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.