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Growth dynamics among adolescent girls in Bangladesh: Evidence from nationally representative data spanning 2011-2014
McGill Univ, Dept Family Med, Fac Med & Hlth Sci, Montreal, PQ, Canada; BRAC Univ, BRAC James P Grant Sch Publ Hlth, Dhaka, Bangladesh.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics.ORCID iD: 0000-0002-9180-392X
McGill Univ, Dept Family Med, Fac Med & Hlth Sci, Montreal, PQ, Canada.
BRAC Univ, BRAC James P Grant Sch Publ Hlth, Dhaka, Bangladesh.
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2021 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 16, no 7, article id e0255273Article in journal (Refereed) Published
Abstract [en]

Background

Adolescence is the last opportunity to reverse any growth faltering accumulated from fetal life through childhood and it is considered a crucial period to optimize human development. In Bangladesh, a growing double burden of underweight and obesity in adolescents is recognized, yet limited data exists on how, when, and where to intervene. This study assesses the dynamics of growth among adolescent girls in Bangladesh, providing insight about critical junctures where faltering occurs and where immediate interventions are warranted.

Methods

We pooled data from Bangladesh’s Food Security and Nutrition Surveillance Project collected between 2011 and 2014 to document the age dynamics of weight and linear growth. 20,572 adolescent girls were measured for height and 19,345 for weight. We constructed growth curves for height, weight, stunting, and underweight. We also stratified growth dynamics by wealth quintile to assess socioeconomic inequities in adolescent trajectories.

Results

Height-for-age z-score (HAZ) in Bangladeshi girls deteriorates throughout adolescence and especially during the early years. Mean HAZ decreases by 0.20 standard deviations (sd) per year in early adolescence (10–14 years) vs 0.06 sd/year during late adolescence (15–19 years), while stunting increases by 16 percentage points (pp) vs 6.7 pp, respectively. Conversely, BMI-for-age z-score (BAZ) increases by 0.13 sd/year in early adolescence vs 0.02 sd/year in late adolescence, and underweight decreases by 12.8 pp vs 3.2 pp. Adolescent girls in all socioeconomic groups show a similar pattern of HAZ and BAZ dynamics, but the curve for the richest quintile stays above that of the poorest across all ages.

Conclusions

Trends and levels of stunting and underweight among adolescent girls in Bangladesh are worrisome, suggesting substantial linear growth faltering in early adolescence, with improving weight-for-age occurring only as linear growth slows and stops. Given the rising burden of non-communicable diseases (NCDs) in Bangladesh and emerging evidence of the link between stunting and later chronic diseases, greater attention to adolescent growth and development is needed. Our findings suggest that, to address stunting, interventions in early adolescence would have the greatest benefits. School-based interventions could be a way to target this population.

Place, publisher, year, edition, pages
Public Library of Science (PLoS), 2021. Vol. 16, no 7, article id e0255273
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-456171DOI: 10.1371/journal.pone.0255273ISI: 000685248200079PubMedID: 34324581OAI: oai:DiVA.org:uu-456171DiVA, id: diva2:1605213
Available from: 2021-10-22 Created: 2021-10-22 Last updated: 2024-01-15Bibliographically approved

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CiteExportLink to record
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