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Objective: The present study aimed to take stock of nutrition interventions that warrant consideration as a minimum package of interventions in Indonesia to improve four key nutrition indicators for adolescents: stunting, thinness, overweight and anaemia., Design: We conducted a review of the peer-reviewed literature published between 1995 and 2017 on nutrition-specific and nutrition-sensitive interventions that target adolescents in Indonesia. The search to identify studies was conducted in PubMed, Google Scholar and EMBASE, using key search terms. We also explored programmatic and policy documents from the grey literature as they related to adolescents and/or Indonesia. Our search yielded thirty-five peer-reviewed articles and programmatic documents., Setting: Indonesia., Subjects: Adolescent girls and boys., Results: There is very limited evidence on the impact of interventions specifically among adolescents in Indonesia. Nevertheless, findings from our review suggest the minimum package of interventions in Indonesia could include the following nutrition-specifc interventions: (i) iron-folic acid supplements, paired with antihelminths delivered at scale via school-based platforms and through health centres; and (ii) diet counselling and nutrition education provided through school-based platforms, adolescent youth centres/peer education and technology-based platforms. The minimum package could also include the following nutrition-sensitive interventions: (i) improving access to reproductive health services; and (ii) increasing the coverage of interventions designed to increase school attendance., Conclusions: Programmes and policies targeting adolescent nutrition are relatively new and coverage is low. To improve the nutritional status of this vulnerable population, additional evaluations of adolescent programming and surveillance data on adolescents are needed.

Objective: To determine the effects of lipid-based nutrient supplements (LNS) on children's Hb, linear growth and development, compared with supplementation with micronutrient powder (MNP)., Design: The study was a two-arm parallel-group randomized controlled trial, where participants received either LNS or MNP for daily consumption during 6 months. Supplements were delivered by staff at government-run health centres. Hb, anthropometric, motor development, language development and problem-solving indicators were measured by trained research assistants when children were 12 months of age., Setting: The study was conducted in five rural districts in the Province of Ambo in the Department of Huánuco, Peru., Subjects: We enrolled 6-month-old children (n 422) at nineteen health centres., Results: Children who received LNS had a higher mean Hb concentration and lower odds of anaemia than those who received MNP. No significant differences in height-for-age, weight-for-height or weight-for-age Z-score, or stunting and underweight prevalence, were observed. Provision of LNS was associated with a higher pre-verbal language (gestures) score, but such effect lost significance after adjustment for covariates. Children in the LNS group had higher problem-solving task scores and increased odds of achieving this cognitive task than children in the MNP group. No significant differences were observed on receptive language or gross motor development., Conclusions: LNS between 6 and 12 months of age increased Hb concentration, reduced anaemia and improved cognitive development in children, but showed no effects on anthropometric indicators, motor or language development.

Objective: To estimate the average annual rates of reduction of stunting, underweight and wasting for the period 1996 to 2011, and to evaluate whether Bangladesh will be expected to achieve the target of Millennium Development Goal 1C of reducing the prevalence of underweight by half by 2015., Design: We used five nationwide, cross-sectional, Demographic and Health Survey data sets to estimate prevalence of undernutrition defined by stunting, underweight and wasting among children under 5 years of age using the WHO child growth standards. We then computed the average annual rates of reduction of prevalence of undernutrition using the formula derived by UNICEF. Finally, we projected the prevalence of undernutrition for the year 2015 using the estimated average annual rates of reduction., Setting: Nationwide covering Bangladesh., Subjects: Children under 5 years of age (n 28,941)., Results: The prevalence of stunting decreased by 18.8% (from 60.0% to 41.2%), underweight by 16.0% (from 52.2% to 36.2%) and wasting by 5.1% (from 20.6% to 15.5%) during 1996 to 2011. The overall average annual rates of reduction were 2.84%, 2.69 % and 2.47%, respectively, for stunting, underweight and wasting. We forecast that in 2015, the prevalence of stunting, underweight and wasting will be 36.7%, 32.5% and 14.0%, respectively, at the national level. The prevalence of undernutrition is likely to remain high in rural areas, in the Sylhet division and in the poorest wealth quintile., Conclusions: Bangladesh is likely to achieve the Millennium Development Goal 1C target of reducing the prevalence of underweight by half by 2015. However, it is falling behind in reducing stunting and further investment is needed to reduce individual, household and environmental determinants of stunting in Bangladesh.

Objective: To investigate the nutritional impact of a community-based programme that focused on social cohesion and action., Design: The change in nutritional status of children aged 12–60 months was examined over a period of 3 years in Makueni District in Eastern Province of Kenya in six communities in which an intervention programme of Participatory Learning and Action was introduced and in ten communities in which only basic preparations were made but no intervention was started., Setting: The intervention was part of the Government of Kenya Community Based Nutrition Programme and was supported by the Government of Denmark., Subjects: Children aged 12–60 months., Results: Among communities without intervention there were similar levels of underweight (mean Z-score: −1·63 v. −1·50 (NS); % with Z-score<–2: 36·6% v. 34·5% (NS)) and stunting (mean Z-score: −2·0 v. −1·99 (NS); % with Z-score<–2: 44·3% and 47·4% (NS)) at baseline and after 3 years. By contrast, among communities who had received interventions, there were significant improvements after 3 years in the levels of underweight (mean Z-score: −1·66 v. −1·37 (P<0·02); % with Z-score <–2: 42·9% v. 31·4% (P<0·035)) and stunting (mean Z-score: −2·05 v. −1·59 (P<0·05); % with Z-score<–2: 52·7% v. 39·7% (P<0·02))., Conclusions: The results indicate considerable potential for using Participatory Learning and Action as a community-based approach to effectively address child undernutrition. It is suggested that these interventions are developed, implemented and evaluated more widely as a mean of tackling childhood undernutrition and improving child survival and development.

