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Food insecurity and linear growth of adolescents in Jimma Zone, Southwest Ethiopia

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Abstract
Background: Although many studies showed that adolescent food insecurity is a pervasive phenomenon in Southwest Ethiopia, its effect on the linear growth of adolescents has not been documented so far. This study therefore aimed to longitudinally examine the association between food insecurity and linear growth among adolescents. Methods: Data for this study were obtained from a longitudinal survey of adolescents conducted in Jimma Zone, which followed an initial sample of 2084 randomly selected adolescents aged 13-17 years. We used linear mixed effects model for 1431 adolescents who were interviewed in three survey rounds one year apart to compare the effect of food insecurity on linear growth of adolescents. Results: Overall, 15.9% of the girls and 12.2% of the boys (P=0.018) were food insecure both at baseline and on the year 1 survey, while 5.5% of the girls and 4.4% of the boys (P=0.331) were food insecure in all the three rounds of the survey. In general, a significantly higher proportion of girls (40%) experienced food insecurity at least in one of the survey rounds compared with boys (36.6%) (P=0.045). The trend of food insecurity showed a very sharp increase over the follow period from the baseline 20.5% to 48.4% on the year 1 survey, which again came down to 27.1% during the year 2 survey. In the linear mixed effects model, after adjusting for other covariates, the mean height of food insecure girls was shorter by 0.87 cm (P<0.001) compared with food secure girls at baseline. However, during the follow up period on average, the heights of food insecure girls increased by 0.38 cm more per year compared with food secure girls (P<0.066). However, the mean height of food insecure boys was not significantly different from food secure boys both at baseline and over the follow up period. Over the follow-up period, adolescents who live in rural and semi-urban areas grew significantly more per year than those who live in the urban areas both for girls (P<0.01) and for boys (P<0.01). Conclusions: Food insecurity is negatively associated with the linear growth of adolescents, especially on girls. High rate of childhood stunting in Ethiopia compounded with lower height of food insecure adolescents compared with their food secure peers calls for the development of direct nutrition interventions targeting adolescents to promote catch-up growth and break the intergenerational cycle of malnutrition.
Keywords
WHO, CATCH-UP GROWTH, adolescents, Adolescent, Aged, boys, catch-up, childhood, catch-up growth, data, development, Ethiopia, food, growth, height, intervention, linear growth, longitudinal, malnutrition, methods, model, nutrition, nutrition interventions, rural, sample, stunting, survey, urban areas, INTRAHOUSEHOLD ALLOCATION, PUBERTAL DEVELOPMENT, NUTRITIONAL-STATUS, EATING BEHAVIORS, ADULT HEIGHT, GENDER BIAS, EARLY-LIFE, HOUSEHOLD, HEALTH, urban

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Chicago
Lema, Tefera Belachew, David Lindstrom, Craig Hadley, Abebe Gebremariam, Wondwosen Kasahun, and Patrick Kolsteren. 2013. “Food Insecurity and Linear Growth of Adolescents in Jimma Zone, Southwest Ethiopia.” Nutrition Journal 12.
APA
Lema, T. B., Lindstrom, D., Hadley, C., Gebremariam, A., Kasahun, W., & Kolsteren, P. (2013). Food insecurity and linear growth of adolescents in Jimma Zone, Southwest Ethiopia. NUTRITION JOURNAL, 12.
Vancouver
1.
Lema TB, Lindstrom D, Hadley C, Gebremariam A, Kasahun W, Kolsteren P. Food insecurity and linear growth of adolescents in Jimma Zone, Southwest Ethiopia. NUTRITION JOURNAL. 2013;12.
MLA
Lema, Tefera Belachew, David Lindstrom, Craig Hadley, et al. “Food Insecurity and Linear Growth of Adolescents in Jimma Zone, Southwest Ethiopia.” NUTRITION JOURNAL 12 (2013): n. pag. Print.
@article{4212554,
  abstract     = {Background: Although many studies showed that adolescent food insecurity is a pervasive phenomenon in Southwest Ethiopia, its effect on the linear growth of adolescents has not been documented so far. This study therefore aimed to longitudinally examine the association between food insecurity and linear growth among adolescents.
Methods: Data for this study were obtained from a longitudinal survey of adolescents conducted in Jimma Zone, which followed an initial sample of 2084 randomly selected adolescents aged 13-17 years. We used linear mixed effects model for 1431 adolescents who were interviewed in three survey rounds one year apart to compare the effect of food insecurity on linear growth of adolescents.
Results: Overall, 15.9\% of the girls and 12.2\% of the boys (P=0.018) were food insecure both at baseline and on the year 1 survey, while 5.5\% of the girls and 4.4\% of the boys (P=0.331) were food insecure in all the three rounds of the survey. In general, a significantly higher proportion of girls (40\%) experienced food insecurity at least in one of the survey rounds compared with boys (36.6\%) (P=0.045).
The trend of food insecurity showed a very sharp increase over the follow period from the baseline 20.5\% to 48.4\% on the year 1 survey, which again came down to 27.1\% during the year 2 survey.
In the linear mixed effects model, after adjusting for other covariates, the mean height of food insecure girls was shorter by 0.87 cm (P{\textlangle}0.001) compared with food secure girls at baseline. However, during the follow up period on average, the heights of food insecure girls increased by 0.38 cm more per year compared with food secure girls (P{\textlangle}0.066). However, the mean height of food insecure boys was not significantly different from food secure boys both at baseline and over the follow up period. Over the follow-up period, adolescents who live in rural and semi-urban areas grew significantly more per year than those who live in the urban areas both for girls (P{\textlangle}0.01) and for boys (P{\textlangle}0.01).
Conclusions: Food insecurity is negatively associated with the linear growth of adolescents, especially on girls. High rate of childhood stunting in Ethiopia compounded with lower height of food insecure adolescents compared with their food secure peers calls for the development of direct nutrition interventions targeting adolescents to promote catch-up growth and break the intergenerational cycle of malnutrition.},
  articleno    = {55},
  author       = {Lema, Tefera Belachew and Lindstrom, David and Hadley, Craig and Gebremariam, Abebe and Kasahun, Wondwosen and Kolsteren, Patrick},
  issn         = {1475-2891},
  journal      = {NUTRITION JOURNAL},
  language     = {eng},
  pages        = {10},
  title        = {Food insecurity and linear growth of adolescents in Jimma Zone, Southwest Ethiopia},
  url          = {http://dx.doi.org/10.1186/1475-2891-12-55},
  volume       = {12},
  year         = {2013},
}

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