Adolescent undernutrition is a persisting public health problem in low and lower middle income countries (LLMICs). Nutritional trajectories are complexly interrelated with socio-cultural and economic (SCE) trajectories. However, a synthesis of the SCE determinants or consequences of undernutrition in adolescents is lacking. We undertook a narrative review of published literature to provide a narrative overview of the SCE determinants and consequences associated with undernutrition among adolescents in LLMICs. We identified 98 articles from PubMed, SCOPUS, and CAB-Abstracts on determinants and consequences of undernutrition as defined by stunting, underweight, thinness, and micronutrient deficiencies. At the individual level, significant determinants included age, sex, birth order, religion, ethnicity, educational and literacy level, working status, and marital status. At the household level, parental education and occupation, household size and composition, income, socioeconomic status, and resources were associated with undernutrition. Only a few determinants at the community/environmental level, including residence, sanitation, school type, and seasonality, were identified. The consequences of adolescent undernutrition were mostly related to education and cognition. This review underscores the importance of the broad range of context-specific SCE factors at several levels that influence adolescent nutritional status and shows that further research on SCE consequences of undernutrition is needed.

During the last decades, the focus of food and nutrition security research has shifted from issues of macro-level availability to problems of unequal access, and distribution within the household. Little systematic attention has however been paid to the role of family systems in household food allocation processes. This study focuses on the extent to which family relations, and particularly gender roles, in two Himalayan communities with different family systems influence intra-household food allocation, and the subsequent nutritional status of women of reproductive age (15-49). In-depth interviews were conducted with 15 Buddhist and 15 Hindu women, the latter belonging either to the higher Chhetri or lower Dalit castes. Additionally, anthropometric data of women were collected. Results show that women from Hindu families were worse off than women from Buddhist households in terms of nutritional status, which is due to different intra-household allocation patterns. Secondly, women's nutritional status varied over the reproductive life course. Women were most vulnerable during menses, pregnancy, and the post-partum period. Comparison with research conducted in the 1980s in this area suggests that the influence of family-level values and practices on women's nutritional status is slowly changing.

Anemia is regarded as major public health problem among adolescents in Low and Middle-Income Countries (LMICs) but there is limited primary data in many countries, including Nepal. This study investigated the prevalence and correlates of anemia in a nationally representative sample of adolescents within the 2014 National Adolescent Nutrition Survey in Nepal. A total of 3780 adolescents aged 10 to 19 years were selected from a cross-sectional survey through multi-stage cluster sampling. Structured interviews, anthropometric measurements and hemoglobin assessments of capillary blood were obtained. Bivariate and multivariable analyses were undertaken to compute the Adjusted Odds Ratio (aOR) for socio-demographic, behavioral and cluster characteristics. The overall prevalence of anemia was 31% (95%CI: 28.2, 33.5), 38% (95%CI: 34.0, 41.8) in female and 24% (95%CI: 20.6, 27.1) in male. The likelihood of anemia was significantly higher among older adolescents (aOR 1.75, 95%CI: 1.44, 2.13), females (aOR 2.02; 95%CI: 1.57, 2.60), among those who walk barefoot (aOR 1.78, 95%CI: 1.08, 2.94), and those residing in the Terai (aOR 1.80, 95%CI: 1.18, 2.77). Food consumption from more than four food groups (aOR 0.71, 95%CI: 0.57, 0.88) was protective against anemia. In conclusion, anemia is common in Nepali adolescents. Efforts to improve the nutritional status of this high-risk age group require nutrition that focus on eating habits, sanitation, iron supplementation and the treatment of hookworm infection.

Background The growing number of community-dwelling older adults and the increased risks of adverse health events that accompany ageing, call for health promotion interventions. Nurses often lead these interventions. The views and experiences of older adults participating in these interventions have rarely been studied. To understand the views of targeted older adults, qualitative studies are essential. The aim of this study was to investigate the views and experiences of older adults on their participation in a nurse-led intervention, taking into account their views on healthy aging. Methods In a qualitative study, nineteen Dutch older adults aged 62 to 92 years participated in semi-structured interviews. These were transcribed verbatim and coded with the Qualitative Data Analysis Miner software program. The Qualitative Analysis Guide of Leuven was used for data analysis. Results Based on the analysis of the interviews, the following main themes emerged from the data reflecting the experiences of the participants: 1) awareness of aging, 2) experienced interaction with the nurse, and 3) perception of the consultations as a check-up and/or personal support. Conclusions This study underscores the importance of nurse-led interventions that match older adults’ personal views concerning healthy living, and their views and experiences concerning these interventions. Older adults’ holistic views of healthy living were not always assessed and valued by the nurses. Also, our study shows a wide variety of expectations, views and experiences among the participating older adults. This implies that health professionals should adjust their working and communication methods to the older adult’s views on life.

Abstract 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.

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