Despite constituting about 21% (>41m) of the population and increased nutrition requirement, Nigerian adolescents remain a largely neglected, difficult-to-measure and hard-to-reach population who have not been prioritized for nutrition intervention, the Nutrition Society of Nigeria (MSN) has warned.
Adolescence is a transitional period between childhood and adulthood with specific physiological, psychological and social implications that have bearing on nutrition and health. World Health Organization (WHO) defines Adolescents’ as individuals in the 10-19 years age group; while adolescence is a critical period in life and a window of opportunity for lifelong health and well-being.
The NSN, in a statement issued at the weekend by its national president, Prof. Wasiu Afolabi, said Nigerian adolescent nutrition status is not quite different from most countries of the world. Malnutrition among adolescents is marked by undernutrition (stunting and thinness/underweight), over nutrition (overweight and obesity) and micronutrient deficiencies notably Iron deficiency disorders which affects more than sixty percent
of Nigerian adolescent girls aged 15-19 years (NPC and ICF, 2019).
Other available evidence shows that vitamin A, zinc and iodine deficiencies are public health problem among children less than 19 years in Nigeria and three other African countries among others. Although the dearth of nationally representative data for adolescent nutrition status makes generalization difficult, evidence from sparse researches showed that underweight/thinness ranged from 13.0-23.1% (Southern part of Nigeria, 2012).
The review of trend from 2003 to 2013 showed a gradual increase among female adolescent 15-19 years of 18 percent and 13 percent of thinness/underweight and obesity respectively. This could be attributed to poor nutrition knowledge and diet quality, low dietary diversity, high consumption of junk food, and inadequate consumption of animal foods and sedentary lifestyle.
This is occasioned by lack of recreational facilities, eroding school sport activities, and increasing screen time activities in this age group. Added to the growing epidemic is teenage pregnancy, with one out of every five (19.2%) adolescents getting pregnant. The risk of malnutrition among such pregnant adolescent increases and so also the risk of morbidity, mortality and poor pregnancy outcomes (NPC and ICF, 2019).
The inadequate policy and lack of strategic direction to properly address the nutrition needs of adolescents has compounded the hydra-headed challenge of poor nutrition among adolescents in Nigeria. Most of the policy documents contain fragment of nutrition interventions for the adolescent, thus: “we do not have a policy that accurately situates adolescent nutrition as a key issue of top priority to us.
“Moreover, most of the nutrition programme are being implemented in an uncoordinated manner. Parallel and vertical programming by both government and partners had led to drain in resources without tangible results in adolescent nutrition,” says Professor Wasiu Afolabi, President of the Nutrition Society of Nigeria.
“Added to this is the paucity of data and researches on the nutritional status of adolescents as most of the data on adolescent nutrition relate only to
female adolescent of reproductive age.”
It is pertinent to note that adolescents gain over 50% of their adult weight and skeletal mass and over 20% of their adult height. (UNICEF 2011)
Thus inadequate nutrition at this time will definitely affect the adult body size, resulting in thinness or shortness or both (WHO 2006) Iron requirements increase sharply during adolescence to support pubertal growth and to meet additional needs for menstruation (Haider 2006)
Forty four percent (44%) of adolescent girls are married before 18 years of age in Nigeria (World Bank 2018) while adolescent fertility rate is 120 /1000(MICS 2016/17). At least 31% of adolescents have at least one live birth (MICS 2016/17).
This increasing menace of adolescent pregnancy provides a breeding ground for future childhood malnutrition with its attendant consequences on intelligence, productivity, morbidity including diet
related non communicable diseases in adult life and childhood mortality.
Window of Opportunity
In view of the foregoing, the Nutrition Society of Nigeria believes that addressing the nutrition needs of adolescents could be a window of opportunity for the improvement of their nutritional status and correcting their poor nutritional practices; reverse growth faltering experienced during childhood. It is also an important step towards supporting their physical growth and preventing future health problems, breaking the vicious cycle of intergenerational malnutrition, chronic diseases and poverty.
Furthermore, investment in advancing adolescent nutrition is critical to promote their health and development which has lifelong implications in order
to secure them and their future families, communities and nation at large.
NSN therefore calls for urgent actions by government, development partners, private sectors and other stakeholders to bridge the identified policy and data gaps, enhance coordination and increase delivery platforms to reach adolescents with a minimum package of nutrition interventions giving special consideration for nutritional needs of pregnant adolescent mothers; and at the same time call on development partners and non-governmental organizations for a more coordinated actions towards implementing adolescent nutrition interventions capable of reducing intergenerational cycle of malnutrition in Nigeria.
These interventions, which are cost effective and evidence based should include:
• Nutrition education in schools on healthy diets with emphasis on reduction in consumption of sugar and
sugar sweetened beverages
• Multiple Micronutrient supplementation including Iron folate and deworming using health facilities,
school and community based platforms
• Regulating social marketing activities by private sector to encourage healthy diets
• Behavioural and lifestyle intervention for overweight and obese adolescents including sporting activities
• Providing access to safe environment and hygiene
• Improved access to reproductive health services
• In addition to the above, the special needs of pregnant adolescents should be considered including food supplements with adequate energy and protein and Improved access to ante-natal care services.