Community Nutrition Interventions and the Double Burden of Malnutrition among Adolescent Girls: Evidence from a Cross-Sectional Study

Abstract

Background: Adolescence is a critical period of rapid growth and development during which
nutritional requirements increase substantially. Adolescent girls are particularly vulnerable to
undernutrition, micronutrient deficiencies and anaemia, while changing dietary patterns and
sedentary lifestyles are contributing to increasing overweight and obesity. This coexistence of
nutritional deficiency and excess weight represents the double burden of malnutrition.
Community nutrition interventions, including nutrition education, iron–folic acid
supplementation, deworming, counselling and health screening, provide important opportunities
to address these nutritional challenges.
Objectives: The present study aimed to assess the nutritional status of adolescent girls aged 10–
19 years in selected communities of North 24 Parganas district, West Bengal, and to examine their
exposure to community nutrition interventions and indicators of the double burden of
malnutrition.
Methods: A community-based cross-sectional study was conducted among 200 adolescent girls
aged 10–19 years from selected rural, peri-urban and urban communities. Data were collected
using a structured and pre-tested questionnaire covering socio-demographic characteristics,
dietary practices, nutrition awareness, physical activity and exposure to community- and school-
based nutrition interventions. Anthropometric measurements, including height and weight, were
obtained and BMI was calculated. Nutritional status was assessed using age-appropriate BMI-for-
age standards. Exposure to nutrition education, iron–folic acid supplementation, deworming,
counselling and health screening was also assessed.
Results: The mean age of participants was 15.02 ± 0.18 years, with a mean BMI of 19.71 ± 0.31
kg/m². Overall, 21.0% of girls were undernourished, while 14.0% were overweight and 6.0%
were obese, demonstrating the coexistence of undernutrition and excess weight. Reported
exposure to community nutrition interventions was relatively high for iron–folic acid
supplementation (84.0%), deworming (81.0%) and nutrition education (77.0%), while exposure
to nutrition counselling, health/nutritional screening and physical-activity counselling was 63.0%,
69.0% and 52.0%, respectively. Regular breakfast consumption was reported by 73.0% of
participants, daily vegetable consumption by 79.0%, and daily fruit consumption by 46.0%.
However, 43.0% reported frequent consumption of packaged or processed foods and 32.0%
reported frequent consumption of sugar-sweetened beverages.
Conclusion: The findings indicate a substantial double burden of malnutrition among adolescent
girls, with undernutrition coexisting alongside overweight and obesity. Although exposure to
several community nutrition interventions was relatively high, the comparatively lower coverage
of physical-activity counselling and the continued consumption of processed foods and sugar-
sweetened beverages indicate important areas for improvement. Community and school-based
nutrition programmes should therefore adopt an integrated, double-duty approach combining
micronutrient interventions with nutrition education, healthy dietary practices, physical-activity
promotion, regular screening and behaviour-change strategies.