Predictors of stunting and thinness in post-menarcheal adolescent girls in rural Bangladesh

Objective: To assess the nutritional status and risk factors of undernutrition in post-menarcheal girls in rural northern Bangladesh. Design: Cross-sectional data on anthropometric measurements, dietary intake, work activity, morbidity, and socio-economic status were collected from 12- to 19-year-old primigravidae (n 209) and never-pregnant adolescents (n 456) matched on age and time since menarche. Multiple regression analyses Were conducted to determine predictors Of stunting, thinness, upper-arm muscle (UAMZ) and fat area 7 scores (UAFZ) among the adolescent girls. Results: A large proportion of adolescents (49%) were stunted (height-for-age 7 score <-2) and underweight (40%; weight-for-age 7 score <-2), but not thin (BMI-for-age <5th percentile; similar to 10%). The mean (si)) UAMZ and UAFZ of the adolescent girls was -0.3 (0.64) and -0.9 (0.40), respectively. Lean mass increased whereas fat mass declined with age. Both stunting and thinness were positively associated with age and time since menarche (P<0.05). Young age (12-14 years) and literacy were protective against stunting among pregnant adolescents (OR=0.29 95% CI 0.09, 0.88 and OR = 0.50, 95% CI 0.26, 0.96, respectively). Having symptoms of diarrhoea or dysentery (OR = 7.40, 95% CI 1.43, 38.29) predicted thinness and was associated with lower UAMZ and UAFZ among never-pregnant girls (both P<0.05). Performing light-to-moderate activities was protective against thinness among never-pregnant girls (OR = 0.43, 95% CI 0.22 0.82), whereas pregnant adolescents who performed high levels of strenuous activities had greater UAMZ (P<0.05). Conclusion: Undernutrition was widespread among this post-menarcheal adolescent population. younger and literate adolescents were less likely to be stunted, whereas thinness and body composition were associated with morbidity and work activity.