their food choices and behaviours.
At this conference there was plenty of ‘food-for thought’ but also for action, on adolescent nutrition:
· Meaningful youth engagement, and no top-down approaches — at a unique stage of identity development, adolescents are keen to be part of decisions that affect them and their lives. We ought to engage them better, build capacities and provide necessary support to find sustainable solutions together.
· Improved definitions for this group — the nutrition needs and risk factors for a 10 year old are different from that of a 15 year old, which are further different from that of a young adult of 18 or 19 years. There is no one size fits all for this widely heterogeneous group, and our proposed solutions must consider this.
· “Chopportunity” — adolescents present a challenge but also an opportunity for nutrition wins. Whilst data and knowledge on diets, barriers, and facilitators to improve adolescent nutrition need considerable advancements, there is still plenty for the global nutrition community and decision makers to not sit back and wait for further evidence.
· Social determinants of nutrition — issues around gender norms, poverty, education, sexual and reproductive health need to be an integral part of the approach to improving adolescent nutrition, without which our efforts will purely be ‘band aid solutions’.
· Less jargon, more agility — adolescents across all geographies are developing more rapidly than we imagine, and our solutions need to adapt to this through a responsive, flexible, and simple manner that makes for easy uptake of information.
· Adolescent role models — youth champions and networks are necessary to get and keep the momentum on adolescent nutrition moving.
· Schools as platforms, but with an equal focus on the large section of adolescents still out of school — schools provide an important ‘one stop shop’ for delivering nutrition, health and wellbeing programmes but this needs resources and efforts to build capacities and support schools and teachers without burdening them. At the same time, a sizeable chunk of adolescent population are still out of school. We ought to reach out to them with nutrition solutions, but also get them to school.
· Data — we need more data on the nutrition status, dietary behaviours, barriers and facilitators to healthy eating specific to adolescents. For example, adolescent girls are often grouped with the women of reproductive age (15–49) group, and overweight-obesity rates are available for under-fives and then for 5–19 years. Without specific data on adolescents, specific solutions are a challenge.
In the middle of the conference my phone battery died, and I was offered a portable phone charger by Annet, the adolescent champion from Zambia. This made me realise — this group is already a step ahead.
If we do not keep pace and work with the adolescents to improve their nutrition and wellbeing, we are already far behind in the race to the goal of ending malnutrition for everyone, everywhere
Read more about the Conference:
Adolescents as Nutrition Catalysts: a Fire has been Lit!
By Lawrence Haddad, GAIN’s Executive Director