Interventions to Improve Adolescent Nutrition: A Systematic Review and Meta-Analysis.
Adequate adolescent nutrition is an important step for optimal growth and development. In this article, we systematically reviewed published studies till December 2014 to ascertain the effectiveness of interventions to improve adolescent nutrition. We found one existing systematic review on interventions to prevent obesity which we updated and conducted de novo reviews for micronutrient supplementation and nutrition interventions for pregnant adolescents. Our review findings suggest that micronutrient supplementation among adolescents (predominantly females) can significantly decrease anemia prevalence (relative risk [RR]: .69; 95% confidence interval [CI]: .62-.76) while interventions to improve nutritional status among "pregnant adolescents" showed statistically significant improved birth weight (standard mean difference: .25; 95% CI: .08-.41), decreased low birth weight (RR: .70; 95% CI: .57-.84), and preterm birth (RR: .73; 95% CI: .57-.95). Interventions to promote nutrition and prevent obesity had a marginal impact on reducing body mass index (standard mean difference: -.08; 95% CI: -.17 to .01). However, these findings should be interpreted with caution due to significant statistical heterogeneity.
Division of Women and Child Health, Aga Khan University, Karachi, Pakistan.
Rehana A
RA
Salam
Division of Women and Child Health, Aga Khan University, Karachi, Pakistan.
Mehar
M
Hooda
Division of Women and Child Health, Aga Khan University, Karachi, Pakistan.
Jai K
JK
Das
Division of Women and Child Health, Aga Khan University, Karachi, Pakistan.
Ahmed
A
Arshad
Robinson Research Institute, University of Adelaide, Adelaide, Australia.
Zohra S
ZS
Lassi
South Australian Health and Medical Research Institute and The University of Adelaide, Adelaide, Australia.
Philippa
P
Middleton
Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada; Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan. Electronic address: zulfiqar.bhutta@sickkids.ca.
Zulfiqar A
ZA
Bhutta
Adolescent nutrition; Micronutrient supplementation; Preconception nutrition; Pregnant adolescents
Arch Pediatr Adolesc Med. 2002 Feb;156(2):131-5
11814373
Int J Obes Relat Metab Disord. 2004 Nov;28 Suppl 3:S2-9
15543214
Obes Rev. 2011 Dec;12(12):997-1021
21848919
JAMA. 1987 Sep 4;258(9):1187-92
3626002
Ann N Y Acad Sci. 1993 Mar 15;678:334-7
8494277
Indian Pediatr. 2009 Feb;46(2):137-43
19242031
Am J Public Health. 2001 Mar;91(3):436-40
11236410
Eur J Clin Nutr. 2003 Apr;57(4):573-9
12700619
Am J Clin Nutr. 1998 Oct;68(4):880-7
9771866
Obstet Gynecol. 2002 Nov;100(5 Pt 1):959-64
12423861
J Health Popul Nutr. 2008 Mar;26(1):74-8
18637530
J Am Diet Assoc. 2005 Jan;105(1):131-8
15635359
J Nurse Midwifery. 1988 Jul-Aug;33(4):178-84
3404281
J Am Diet Assoc. 2002 Mar;102(3 Suppl):S100-2
11902382
J Adolesc Health. 2016 Oct;59(4S):S40-S48
27664595
Clin Med Res. 2003 Jan;1(1):29-36
15931282
Indian J Med Res. 2009 Nov;130(5):584-9
20090111
Obes Rev. 2010 Dec;11(12):835-46
20973911
