Prevalence and socio-economic determinants of inadequate dietary diversity among adolescent girls and boys in Bangladesh: findings from a nationwide cross-sectional survey

Diet quality and associations with motivation and ability to consume a healthy diet among adolescents from urban low-income households in Bangladesh

In low- and middle-income countries, particularly in urban areas, adolescent diets consist mainly of energy-dense and nutrient-poor foods, putting them at risk of malnutrition and non-communicable diseases (NCD). In Bangladesh, little is known about the diet quality of adolescents, their food choices and the drivers of such choices. This study assessed motivations and ability to consume a healthy diet among adolescent girls and boys from low-income urban families and how these drivers were associated with dietary diversity and diet quality. A cross-sectional survey was conducted among 299 adolescents (15-19 years) from low-income households in Dhaka city during September-October 2020. The Diet Quality Questionnaire was used to collect non-quantitative food intake in the previous day or night to calculate diet quality indicators of food group diversity score, % of adolescents achieving minimum dietary diversity, NCD-Protect and NCD-Risk and the Global Dietary Recommendations score. Motivation was measured by 11 food choice motives. Ability was measured by belief in own ability to engage in healthy eating behaviors (self-efficacy). Adolescent diets showed a mean food group diversity of 4.9 out of 10, with 60% of adolescents achieving minimum dietary diversity, but lacked health-promoting foods (average of 2.7 out of 9 food groups) yet included few foods to avoid and limit (1.6 out of 9). Adolescents valued food choice motive 'safety' the most, followed by 'health', 'taste', 'price', 'convenience' and 'local or seasonal'. A higher motivation to consume 'local or seasonal' and a lower motivation driven by 'price', and a higher perceived self-efficacy were associated with better diet quality. Future interventions should address self-efficacy, concerns about food price and increase local and seasonal foods availability in the urban poor food environment of Dhaka to improve overall diet quality.

Determinants of Full Vaccination Coverage among Children Aged 12-23 Months in Bangladesh: A Comparison between High- and Low-Performing Divisions

Introduction

A better understanding of the significant factors behind childhood vaccination is important for designing strategies to increase vaccination coverage and reduce child mortality and morbidity. The study is aimed at identifying the determinants of full vaccination coverage among children aged 12-23 months in Bangladesh and at comparing the determinants between high- and low-performing areas.

Methods

This study used the latest available Bangladesh Demographic and Health Survey 2017-18 data. A weighted sample of 1678 children was included in this study. The association between full vaccination coverage and explanatory variables was identified using chi-square test. Multivariable logistic regression analysis was employed to identify associated factors of full vaccination coverage.

Results

Findings showed that about 88% of the children had full vaccination coverage. The odds of full vaccination coverage was significantly higher among children of mothers with secondary education compared to children of mothers with no formal education (AOR = 2.07, 95%CI = 1.16 to 3.70). Mother's working status was another significant factor behind full vaccination coverage (AOR = 1.53, 95%CI = 1.002 to 2.34). In addition, we identified that higher age of mother (AOR = 2.76, 95%CI = 1.28 to 5.96 for 20-34 years group and AOR = 12.14, 95%CI = 1.21 to 122.41 for 35 and above age group) and being in middle-income household (AOR = 4.66, 95%CI = 1.33 to 16.34) were significantly associated with full vaccination coverage in high-performing areas. On the other hand, children of mothers with secondary education level (AOR = 2.31, 95%CI = 1.86 to 4.49) and exposure to media (AOR = 1.58, 95%CI = 1.001 to 2.50) had higher odds of having full vaccination coverage in low-performing areas.

Conclusions

This study identified the associated factors of full vaccination coverage among children. The findings indicate the importance of maternal education and mothers' employment for children's vaccination uptake. In low-performing areas, investment in education and awareness raising initiatives may play instrumental role in achieving full vaccination coverage.

Factors associated with inadequate dietary diversity among adolescent girls in Hurumu Woreda High School, Oromia Region, Southwest Ethiopia

Background

Inadequate diet among adolescent girls leads to anatomical and physiological disturbances which will contribute to the vicious intergenerational cycle of malnutrition. However, only a few studies are available in Ethiopia on dietary diversity among adolescent girls who are attending school.

Objective

The objective of this study is to assess factors associated with inadequate dietary diversity among high school adolescent girls in Hurumu Woreda, Southwest Ethiopia, 2022.

Methods

An institution-based cross-sectional study was conducted among 374 high school adolescent girls from 3 May 2022 to 12 June 2022 and selected by using simple random sampling techniques. Data were collected through face-to-face interviews using structured questionnaires. Epi-data version 4.6.0 was used to enter the data, which were then exported to SPSS version 26 for analysis. Simple binary and multivariable logistic regressions were performed to identify factors associated with inadequate dietary diversity.

