Adolescent nutrition in West Africa: A rapid review of the research evidence

Transform Nutrition West Africa is a regional initiative to support effective policy and programmatic action on nutrition through evidence generation, synthesis, and mobilization. This technical note provides methodological detail on the rapid review of literature on adolescent nutrition in the West Africa region. Results are presented in the evidence brief, a poster, a presentation, and a blog, and can also be accessed through an Excel spreadsheet.


Definition of adolescence
The World Health Organization definition for adolescence was applied, i.e. the period between ages 10 and 19 (https://www.who.int/maternal_child_adolescent/adolescence/en/), throughout this review Source: Sawyer SM, Afi fi RA, Bearinger LH, Blakemore SJ, Dick B, Ezeh AC, Patton GC. Adolescence: a foundation for future health. Lancet, 2012;379: 1630-40 Box 1: Definitions of adolescence and young adulthood Child: Defined by the Convention on the Rights of the Child (1989) as a person younger than 18 years, unless majority (ie, the legal threshold of adulthood) is attained at a younger age in a particular country.
Adolescence: Historically defined by WHO as the period between ages 10 and 19 years.16 It is derived from the Latin adolescere-the present participle adolescens means growing up, whereas the past participle adultus means grown up.

Youth:
The UN defines youth as people aged between 15 years and 24 years, a definition made in the lead up to the International Youth Year of 1985.
Teenager: Refers to people aged 13-19 years. The term was fi rst used in the USA in the 1920s, and became widely used within popular culture after World War 2.
Young people: A less formally defined term that generally refers to people aged 10-24 years, as does the composite term adolescents and young adults. When data are reported, the 10-24 year age range is increasingly being divided into three categories: 10-14 years (early adolescence); 15-19 years (late adolescence); and 20-24 years (young adulthood) to appropriately examine the extent of changes in health that take place during these years.17-19 Adulthood: The age that children and adolescents gain legal rights and accountabilities varies.18 years is the legal age of majority in many countries, although not universally. Even inlaw, no unified definition of adulthood exists-instead, laws define adulthood at different ages depending on the activity in question.

Search strategy and screening
To conduct this rapid review of the literature, we used a systematic search strategy in the bibliographic database MEDLINE (https://pubmed.ncbi.nlm.nih.gov/) only. The search syntax can be found in Table 2. In brief, we used a combination of terms relating to the Population (adolescents), Outcomes (any nutritional outcome), and Setting (West Africa). The search was carried out on August 13, 2019. The title and abstract were screened against predetermined eligibility criteria (Table 3). For studies to be included in this rapid review, they had to: report on primary research in West Africa, report on a nutritional outcome in an adolescent population, be published in peer-reviewed journals, and be written in English or French. The search resulted in 2,728 studies, of which 154 qualified for inclusion. Reasons for exclusion included not reporting on adolescent age group, not reporting on nutrition outcomes, not reporting on the West Africa region, reporting on animal populations, or disease specific studies (more details in Figure 1).

#1
adolescents OR "adolescence" OR youth OR "young person" OR "young people" OR "young adult" OR teenager OR pupils OR school-aged OR "young women" OR "young man" OR "young woman" OR "young men" OR "school girl*" OR "school boy*"

Data extraction
Five reviewers performed data extraction at the abstract level in Excel. For each eligible study, the following information was extracted: language, country, focus of research, outcome, broad nutrition categories, study design, setting, adolescent age range, subset of adult/child data set, number of participants, drivers, intervention and/or policy description. Further details are provided in Table 4.

Synthesis and quality assessment
The extracted information was analyzed in Excel to identify trends and gaps in the information retrieved. This was then summarized using narrative synthesis. Within this rapid review we did not conduct a full quality appraisal of these studies but included only peer-reviewed studies as a quality control. For a synthesis of the results please see the Evidence Note.

Outcome
What nutrition outcome is being studied?

Broad nutrition categories
Which broad nutrition category/ categories does this study relate to?

Study design
What is the study design? Cross-sectional, cohort, longitudinal, case control, case study, randomized controlled trial, quasi-experimental, other program design, qualitative, mixed-methods, policy analysis

Setting
What was the setting in which the study took place?
Home, village, community, city, health facility, hospital, school, district, not described

Adolescent age range
What is the age of the adolescents included in study?

Subset of adult/child data set?
Is the included adolescent population a subset of an adult-or child-focused study population?
Yesadult population Yeschild population No

Participants (n)
How many participants are included in the study? 500

Drivers
For studies exploring drivers of nutrition outcomes, what drivers are reported?
Poverty, food security, food preferences, etc

Intervention and/or policy description
For studies exploring interventions and/or policy, what are the details of the intervention and/or policy?
Impact of physical exercise on BMI