title: Predictors of stunting and thinness in post-menarcheal adolescent girls in rural Bangladesh.
abstract: OBJECTIVE
  To assess the nutritional status and risk factors of undernutrition in post-menarcheal girls in rural northern Bangladesh.
  
  
  METHODS
  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 Z-scores (UAFZ) among the adolescent girls.
  
  
  RESULTS
  A large proportion of adolescents (49 %) were stunted (height-for-age Z-score <-2) and underweight (40 %; weight-for-age Z-score <-2), but not thin (BMI-for-age <5th percentile; approximately 10 %). The mean (sd) 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Center for Human Nutrition, Room W2041, Baltimore, MD 21205, USA.
authors.forename: Jee H
authors.initials: JH
authors.lastname: Rah
authors.forename: Parul
authors.initials: P
authors.lastname: Christian
authors.forename: Abu Ahmed
authors.initials: AA
authors.lastname: Shamim
authors.forename: Ummeh T
authors.initials: UT
authors.lastname: Arju
authors.forename: Alain B
authors.initials: AB
authors.lastname: Labrique
authors.forename: Mahbubur
authors.initials: M
authors.lastname: Rashid