Results

In this study, the magnitude of inadequate dietary diversity among adolescent girls was 62.6% [95% CI: 57.5-66.5]. Living with more than five family members (AOR = 1.8, 95% CI: 1.16-3.44), consumption of sweet foods/beverages (AOR = 2.2, 95% CI: 1.07-3.41), poor nutritional knowledge (AOR = 2.5, 95% CI: 1.48-3.89), and poor household wealth tercile (AOR = 2.8, 95% CI: 1.44-5.12) were significantly associated with inadequate dietary diversity.

Conclusion

Living with more than five family members, poor household wealth status, consumption of sweet foods/beverages, family size, and poor nutritional knowledge were factors significantly associated with inadequate dietary diversity. Hence, nutrition education, the use of family planning methods, and securing income-generating activities should be implemented.

Clustering of health risk behaviors among school-going adolescents in Mymensingh district, Bangladesh

BACKGROUND

Adolescents frequently engage in risky behaviors that negatively influence their health and pose a serious public health concern. This study aimed to examine the clustering pattern of health risk behaviors among school-going adolescents in Bangladesh.

METHODS

A cross-sectional study was conducted from 15 April to 27 June 2022 among 412 school-going adolescents in Mymensingh district of Bangladesh through a convenience sampling technique. Data were collected via face-to-face interviews using a modified Global School-Based Student Health Survey (GSHS) 2021 questionnaire. Cluster membership was identified using the k-means clustering algorithm. The chi-square test was adopted to explore the association between sociodemographic variables and each cluster membership. The ordinal logistic regression model was employed to examine the predictors associated with cluster membership.

RESULTS

Most of the respondents were female (55.3%) and belonged to the 16-19 years (74.5%) age group. Three behavioral clusters were identified, including Cluster 1: Low-risk taker (50.2%), Cluster 2: Moderate risk taker (39.6%), and Cluster 3: High-risk taker (10.2%). Influential factors of high-risk behavior among adolescents were significantly associated with their age (p = 0.03), father's education who were illiterate (p = 0.02), monthly family income >30000 BDT (p = 0.04), parent's those were understanding their child's problems in most of the time (p = 0.001).

CONCLUSIONS

The study found that high-risk behaviors are significantly higher among late adolescents, those whose fathers are illiterate, whose monthly income is higher, those whose parents or guardians never realize their child's complications and worries, and those whose parents or guardians never recognize what they did in their leisure time. These findings will help to develop intervention programs, policies, strategies, and curricula in school by the experts following the necessity to adopt the adolescent toward healthy behavior and help to reduce the prevalence of health risk behavior.

Impact of COVID-19 on Micronutrient Adequacy and Dietary Diversity among Women of Reproductive Age from Selected Households in Bangladesh

Women of reproductive age (WRA) are recognized as a nutritionally sensitive demographic that is vulnerable to micronutrient deficiencies. The purpose of this study is to determine the situation and influencing factors of diet diversity and micronutrient adequacy during the pandemic-induced economic lockdown period among women living in a selected area of Bangladesh. Twenty-four-hour dietary recall was used to measure the nutrient intake and also used for constructing the Minimum Dietary Diversity for Women (MDD-W) and nutrient adequacy ratio (NAR). Household food insecurity and coping strategies were also measured. Multivariate logistic regression was carried out to identify the link between potential risk factors and MDD-W. About two-thirds (59.9%) of the study subjects did not meet the MDD-W threshold. The women's total energy and protein consumptions were 1475.1 kcal and 46.3 g, respectively, with the diversified diet group consuming more than the non-diverse diet group. Except for vitamin C, vitamin A, and vitamin D, all micronutrients evaluated in the diversified diet group had significantly higher NAR values than the non-diverse diet group. The mean adequacy ratio (MAR) of the overall reproductive women was 0.468 ± 0.096, and it was significantly associated with MDD-W. Another notable finding is that attainment of minimal diversity was not sufficient to achieve acceptable nutrient adequacy for women, pertaining to their low-quantity intake. In addition to this, household size, women's education, coping strategy, and the MAR were found to be significant determinants of MDD-W in the multivariate logistic regression analysis. The findings of the present study therefore highlight the impending need for interventions that ensure good dietary quality for women even during crisis periods.

Nutritional status of a young adult population in saline-prone coastal Bangladesh

Introduction

Like many low- and middle-income countries, understanding the nutritional status of the young population in Bangladesh has had less attention. With projected climate change and associated sea level rise, the existing problem of salinity in coastal Bangladesh will significantly increase and further worsen agrobiodiversity. This research aimed to examine the nutritional status of a young population in climate-vulnerable coastal Bangladesh to inform appropriate intervention strategies to reduce the burden on health and economic outcomes.

