SHiFT symposium at Micronutrient Forum sheds light on adolescent nutrition in Ghana and Viet Nam

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The world is facing an unprecedented global food and nutrition crisis caused by rising food prices, regional conflicts, more frequent and intense climate-related disasters, and the lasting effects of the COVID-19 pandemic. These challenges threaten the current and future health and well-being of vulnerable communities, especially women and young children. To align priorities and action plans to address these crises, the Micronutrient Forum’s 6th Global Conference on Nutrition for Resilience brought together an estimated 3,000 experts, leaders, and advocates from diverse fields from October 16 to 20, 2023 in The Hague, The Netherlands.

An active participant in the conference, the CGIAR Research Initiative on Sustainable Healthy Diets Through Food Systems Transformation (SHiFT) engaged in presentations and hosted a symposium on Adolescent Nutritional Status, Dietary Intake, and the Food Environment in Ghana and Viet Nam, where SHiFT researchers from the International Food Policy Research Institute (IFPRI) and Wageningen University and Research (WUR) shared preliminary results from their recent studies. Inge Brouwer, IFPRI Senior Research Fellow and SHiFT’s Lead, and Jef Leroy, IFPRI Senior Research Fellow and Lead of SHiFT’s Work Package 1, moderated the symposium.

The symposium featured six presentations from two separate studies on adolescents and their diets, nutritional status, and food environments in Ghana and Viet Nam. The research demonstrates SHiFT’s progress in filling evidence gaps on consumption patterns among adolescents and their individual and food environment drivers.

Dietary patterns, nutritional status, and food environments in Ghana

IFPRI’s work in Ghana contributes to a broader effort to improve adolescent nutrition in urban environments. The Accra Urban Adolescent Nutrition Study aimed to better understand adolescent diet and nutrition and to assess how they engage with the food environment by surveying adolescents across 10 neighborhoods in Accra. Although this study preceded SHiFT, aspects of the study design were replicated for use in SHiFT’s study in Viet Nam.

Elodie Becquey, Senior Research Fellow at IFPRI, showed that adolescent diets were generally balanced in macronutrients but lacking in micronutrient-dense food groups, such as fruits and vegetables. More than 60% of the energy adolescents consumed came from foods obtained out of the home (i.e., directly from the food environment). Two-thirds of these foods were consumed away from home. Foods consumed out of the home were much less micronutrient-dense than foods consumed at home. The study concluded that entry points for improving adolescent diets could include behavior change interventions and policies targeting the food environment around schools.

Understanding the nutritional status of adolescents is critical to develop effective policies to improve micronutrient intake. Richmond Aryeetey, Professor at the University of Ghana, presented the team’s data on the nutritional status of adolescents in the Accra study. The researchers found the double burden of malnutrition (the cooccurrence of overweight/obesity alongside undernutrition) varied by neighborhood affluence and type of school attended (public vs private). Higher rates of overweight/obese adolescents were observed in affluent neighborhoods, while more underweight adolescents were observed in poorer neighborhoods.

Analyzing food environments can help to better understand the determinants of adolescent diets and nutritional status. Lieven Huybregts, Senior Research Fellow at IFPRI, discussed the types of food available to adolescents in Accra. The study revealed that unhealthy and ultra-processed foods were significantly more accessible than healthy, nutrient-dense foods in the home and in school, as well as in the food environment on the way to/from school. Adolescents residing in neighborhoods of high socioeconomic status (SES) had greater access to outlets selling unhealthy foods, while adolescents in low SES neighborhoods were closer to outlets selling healthy foods and fruits.

Dietary intake, diet quality, and food environments in Viet Nam

Building upon the insights from Ghana, the focus of the symposium then transitioned to Viet Nam. SHiFT researchers presented findings from a large survey conducted from December 2022 to June 2023 in collaboration with the National Institute of Nutrition (NIN), the Mekong Development Research Institute (MDRI), the French Agricultural Research Centre for International Development (CIRAD), and the French National Research Institute for Sustainable Development (IRD). The research team interviewed adolescents and their mothers from more than 3,000 households in three districts representing rural, peri-urban, and urban contexts.

Phuong Nguyen, Senior Research Fellow at IFPRI, delivered a presentation on adolescent diet quality in the study communities. Using the Global Diet Quality Score to evaluate adolescents’ diets, researchers found that Vietnamese adolescents had a moderate risk of nutrient inadequacy, with adolescents in rural areas at a higher risk than urban areas. The study suggested that interventions to improve adolescent diet quality should promote higher consumption of healthy foods and lower consumption of unhealthy foods.

To examine the effect of food environments on diet quality, researchers compared foods consumed by adolescents in the home versus outside of it. Elise Talsma, Assistant Professor at WUR, found that consumption of unhealthy foods outside the home was prevalent among adolescents in Viet Nam. A higher percentage of foods consumed and prepared outside the home was associated with lower diet quality.

Gabriela Fretes, Associate Research Fellow at IFPRI, presented findings from the analysis of food environments in Viet Nam. In all study areas, sugar-sweetened beverages and processed foods were more prevalent than fruits or vegetables. Advertisements for unhealthy foods and drinks were more common in rural areas than in urban and per-urban areas. A better understanding of food environments in Viet Nam helps to identify policies and innovations that could promote healthy diets among adolescents.

Moving Forward

The symposium illustrated SHiFT’s ongoing efforts to understand adolescent nutrition. The findings underscore the importance of studying food environments to better understand complex dietary issues.

SHiFT’s participation in the Micronutrient Forum highlights its focus on increasing stakeholder awareness of challenges and opportunities related to sustainable healthy diets. These studies are expected to inform interventions that increase the consumption of sustainable healthy diets for all, which will be tested and evaluated with partners in SHiFT’s target countries.

The International Food Policy Research Institute and the Alliance of Bioversity and CIAT lead SHiFT in close collaboration with Wageningen University and Research and with contributions from the International Potato Center. SHiFT combines high-quality nutritional and social science research capacity with development partnerships to generate innovative, robust solutions that contribute to healthier, more sustainable dietary choices and consumption of sustainable healthy diets. It builds on CGIAR’s unparalleled track record of agricultural research for development, including ten years of work on food systems and nutrition under the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH).

Header image: Students enjoy a warm meal in their classroom at Kanda Estate Primary School in Accra, Ghana on October 13, 2015. Photo by Dominic Chavez/World Bank from Flickr

This news item was written by Sydney Honeycutt, Communications Consultant. 

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