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Open Access

Document Type


Degree Program


Degree Type

Master of Science (M.S.)

Year Degree Awarded


Month Degree Awarded



Dietary Intake, Nutritional Status, Adolescent Girls, Zinc


Underweight and stunting are highly prevalent public health problems in developing countries, particularly among populations exposed to food insecurity and chronic malnutrition. Underweight results from relatively recent malnutrition whereas empirical research has shown that early childhood malnutrition is a strong predictor of stunting. Dietary diversity has been recognized as an indicator of food security, with consumption of more food groups suggesting better nourishment. Greater dietary diversity has been associated with better nutritional outcomes and improved micronutrient intake. Zinc, an essential mineral, plays a critical role in child growth and development. A deficiency in Zinc may contribute to increased risk for stunting in childhood and adolescence.

This cross-sectional study examined the independent associations between underweight, stunting, dietary diversity, and dietary intake of zinc among a sample of never-married adolescent girls (n=307) living in Kilosa District, Tanzania. Dietary, anthropometric, physical activity, morbidity and demographic data were collected. The associations between underweight (determined as weight by age less than 5th percentile of WHO reference) and dietary diversity (defined by the number of food groups consumed by adolescent girls); as well as stunting (determined as height by age less than 3rd percentile of WHO reference) and dietary intake of zinc were tested using multivariate analyses.

We found that adolescent girls’ diets were largely deficient in macronutrients and micronutrients, with the mean intake of energy and protein being 810kcals/d and 21.9g/d, respectively. The rates of underweight and stunting were 16.2% and 62.2%, respectively. Greater dietary diversity was associated with decreased risk of underweight among adolescent girls, after adjusting for confounders including age, village location, school enrollment, pubertal status, socioeconomic status and energy intake, (OR, 0.55, 95%CI 0.39-0.98, p<0.05). Similarly, higher intake of zinc was found to be associated with lower risk of stunting, after controlling for age, physical activity, BMI, energy intake and individual’s dietary diversity (OR, 0.87; 95%CI, 0.76-0.99, p<0.05). In conclusion, these findings suggest that dietary diversity and nutrient intake, especially intake of zinc, may play an important role in the long-term nutritional health of adolescent girls. Longitudinal studies examining these associations in developing countries settings are needed.


First Advisor

Lorraine Cordeiro

Second Advisor

Alayne G. Ronnenberg