by Christiana Gokyo, Jos
The Nutrition Society of Nigeria (NSN) has asserted 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.
This 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.
In this regard, NSN therefore, has called for urgent actions by government, development partners, private sectors and other stakeholders to bridge the identified policy and data gaps, to 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.
It also called on development partners and non-governmental organizations for more coordinated actions towards implementing adolescent nutrition interventions capable of reducing intergenerational cycle of malnutrition in Nigeria.
According to NSN, these interventions, which are cost effective and evidenced should include, nutrition education in schools on healthy diets with emphasis on reduction in consumption of sugar and sugar-sweetened beverages, multiple micronutrient supplementations, including iron foliate and de-worming using health facilities, school and community-based platforms and regulating social marketing activities by private sector to encourage healthy diets, behavioural and lifestyles intervention for overweight and obsessed adolescents, including sporting activities, providing access to safe environment and hygiene.
Others is to 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 anti-natal care service.
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.
It has been observed that, 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.
Nigerian adolescent nutrition status is not quite different from most countries of the world, for malnutrition among adolescents is marked by under-nutrition (stunting and thinness/underweight), over-nutrition (overweight and obesity) and micronutrient deficiencies, notably iron deficiency disorders, which affect 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 problems 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 trends, from 2003 to 2013, showed a gradual increase among female adolescents 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 a sedentary lifestyle.
This is occasioned by lack of recreational facilities, eroding school sports 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 programmes 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).
NSN also observed that, 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.