Nutritional Status of Adolescent Girls and its Association with Various Factors in an Underserved Area in Karachi; A baseline Cross-Sectional Study from an RCT

Saira Zafar¹Babar Tasneem Shaikh¹Zoha Imtiaz Malik²Syed Hassan Bin Usman Shah³Abdul Momin Rizwan Ahmad^4*

• ¹Health Services Academy, Islamabad, Pakistan
• ²National University of Sciences and Technology, Islamabad, Pakistan
• ³University of New South Wales, Sydney, Australia
• ⁴University of York, York, United Kingdom

Background: Adolescence is marked by rapid growth and development, coupled with higher nutritional needs. Lack of adequate nutrition during this period results in physical and cognitive decline. Adolescent health remains a neglected issue in Pakistan, as evidenced by lack of anthropometric, and dietary data in this age group. Objective: Our study aimed to assess the nutritional status of adolescent school girls, and to determine the associations between mid-upper arm circumference (MUAC), body mass index (BMI), and dietary and hygiene practices among this age group. Methods: A cross-sectional study was conducted on adolescent school girls, aged 10 to 14 years, attending a public secondary school in an underserved area of District Malir, Karachi. A total of 84 girls were included in the study through simple random sampling. Structured questionnaires consisting of socio-demographic, anthropometric, dietary intake, and hygiene practices components, were used to collect data. Primary outcome measures included BMI and MUAC, while nutrition behaviors, dietary intake frequency, and hygiene practices, were secondary outcome measures. Data was analyzed using SPSS version 27.0 and Chi square test, ANOVA, and t-tests were applied where appropriate to develop associations between key variables. A p-value ≤ 0.05 was considered statistically significant. Results: Our study found mean MUAC and BMI values to be 19.8 ± 2.4 cm and16.4 ± 2.2 kg/m² respectively. The mean BMI-for-age z-score was −1.18 ± 1.05. MAUC was significantly associated with family participation in food preparation (p = 0.018), and food purchasing (p=0.045). Participants who reported to wash hands to prevent diseases had lower MUAC as compared to others (p=0.004), similarly participants who reported to washwashing hands with soap when they are dirty had lower MUAC (p=0.048). Additionally, more proportion of underweight participants reported hand washing when their hands were dirty in comparison to those with a normal BMI (p=0.041). Conclusion: Our study found a significant prevalence of under nutrition in terms of MUAC and BMI. Significant associations between both nutrition indicators and food related behaviors, and family decision making, highlight the complex interplay between them, and the need to develop targeted nutrition education interventions.