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Food insecurity and linear growth of adolescents in Jimma Zone, Southwest Ethiopia

Tefera Belachew12*, David Lindstrom3, Craig Hadley4, Abebe Gebremariam1, Wondwosen Kasahun5 and Patrick Kolsteren26

Author Affiliations

1 Department of Population and Family Health, Nutrition Unit, College of Public Health and Medical Sciences, Jimma University, PO.Box:1104, Jimma, Ethiopia

2 Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, B- 9000 Ghent, Belgium

3 Department of Sociology, Brown University, Box 1916, Providence, RI 02912 USA

4 Department of Anthropology, Emory University, 207 Anthropology Building 1557 Dickey Drive, Atlanta, USA

5 Department of Epidemiology and Biostatistics, College of Public Health and Medical Sciences, Jimma University, PO.Box:1104, Jimma, Ethiopia

6 Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium

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Nutrition Journal 2013, 12:55  doi:10.1186/1475-2891-12-55

Published: 2 May 2013



Although many studies showed that adolescent food insecurity is a pervasive phenomenon in Southwest Ethiopia, its effect on the linear growth of adolescents has not been documented so far. This study therefore aimed to longitudinally examine the association between food insecurity and linear growth among adolescents.


Data for this study were obtained from a longitudinal survey of adolescents conducted in Jimma Zone, which followed an initial sample of 2084 randomly selected adolescents aged 13–17 years. We used linear mixed effects model for 1431 adolescents who were interviewed in three survey rounds one year apart to compare the effect of food insecurity on linear growth of adolescents.


Overall, 15.9% of the girls and 12.2% of the boys (P=0.018) were food insecure both at baseline and on the year 1 survey, while 5.5% of the girls and 4.4% of the boys (P=0.331) were food insecure in all the three rounds of the survey. In general, a significantly higher proportion of girls (40%) experienced food insecurity at least in one of the survey rounds compared with boys (36.6%) (P=0.045).

The trend of food insecurity showed a very sharp increase over the follow period from the baseline 20.5% to 48.4% on the year 1 survey, which again came down to 27.1% during the year 2 survey.

In the linear mixed effects model, after adjusting for other covariates, the mean height of food insecure girls was shorter by 0.87 cm (P<0.001) compared with food secure girls at baseline. However, during the follow up period on average, the heights of food insecure girls increased by 0.38 cm more per year compared with food secure girls (P<0.066). However, the mean height of food insecure boys was not significantly different from food secure boys both at baseline and over the follow up period. Over the follow-up period, adolescents who live in rural and semi-urban areas grew significantly more per year than those who live in the urban areas both for girls (P<0.01) and for boys (P<0.01).


Food insecurity is negatively associated with the linear growth of adolescents, especially on girls. High rate of childhood stunting in Ethiopia compounded with lower height of food insecure adolescents compared with their food secure peers calls for the development of direct nutrition interventions targeting adolescents to promote catch-up growth and break the intergenerational cycle of malnutrition.