Adolescent-Specific Nutrition Guidance Is Largely Absent from Food-Based Dietary Guidelines Across Africa and Asia

Adolescence is a period of rapid growth and rising nutrient needs, with girls facing additional iron requirements from menstrual losses, yet Food-Based Dietary Guidelines (FBDGs) in many low- and middle-income countries (LMICs) inadequately address these needs.

This study assessed the adequacy and equity of national FBDGs and government-run adolescent nutrition programs in supporting adolescent nutrition and anemia prevention across eight LMICs in Africa and Asia.

A structured desk review of national FBDGs and government-led adolescent nutrition programs was conducted across Ethiopia, Kenya, Nigeria, Tanzania, Bangladesh, India, Indonesia, and Pakistan, with specific focus on adolescents' nutritional needs, particularly iron; cultural and economic relevance; behavioral communication strategies; and equity considerations. Documents were identified via the FAO FBDG repository, government websites, WHO/UNICEF/World Bank sources, and Nutrition International offices, with duplicate screening and extraction by two independent reviewers, discrepancies resolved by a third. Iron recommendations were cross-referenced against FAO/INFOODS food composition data, and iron-source food affordability, seasonality, and accessibility were rated by two independent reviewers on a 5-point scale, reconciled by a third. No statistical hypothesis testing was performed.

Thirty-one documents were identified (8 national FBDGs, 10 communication materials, 13 program documents). Most FBDGs lacked age- and gender-specific recommendations and gave only general iron guidance despite elevated anemia risk among adolescent girls; iron supplementation and fortification recommendations were inconsistent and poorly aligned with national anemia programs. Adolescent-friendly communication and equity considerations, particularly for out-of-school, rural, and marginalized adolescents, were largely absent.

Among the FBDGs and program documents reviewed across eight LMICs, adolescent-specific guidance on iron, communication, and equity remains substantially underdeveloped. Strengthening FBDGs through adolescent-specific recommendations and closer alignment with supplementation/fortification programs could improve the relevance of adolescent nutrition guidance; effects on dietary behavior or anemia reduction were not assessed and warrant prospective evaluation.