Department of Social Sciences, Health and Society, Wageningen University & Research, The Netherlands.
Department of History, University of Groningen, The Netherlands.
J Biosoc Sci. 2021 Jul;53(4):531-556. doi: 10.1017/S0021932020000358. Epub 2020 Jul 8.
Despite the increasing interest in the determinants of adolescent undernutrition in low- and middle-income countries, a comprehensive multi-level overview at the country level is missing. Using the nationally representative 2014 Nepal Adolescent Nutrition Survey, this study aimed to provide a comprehensive overview of the sociocultural and economic determinants of stunting and thinness of adolescent boys and girls in Nepal. Multivariate logistic regression models were used to estimate the associations between multiple individual, household and community determinants and stunting and thinness among 3773 adolescents aged 10-19 years (1888 boys and 1885 girls). The prevalence rates of stunting and thinness indicated suboptimal nutritional status and an inadequate growth environment in Nepali adolescents. The results highlighted an association of paternal occupation and education, household income, number of earning household members, geographical place of residence, caste/ethnicity and nutritional knowledge with stunting, with higher odds for males and older adolescents. Paternal occupation, education, household income, geographical region, caste/ethnicity and nutrition knowledge were associated with thinness, with higher odds for males and younger adolescents. The findings underscore the importance of involving adolescents, their parents and their communities in interventions. Such interventions should not only be aimed at improving adolescent nutrition but also at optimizing adolescents' growth environment for better health and development. Future research should focus on context-specific causal pathways and mechanisms through which sociocultural and economic determinants influence nutritional outcomes within broader societal, cultural and political settings. A longitudinal approach, including a range of dietary and nutrition indicators would allow understanding how and when the relative importance of these factors change during adolescence.
尽管人们对中低收入国家青少年营养不良的决定因素越来越感兴趣，但在国家层面上仍缺乏全面的多层次概述。本研究利用具有全国代表性的 2014 年尼泊尔青少年营养调查，旨在全面概述尼泊尔青少年身材矮小和消瘦的社会文化和经济决定因素。使用多变量逻辑回归模型来估计多个个体、家庭和社区决定因素与 3773 名 10-19 岁青少年（1888 名男孩和 1885 名女孩）的身材矮小和消瘦之间的关联。身材矮小和消瘦的流行率表明尼泊尔青少年的营养状况不佳和生长环境不足。结果强调了父亲的职业和教育、家庭收入、有收入的家庭成员数量、居住地点、种姓/种族和营养知识与身材矮小的关联，男性和年龄较大的青少年出现这种情况的几率更高。父亲的职业、教育、家庭收入、地理区域、种姓/种族和营养知识与消瘦有关，男性和年龄较小的青少年出现这种情况的几率更高。研究结果强调了让青少年、他们的父母和他们的社区参与干预的重要性。此类干预措施不仅应旨在改善青少年的营养状况，而且还应优化青少年的生长环境，以促进更好的健康和发展。未来的研究应侧重于特定于背景的因果途径和机制，了解社会文化和经济决定因素如何以及在何种情况下在更广泛的社会、文化和政治背景下影响营养结果。纵向方法包括一系列饮食和营养指标，可以帮助了解这些因素在青少年时期的相对重要性是如何以及何时发生变化的。