Methods

A cross-sectional survey was conducted in 2014, and anthropometric measures were conducted for 309 young people aged 19-25 years in a rural saline-prone subdistrict in southwestern coastal Bangladesh. Body mass index (BMI) was calculated from body height and weight, and data about socio-demographic factors were collected. To identify the socio-demographic risk factors affecting undernutrition (BMI <18.5 kg/m²) and overweight/obesity (BMI ≥ 25.0 kg/m²), multinomial logistic regression analysis was used.

Results

Overall, one-fourth of the study population was classified as underweight, and nearly one-fifth were overweight or obese. The proportion of underweight was significantly higher in women (32.5%) compared to that of men (15.2%). Overall, employment, especially in women, was associated with reduced odds of being underweight (adjusted odds ratio-aOR: 0.32; 95% confidence interval - CI: 0.11, 0.89). Subjects with secondary education incomplete (grades 6-9) compared to those with primary or below education (grades 0-5; aOR: 2.51; 95% CI: 1.12, 5.59) and employed compared to those unemployed groups (aOR: 5.84; 95% CI: 2.67, 12.74) were more likely to be overweight or obese in this study population. These associations were more pronounced in women.

Discussion

Multisectoral program strategies are required to tackle the growing burden of malnutrition (both under and overweight) in this young age group tailored to local contexts including in climate-vulnerable coastal Bangladesh.

Nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals living in Bhasan Char relocation camp, Bangladesh: a cross-sectional survey

OBJECTIVE

To generate baseline evidence regarding the nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals (FDMN) relocated to Bhasan Char relocation camp of Bangladesh.

DESIGN

Cross-sectional survey.

SETTING

Bhasan Char relocation camp, Bangladesh, 7 November 2021-12 November 2021.

PARTICIPANTS

299 under-5 children (both male and female) and 248 adolescent girls (11-17 years) were surveyed.

OUTCOME MEASURES

Anthropometric indices and nutritional status of the study participants.

RESULTS

Nearly 17% of the adolescent girls were suffering from severe thinness/thinness, while 5% were overweight/obese. Severe thinness was more prevalent (2% vs 3.9%) in older adolescents (15-17 years) than their younger counterparts (11-14 years). The prevalence of severe stunting and stunting in adolescents were 14% (95% CI 11.21 to 16.87%) and 29% (95% CI 25.93 to 31.59%), respectively. One-third of the surveyed under-5 children were severely (8.50% (95% CI 5.60 to 11.33%)) or moderately (23.08% (95% CI 20.24 to 25.90%)) stunted, 27% were either severely (4.43% (95% CI 1.60 to 7.27%)) or moderately (22.98% (95% CI 20.15 to 25.81%)) underweight and 12% were severely (1.21% (95% CI 0.00 to 4.04%)) or moderately (10.88% (95% CI 8.05 to 13.72%)) wasted. The prevalence of moderate and severe acute malnutrition in children was low. Surveyed adolescents took a mean of 3.10 (SD 1.03) of nine food groups and 25% (95% CI 22.97 to 28.64%) of under-5 children took minimum diversified diet. The survey respondents mostly consumed carbohydrate-based poorly diversified diets. Nutritional status of the participants did not show any statistically significant association to the dietary diversity status.

CONCLUSION

A significant number of surveyed under-5 children and adolescent girls of relocated FDMN living in Bhasan Char of Bangladesh were suffering from thinness, stunting, underweight and wasting. Dietary diversity was poor among the surveyed population.

Household food insecurity and associated factors in the Northeast of Iran: a cross-sectional study : Household food security in Northern Iran

BACKGROUND

Food Insecurity (FI) is a global health concern. For the first time, this study evaluated households' food insecurity and factors related to it in Golestan province, North of Iran.

METHODS

This cross-sectional study was conducted on 5129 randomly selected households in the Golestan Province in 2016. Sociodemographic characteristics, including age, ethnicity, household size, education level, and occupation status, were collected via interview. The prevalence and severity of food insecurity were identified by the Household Food Insecurity Access Scale (HFIAS), whose scores are between 0 and 27, with larger values indicating more severe food insecurity. The prevalence of food insecurity based on the geographical area was presented using GIS.

RESULTS

Out of 5129 households, 2216 (43.21%) had food security, and 2913 (56.79%) households had food insecurity, with a Mean ± SD HFIAS score of 4.86 ± 5.95. Out of 2913 households with FI, 1526 (52.39%), 956 (32.82%), and 431 (14.79%) had mild, moderate, and severe food insecurity, respectively. Among 14 regions of the province, three regions had the most cases of food insecurity. Food insecurity (moderate or severe) was significantly associated with mothers as the household head (adjusted OR = 1.67, 95% CI: 1.03-2.70) and lower education level of the household head.

CONCLUSION

The prevalence of household food insecurity in the Golestan Province is higher than the national average. Factors such as literacy, employment status, and gender of the household head can be significantly associated with food insecurity.