The period of pregnancy and the first two years of life are crucial for a child’s survival, development, and ability to carve a healthy and prosperous life. Over 3 million children die before their fifth birthday due to poor nutrition in early years, and over 200 million who manage to survive are unable to reach their true potential because poor nutrition has hindered their growth and development, which pushes them into a cycle of ill-health and poverty. The first 1000 days are a critical window to intervene with a host of essential nutrition interventions which reap benefits across the life cycle. However, the focus on this period for decades has resulted in us missing another key opportunity; Adolescence.
At the junction of childhood and adulthood, adolescence is a period of second growth spurt. Hormonal and reproductive changes also impact physical and psychological development. Ensuring adequate nutrition is critical for this stage in life as inadequate and imbalanced diets and improper care practices can seriously compromise health, development, and educational attainment. Furthermore, pregnancy in adolescence severely threatens health, survival, and development of adolescent girls as well as that of their offspring. Adolescent pregnancies contribute significantly to global maternal and child mortality, and to the cycle of ill-health and poverty. Around 16 million girls between 15-19 years (and roughly 1 million younger girls) give birth every year, 95% of which are in Low and Middle Income Countries[i]. Adolescents must consume diets which are adequate in calories so as to prevent underweight and facilitate achievement of their true height potential. Their diets should also be diverse enough to meet their need for all essential micronutrients. This is particularly important for adolescent girls as massive iron losses occur through menstrual blood flow, which increase the susceptibility of anaemia. Anaemia (low haemoglobin due to inadequate iron, folic acid, and other blood forming vitamins and minerals) leads to fatigue, loss of body weight and pallor, but overall it adversely affects physical and cognitive development. In the long run it drives inter-generational ill-health and compromised economic potential. Globally, over 30% of women 15-49 years of age are anaemic (nearly 500million non-pregnant, and 30million pregnant), which makes it necessary to think of policies, programmes, and interventions to improve health and nutrition of adolescents and set a strong foundation for themselves and the generations to come. In 21 out of 41 countries with data, 1/3rd of all girls 15-19 years were anaemic. In some countries, more than 50% of adolescent girls are anaemic[ii] Governments must include adolescents while planning policies and strategies, allocating resources, and implementing programmes for health, nutrition, and development. It is important to note that programmes for this group must go hand in hand with reproductive health and education programmes. Finally, global and national data on adolescent health and nutrition is much needed and should be prioritised in nutrition and health surveys so as to get a clearer picture of the issues that concern this group. This would also inform need and evidence based interventions to improve overall health and nutrition of communities. This World Food Day, it is time to acknowledge adolescence is an equally important window of opportunity that sets the foundation for the first 1000 days. [i] WHO (2015) Fact sheet on Adolescent Pregnancy http://www.who.int/mediacentre/factsheets/fs364/en/ [ii] UNICEF (2012) Progress for Children. A report card on adolescents http://www.unicef.org/media/files/PFC2012_A_report_card_on_adolescents.pdf