Micronutrient status of female adolescent school dropouts

Abstract

Objectives No data exists for nutritional status of female adolescent school dropouts despite one in seven adolescent girls in Sri Lanka being an early school leaver. The aim of this study was to assess the nutritional status of working and non-working female adolescent school dropouts. Methods A cross-sectional design was used to recruit 613 female adolescent school dropouts, aged 15-19 years, in two districts of the Western Province of Sri Lanka. BMI was calculated by assessment of weight and height. Haemoglobin, serum ferritin, serum folic acid, vitamin B12, and serum zinc were measured. Results When girls were grouped into age specific BMI categories, 32.8% of girls were underweight, while 6.1% were overweight. Prevalence of anaemia (haemoglobin <120 g/l) in the study population was 17 %. Low iron status (serum ferritin <20 μg/l) was noted in 29.4 % of girls, low serum folate in 28% (folic acid <3 μg/l) and zinc deficiency in 28.8% (zinc <66 μg/dl). Regression modeling indicated that dropping out of school early (at <14 years of age) was a significant risk factor for low serum ferritin (p=0.001, odds ratio=2.1). Working adolescents were at greater risk of low micronutrient status: low serum ferritin (p=0.009; odds ratio=1.8) serum folic acid (p=0.006; odds ratio=1.9) and zinc deficiency (p=0.001; odds ratio=2.1) than non-working adolescents.

Socio‐cultural and economic determinants and consequences of adolescent undernutrition and micronutrient deficiencies in LLMICs: a systematic narrative review

“…Generally, household size was positively associated with undernutrition, but only once with status indexes . The number of siblings was in four studies positively associated with undernutrition . This was more the case for girls, or when there were more girls in a household .…”

“…Within the economic domain, household economic status and socioeconomic status (SES) were commonly associated with nutritional status. Household and per capita income were negatively associated with stunting, underweight, and thinness and to a lesser extent positively with HAZ, WAZ, and WHZ . One study showed that per capita food expenditure was positively associated with all nutritional status indexes .…”

“…Reverse causation, in which undernutrition constrains workload, might be a possible explanation . However, two studies also concluded that working girls had a higher risk of anemia and iron and zinc deficiency compared to their nonworking peers, showing that the additional small income generated by working girls may not always have a positive effect on their nutritional status …”

“…Mixed results were found regarding sex, with many studies reporting nonsignificant differences. Interestingly, studies reporting significant associations showed that boys were often worse off in terms of stunting and HAZ; [39][40][41][42][43][44][45][46][47][48][49] underweight and WAZ; 39,[41][42][43]48,[50][51][52] and thinness or WHZ. 39,44,45,47,[53][54][55][56][57][58] Only three studies in Ghana, Ethiopia, and Cambodia found that height or WAZ was lower for girls when compared with boys.…”

Urbanisation, dietary patterns and body composition changes in adolescent girls: a descriptive cross sectional study

“…This is more so in children from urban, low income groups, who often drop out of school [8]. While adolescent diets tend to be lacking nutrient adequacy [9], adolescent school dropouts have been found to be even more vulnerable to nutritional setbacks [10]. The aim of this study was to observe the effect of urbanization, through the association between area of residence, with dietary patterns and body composition measures, and to relate these findings to life style factors and habits influencing dietary intake obtained through qualitative data in Sri Lankan female adolescent school dropouts.…”