Micronutrient Deficiencies in Nepalese Adolescents: National Prevalence and Associated Factors

Micronutrient deficiencies, including iron, vitamin A, and folate, remain a major public health among adolescents in low- and middle-income countries, including Nepal. Understanding the prevalence and factors associated with deficiencies is essential for designing targeted nutrition interventions. Data from 1025 boys and 1852 girls ages 10-19 years were extracted from the 2016 Nepal National Micronutrient Status Survey (NNMSS) to examine the prevalence and factors associated with ferritin, soluble transferrin receptor (sTfR), vitamin A, and red blood cell (RBC) folate status among adolescent boys and girls. All micronutrient outcomes were categorized as binary (1 = if deficiency and 0 otherwise). The prevalence of RBC folate deficiency among adolescent girls was 16.2% and other micronutrient deficiencies were higher in girls compared with boys, ferritin (18.0% vs. 4.8%), sTfR (13.8% vs. 12.2%), and vitamin A (4.4% vs. 2.8%). Multivariable analysis indicated that dietary factors, region, and low and normal Body Mass Index (BMI) were significantly associated with micronutrient deficiencies. Adolescents who did not consume eggs had higher odds of iron deficiency (boys: AOR: 4.35, 95% CI: 1.24-15.24; girls: AOR: 3.15, 95% CI: 1.48-6.69). Girls from the far-western region or with low and normal BMI were more likely to be iron-deficient. Eastern-region girls had higher odds of folate deficiency, and those not consuming nuts or seeds were more prone to vitamin A deficiency. This study found that adolescent boys and girls in Nepal experience a substantial burden of micronutrient deficiencies, with girls disproportionately affected. These findings highlight the need for sustainable and equitable adolescent nutrition programs in Nepal.