The Dietary Intake and Practices of Adolescent Girls in Low- and Middle-Income Countries: A Systematic Review

Abstract

In many low- and middle-income countries (LMICs) the double burden of malnutrition is high among adolescent girls, leading to poor health outcomes for the adolescent herself and sustained intergenerational effects. This underpins the importance of adequate dietary intake during this period of rapid biological development. The aim of this systematic review was to summarize the current dietary intake and practices among adolescent girls (10⁻19 years) in LMICs. We searched relevant databases and grey literature using MeSH terms and keywords. After applying specified inclusion and exclusion criteria, 227 articles were selected for data extraction, synthesis, and quality assessment. Of the included studies, 59% were conducted in urban populations, 78% in school settings, and dietary measures and indicators were inconsistent. Mean energy intake was lower in rural settings (1621 ± 312 kcal/day) compared to urban settings (1906 ± 507 kcal/day). Self-reported daily consumption of nutritious foods was low; on average, 16% of girls consumed dairy, 46% consumed meats, 44% consumed fruits, and 37% consumed vegetables. In contrast, energy-dense and nutrient-poor foods, like sweet snacks, salty snacks, fast foods, and sugar-sweetened beverages, were consumed four to six times per week by an average of 63%, 78%, 23%, and 49% of adolescent girls, respectively. 40% of adolescent girls reported skipping breakfast. Along with highlighting the poor dietary habits of adolescent girls in LMIC, this review emphasizes the need for consistently measured and standardized indicators, and dietary intake data that are nationally representative.

Keywords: adolescent girls; developing countries; diet; dietary practices; energy intake; nutrition transition.

Figure 1

Flow diagram for study retrieval and selection.

Figure 2

Global map representing records included by region.

Figure 3

Adolescent girls’ energy intake (kcal/day) across different geographical world regions.

Figure 4

Adolescent girls’ macronutrient intake (g/day) across different geographical world regions.

Figure 5

(a) Daily intake of food groups reported by adolescent girls; (b) Frequency of consumption of energy-dense foods (sweet and salty snacks, fast foods, and SSBs) by adolescent girls.

Figure 6

Proportion of inadequate fruit and vegetable intake (g/day) among adolescent girls across different geographical world regions.

Figure 7

(a) Proportion of breakfast skipping practice among adolescent girls by age group. (b) Proportion of breakfast skipping practice among adolescent girls by region.