Lancet. 2013 Aug 3;382(9890):427-451
23746772
J Adolesc Health. 2016 Oct;59(4S):S49-S60
27664596
Lancet. 1999 Aug 7;354(9177):485
10465179
Southeast Asian J Trop Med Public Health. 2012 Jan;43(1):192-200
23082570
Lancet. 1996 Oct 12;348(9033):992-6
8855856
Obstet Gynecol. 1993 Jan;81(1):142-6
8416450
J Adolesc Health. 2016 Oct;59(4S):S76-S87
27664598
Cochrane Database Syst Rev. 2002;(1):CD002272
11869635
Eur J Clin Nutr. 2008 Jul;62(7):856-65
17522609
J Adolesc Health. 2016 Oct;59(4S):S88-S92
27664599
Obstet Gynecol. 1987 Mar;69(3 Pt 1):300-6
3822275
J Hum Lact. 2004 Feb;20(1):18-29
14974697
J Am Diet Assoc. 2002 Mar;102(3 Suppl):S86-9
11902397
Int J Gynaecol Obstet. 2006 Dec;95(3):242-7
17007857
Obes Rev. 2007 Sep;8(5):385-94
17716296
Cochrane Database Syst Rev. 2011 Dec 07;(12):CD001871
22161367
Int J Vitam Nutr Res. 2000 Jul;70(4):172-7
10989766
J Nurse Midwifery. 1985 Mar-Apr;30(2):88-98
3850946
J Adolesc Health Care. 1989 Mar;10(2):97-104
2925477
Am J Obstet Gynecol. 2005 Apr;192(4):1133-6
15846192
Int J Obes (Lond). 2006 Apr;30(4):579-89
16570086
Food Nutr Bull. 2005 Sep;26(3):281-6
16222919
Obstet Gynecol. 2006 Sep;108(3 Pt 1):565-71
16946216
Osteoporos Int. 2001;12(10):875-9
11716192
Am J Clin Nutr. 2003 Apr;77(4):931-6
12663294
Eur J Clin Nutr. 2013 Nov;67(11):1188-92
24022261
Am J Clin Nutr. 1999 Jun;69(6):1249-56
10357747
Nutrition. 2012 May;28(5):551-8
22129855
BMC Med Res Methodol. 2007 Feb 15;7:10
17302989
Food Nutr Bull. 2011 Dec;32(4):315-23
22590964
JAMA. 2006 Apr 19;295(15):1809-23
16622143
J Adolesc Health Care. 1981 Mar;1(3):193-7
7333920
J Adolesc Health. 2016 Oct;59(4S):S61-S75
27664597
Int J Epidemiol. 2010 Apr;39 Suppl 1:i21-31
20348122
J Adolesc Health. 2016 Oct;59(4S):S11-S28
27664592
Asia Pac J Clin Nutr. 2010;19(4):465-72
21147706
Am J Obstet Gynecol. 2001 Oct;185(4):845-9
11641663
Eur J Clin Nutr. 2002 May;56(5):431-7
12001014
Eur J Clin Nutr. 2002 Jul;56(7):666-73
12080408
Cochrane Database Syst Rev. 2004 Oct 18;(4):CD000456
15494996
Obstet Gynecol. 1987 Aug;70(2):263-6
3601290
Am J Clin Nutr. 1997 Jul;66(1):177-83
9209187
Obes Rev. 2009 Jan;10(1):110-41
18673306
J Nutr. 2000 Feb;130(2S Suppl):452S-455S
10721926
J Am Diet Assoc. 1997 Aug;97(8):871-8
9259709
J Nurse Midwifery. 1983 Jul-Aug;28(4):23-9
6554311
Int J Obes (Lond). 2011 Jul;35(7):916-24
21427698
Int J Obes (Lond). 2012 Jan;36(1):1-11
22041985
J Adolesc Health. 2016 Oct;59(4S):S4-S10
27664594
J Adolesc Health Care. 1981 Jun;1(4):261-7
7333930
Lancet. 2006 Jun 3;367(9525):1835-41
16753486
Food Nutr Bull. 2002 Mar;23(1):57-64
11975370
J Nutr. 2010 Oct;140(10):1879-86
20702745
Eur J Clin Nutr. 2004 Jun;58(6):927-37
15164114
J Bone Miner Res. 2006 Jun;21(6):836-44
16753014
J Clin Endocrinol Metab. 2006 Jun;91(6):2017-20
16551739
Eur J Clin Nutr. 2006 Apr;60(4):545-52
16340950
Obes Rev. 2004 May;5 Suppl 1:4-104
15096099
Anaesthesia. 2006 Jan;61(1):36-48
16409341
Indian Pediatr. 2003 Apr;40(4):296-301
12736400
Cochrane Database Syst Rev. 2013 May 31;(5):CD008635
23728678
Asia Pac J Clin Nutr. 2002;11(1):36-41
11890637
Am J Clin Nutr. 2005 Oct;82(4):829-35
16210713