Associations between nutritional deficiencies and food insecurity among adolescent girls: A cross-sectional study

There is a research gap in understanding the relationship between nutrient deficiency and food insecurity among adolescent girls in Afghanistan. The objective of this study was to investigate the associations between nutrient deficiencies and food insecurity among middle and high school-aged girls in Kabul. We conducted a cross-sectional study of 380 randomly selected 11-18-year-old girls attending public schools in grades 6-12. We assessed girls' food insecurity, food and nutrient intake, socioeconomic status, and physical activity. Nutrient consumption was calculated using Nutritionist IV software. Statistical analyses, including one-way analysis of variance, Chi-square tests, and t-tests, were used to assess the association between dietary intake and food insecurity. More than half (52.9%) of the participants were food insecure, with 35.8% experiencing hunger and 17.1% without hunger. Vitamin B3, C, selenium, and iron had the highest sensitivity, specificity, and accuracy and were the best indicators of food insecurity with and without hunger. The most prevalent nutrient deficiencies were vitamin B9 and E, calcium, magnesium, and zinc inadequacies. Food security was positively associated with fruit, vitamins E and K, dairy products (e.g., milk, yogurt, and cheese), meat products (e.g., chicken, meat, red meat, and egg), and nut intake. Our findings suggest that adolescent girls in Kabul may benefit from food programs that enrich nutrients such as B9 and E, calcium, magnesium, and zinc, which were found to be the most prevalent nutrient deficiencies. These findings highlight the importance of addressing food insecurity and nutrient deficiencies among adolescent girls in Afghanistan.