Background: 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.
Methods: 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.
Results: 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).
Conclusions: 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.