Food consumption and nutrient intake among adolescent girls in The Gambia: a cross-sectional study with urban-rural and nutritional status comparisons

BACKGROUND: Heightened biological and sociocultural vulnerability among adolescent girls places them at increased risk of malnutrition in The Gambia, as elsewhere. This cross-sectional study therefore aimed to explore food consumption and nutrient intakes comparing urban and rural and nutritional status groups, providing novel data for The Gambia. METHODS: Adolescent girls aged 10-19 years from urban or rural communities took part in the study. Participants completed a questionnaire collecting socio-demographic information. Anthropometric measurements were obtained to derive body mass index-for-age and height-for-age z-scores, and nutritional status (stunting, underweight, and overweight). Dietary intake was assessed using two interviewer-administered multiple-pass 24-hour dietary recalls. RESULTS: A total of 208 adolescent girls participated in the study. The diets of those in urban areas featured frequent consumption of processed cereals, sandwiches, and meat-based stews. By contrast, traditional porridges and fish-based stews predominated in the diets of rural participants. Overall, diets in both groups were energy-dense, but low in fruit and vegetables (180 g per day, on average), fibre and iron. Excess fat and carbohydrate as a percentage of energy intake featured in the diets of both groups. Despite greater intakes among the urban compared to rural adolescents for vitamin A (222 vs. 164 µg per day), vitamin D (2 vs. 1 µg) and calcium (390 vs. 289 mg), deficiencies were evident for both urban and rural participants. Higher intakes of free sugars among urban adolescents, inadequate vitamin C intakes among rural adolescents, and (in the context of deficient intakes overall) lower calcium intakes among adolescent girls who were stunted compared to those who were not (325 vs. 367 mg; p = 0.018), were also notable disparities. White rice provided nearly half of total energy intake, and nearly 40% of daily protein across settings. The predominance of sugar-sweetened beverages, and the importance of traditional sweetened drinks as a source of vitamin C, is also a notable concern. CONCLUSIONS: This study describes similarities and differences in urban and rural diets in The Gambia, with nutritional inequalities evident in both settings. The findings are context-specific and descriptive, but are likely to resonate with other West African contexts and underscore the need for targeted intervention strategies to address malnutrition among adolescent girls.