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Session: Predictors of Diet Quality Across the Lifespan (Oral 17)

(OR17-04-23) Meals, Education, and Gardens for In-School Adolescents (MEGA): A Cluster Randomized Trial of Adolescent Nutrition Intervention Packages in Tanzania

Monday, July 24, 2023
10:36 AM – 10:48 AM ET
Location:  Constitution B
Disclosure(s):
Dongqing Wang, PhD, MPH: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: The Meals, Education, and Gardens for In-School Adolescents (MEGA) study aimed to design, implement, and evaluate an integrated, school-based nutrition intervention package among adolescents in Dodoma, Tanzania.

Methods: A cluster randomized controlled trial was conducted among six secondary schools in Dodoma, Tanzania. Two schools were randomized to receive the full-intervention package, which included school meals, nutrition education, school gardens, and community workshops; two schools received the partial-intervention package that did not have the school meals component; two schools were the controls and did not receive any intervention. The intervention was implemented over one academic year, from February to September 2022. The analytical sample included 534 adolescents aged 14 to 17 who participated in both the baseline and end-line data collection. Study outcomes included diet quality based on the Global Diet Quality Score (GDQS), food preferences, food security, physical activity, anthropometry, and anemia. Linear models were used to estimate the effect of the intervention on continuous outcomes. Logistic regression models were used for binary outcomes, and odds ratios (ORs) were computed. Generalized estimating equations were used to account for the clustered design. 

Results: Compared to the control, the partial-intervention package was associated with 0.34 standard deviations greater BMI-for-age z-score (95% CI: 0.24, 0.45). Partial-intervention and full-intervention packages were associated with 41% (OR: 0.59; 95% CI: 0.35, 1.00) and 51% (OR: 0.49; 95% CI: 0.40, 0.59) lower odds of high risk for poor diet quality outcomes based on GDQS, respectively, compared to control. Partial-intervention and full-intervention packages were associated with 71% (OR: 0.29; 95% CI: 0.18, 0.47) and 53% (OR: 0.47; 95% CI: 0.30, 0.72) lower odds of overweight or obesity, respectively, compared to control.

Conclusions: School-based nutritional intervention packages incorporating multiple actions may improve adolescent diet quality and reduce the double burden of adolescent malnutrition. Further studies are needed to examine the impacts of adolescent nutrition intervention packages implemented over an extended period of time.

Funding Sources: Anonymous funder