Alam Nurul, Roy Swapan Kumar, Ahmed Tahmeed, Ahmed A M Shamsir
Public Health Sciences Division, ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh.
J Health Popul Nutr. 2010 Feb;28(1):86-94. doi: 10.3329/jhpn.v28i1.4527.
This study estimated the levels and differentials in nutritional status and dietary intake and relevant knowledge of adolescent girls in rural Bangladesh using data from the Baseline Survey 2004 of the National Nutrition Programme. A stratified two-stage random cluster-sampling was used for selecting 4,993 unmarried adolescent girls aged 13-18 years in 708 rural clusters. Female interviewers visited girls at home to record their education, occupation, dietary knowledge, seven-day food-frequency, intake of iron and folic acid, morbidity, weight, and height. They inquired mothers about age of their daughters and possessions of durable assets to divide households into asset quintiles. Results revealed that 26% of the girls were thin, with body mass index (BMI)-for-age <15th percentile), 0.3% obese (BMI-for-age >95th percentile), and 32% stunted (height-for-age < or = 2SD). Risks of being thin and stunted were higher if girls had general morbidity in the last fortnight and foul-smelling vaginal discharge than their peers. Consumptions of non-staple good-quality food items in the last week were less frequent and correlated well positively with the household asset quintile. Girls of the highest asset quintile ate fish/meat 2.1 (55%) days more and egg/milk two (91%) days more than the girls in the lowest asset quintile. The overall dietary knowledge was low. More than half could not name the main food sources of energy and protein, and 36% were not aware of the importance of taking extra nutrients during adolescence for growth spurt. The use of iron supplement was 21% in nutrition-intervention areas compared to 8% in non-intervention areas. Factors associated with the increased use of iron supplements were related to awareness of the girls about extra nutrients and their access to mass media and education. Community-based adolescent-friendly health and nutrition education and services and economic development may improve the overall health and nutritional knowledge and status of adolescents.
本研究利用国家营养计划2004年基线调查的数据,估算了孟加拉国农村地区少女的营养状况、饮食摄入量及相关知识水平和差异情况。采用分层两阶段随机整群抽样法,从708个农村群组中选取了4993名年龄在13 - 18岁的未婚少女。女性访员到女孩家中记录她们的教育程度、职业、饮食知识、七天食物频率、铁和叶酸摄入量、发病率、体重和身高。她们向母亲询问女儿的年龄以及家庭耐用品拥有情况,以便将家庭划分为资产五分位数组。结果显示,26%的女孩消瘦(年龄别体重指数(BMI)<第15百分位数),0.3%肥胖(年龄别BMI>第95百分位数),32%发育迟缓(年龄别身高<或=2个标准差)。与同龄人相比,如果女孩在过去两周内有一般发病率且阴道分泌物有异味,消瘦和发育迟缓的风险更高。过去一周非主食优质食品的消费频率较低,且与家庭资产五分位数组呈显著正相关。资产五分位数最高组的女孩吃鱼/肉的天数比最低组多2.1天(55%),吃鸡蛋/牛奶的天数比最低组多两天(91%)。总体饮食知识水平较低。超过一半的人说不出能量和蛋白质的主要食物来源,36%的人没有意识到青春期额外摄入营养对生长突增的重要性。营养干预地区铁补充剂的使用率为21%,非干预地区为8%。与铁补充剂使用增加相关的因素与女孩对额外营养的认知以及她们接触大众媒体和教育的机会有关。基于社区的青少年友好型健康和营养教育及服务以及经济发展可能会改善青少年的整体健康、营养知识和状况。