Objective: The number of extremely thin young women has increased and education at school on maintaining an optimal weight has become important. The aim of the present study was to assess the effectiveness of a group-based home-collaborative dietary education (HCDE) programme to maintain appropriate dietary intake compared to conventional school classroom education., Design: Two-arm cluster randomized controlled trial. Twelve classes were randomly assigned as clusters to either the HCDE group or the control group. Each participant in the HCDE group received twelve sessions of group counselling aimed at increasing energy intake at breakfast by modifying dietary intake and adopting appropriate habits. The hypothesis underlying the study was that after 6 months of HCDE the total energy intake would be increased by 627 kJ from baseline (primary endpoint). Secondary outcomes were differences in intake of various nutrients from baseline. Outcome measures after log transformation were examined by t tests and linear mixed models (crude and baseline-adjusted)., Setting: Young women among Japanese female adolescents in Tokyo., Subjects: Four hundred and seventy-four participants aged 13-15 years., Results: Students in twelve classes were used for analysis (n 459). Energy intake was decreased in many of the classes during the 6-month period, especially for those in the control group. After adjustment for the baseline value, significant increases in energy intake and protein, calcium, magnesium and iron intakes at breakfast were observed (P<0.05), Conclusions: Although energy intake was increased in the HCDE group compared to the control group, further study of the HCDE is warranted.

Objective: To determine the nutrition transition stage of female Jordanian college students., Design: A cross-sectional survey was used to assess eating styles, disordered eating attitudes and behaviours, body esteem and dissatisfaction, and media influence., Setting: Public and private universities in Jordan., Subjects: A total of 255 subjects were recruited through a government-initiated youth campaign., Results: The majority of participants had a normal BMI (70.6%) with almost all (99.4%) reporting restrained eating behaviour. Scores on the Eating Attitudes Test (EAT-26) indicated that 45.2% of these female college students should be screening for eating disorders. Subscales of the Body Esteem Scale (BES) showed that these women did not have substantial body esteem issues and mean scores on the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-3) indicated that overall these women did not feel the media was dictating the way their body should look. Where Jordanian women did feel pressure from Western media, there was a 6.7-fold increase in the likelihood that they wanted to lose weight. In addition, 48.2% of the female college students desired to lose weight and 14.4% desired weight gain, indicating a certain level of body dissatisfaction., Conclusions: With low levels of overweight and obesity and a propensity towards eating based on external hunger cues, college-aged Jordanian women may be less advanced in their development through the nutrition transition than the general population of women. However, high levels of restrained eating and disordered eating attitudes and behaviours indicate the need for an intervention to address healthy weight-loss strategies, assess eating disorders and help maintain healthy body esteem.

Objective: To assess whether Swiss residents aged 15-24 years follow current nutritional guidelines and whether differences exist according to gender and weight status., Design: Cross-sectional national survey., Setting: Switzerland., Subjects: The 1786 participants (48·4 % women) were divided into overweight, normal weight and underweight. We used traditional BMI cut-offs for people ≥18 years of age (underweight = BMI < 18·5 kg/m2, normal weight = BMI ≥ 18·5 kg/m2 and <25 kg/m2, overweight = BMI ≥ 25 kg/m2) and age- and gender-appropriate tables for people aged <18 years, with BMI calculated from self-reported weight and height. We performed bivariate analyses by gender, and then bivariate and multivariate analyses comparing overweight to normal weight people (excluding underweight, n 129, 71·6 % women) regarding adherence to recommendations for fruit, vegetables, meat, fish and dairy products; physical activity; attitude towards body weight; depression, smoking and alcohol consumption., Results: Overall, adherence to nutritional guidelines was low, particularly for vegetables and dairy products. Women had a higher adherence than men except for fish and dairy products. In the multivariate analyses, overweight women had a lower vegetable intake, were less satisfied with body weight and had more often been on a diet, whereas overweight men were less satisfied with body weight and wanted to lose weight more often than their normal weight peers. There were no significant differences for physical activity., Conclusions: Overweight prevention programmes should target youth specifically by gender and promote an appropriate self-perception. Overweight women should be encouraged to eat more vegetables and men to be more sensitised on healthy food. Further research is needed to assess how to make nutritional guidelines more adaptable to young people's daily life.

There are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0.83 (95% CI 0.686, 1.000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control.

Objective: The present paper reports the prevalence of underweight, overweight and obesity by gender, ethnicity and grade, among participants in a 2002 national survey among South African school-going youth that included height and weight measurements., Design: A stratified two-stage sample was used. Nationally representative rates of underweight, overweight and obesity were calculated using weighted survey data and compared using chi2 analysis., Setting: In all, 9224 grade 8 to grade 11 students, present at school in selected classes within selected South African government-funded schools in all nine provinces, participated in this study. Most of the students were between 13 and 19 years of age., Results: Higher rates of underweight were observed for males than females as well as for black and 'coloured' than white students. Within each gender group, black and 'coloured' students had significantly higher rates of underweight than their white counterparts. Higher percentages of females than males were overweight and obese, overall and among black students. Furthermore, white male students had significantly higher rates of overweight than their black and 'coloured' counterparts. Among females, black and white students had significantly higher rates than 'coloured' students. Students in higher grades showed significantly lower rates of underweight and higher rates of overweight., Discussion: These data confirm that South Africa, a developing nation in socio-economic transition, is experiencing both undernutrition and overnutrition. However, these problems are disproportionately distributed by gender, socio-economics and ethnicity. Continued surveillance of nutritional status may be one important component of a national strategy to prevent and control malnutrition.