Research in context
Alive
CURBING

Adolescent nutrition has been largely overlooked in intervention and policy research. We searched PubMed from database inception to Aug 31, 2022, using the search terms (in various combinations) “adolescent”, “nutrition”, “intervention”, “diet”, “school”, “school-based”, and “education”, for intervention studies with adolescent diet or nutrition outcomes. We had filters for English language and human studies, and cross-referenced intervention studies cited in the 2022 
This study evaluates a package of school-based nutrition education interventions coupled with community and health platform-based interventions and capacity building of school staff and service providers to improve the diet of adolescent girls in Ethiopia. Our sample includes adolescent girls aged 10–14 years, an age group for which data and research on nutrition challenges and determinants are scarce, but that represents a key phase of development and habit formation. Our study adds to the limited literature on the effects of school-based nutrition interventions on adolescent nutrition in LMICs. The results showed that developing a package of adolescent nutrition interventions delivered primarily through school-based platforms was feasible and improved adolescent girls’ dietary diversity and meal frequency, even with a short implementation duration (about 4 months). Junk food consumption, however, remained largely unchanged. Despite an intervention effect on the consumption of other sweets, more than half of adolescent girls reported consuming junk foods in the past 24 h.
The findings of our study, together with those of previous studies, reflect the importance of nutrition education and the enabling environment for influencing nutrition behaviours among adolescents. Reinforcing messages about eating diverse foods and eating more often resulted in an incremental behaviour change related to dietary diversity and meal frequency; however, advising adolescents not to eat junk foods without changing their food environments appeared to be largely unsuccessful in curbing consumption of junk food. These findings suggest that nutrition knowledge is likely to have little effect without an enabling environment.In Ethiopia, where 39% of the population is younger than 15 years,Intervention studies on adolescent nutrition in Ethiopia are scarce and have largely focused on supplementation of single micronutrients, such as iron or folic acid;Alive & Thrive is a global initiative that supports the scaling up of nutrition interventions to save lives, prevent illnesses, and contribute to healthy growth and development. In Ethiopia, Alive & Thrive has been supporting the government to achieve targets set out in its National Nutrition Program II (2016–20), and, in 2019, Alive & Thrive developed a package of locally tailored adolescent nutrition interventions to be delivered in school, household, and community settings. The core interventions involved nutrition education targeted to adolescent girls through school-based activities such as classroom lessons, flag ceremonies, school clubs, peer mentoring sessions, and BMI measurement and counselling sessions, and to their parents through parent–teacher meetings and take-home messages. The school-based interventions were delivered by existing cadres of school principals and teachers, who received training about adolescent nutrition and how to implement classroom dialogue and hands-on activities to engage adolescents and parents. Secondarily, health extension workers and influential community actors were encouraged to deliver information about adolescent nutrition to families and the broader community during health facility and home visits for other health services and at community gatherings.We present the results of the core package of school-based nutrition education interventions delivered through public primary schools in two regions (Southern Nations, Nationalities, and People's Region [SNNPR] and Somali) in Ethiopia in terms of feasibility and impact on dietary diversity, meal frequency, and consumption of unhealthy (junk) foods in adolescent girls.