Collaborative network for adolescent nutrition and health in sub-Saharan Africa and India

我们提议的项目将侧重于青春期男女的营养和健康。青春期是生命的阶段，从10岁到19岁，儿童过渡到成年人。它的特点是快速成长、性成熟、大脑广泛的“重新连接”和重组，以及社会互动的范围和复杂性的增加。我们目前拥有人类历史上最大的一代10至19岁的青少年，全世界有超过10亿人，其中一半人在营养质量较差且非传染性疾病(非传染性疾病：肥胖症、心脏病和糖尿病)发病率上升的国家长大。在撒哈拉以南非洲和南亚，青少年占总人口的20%-35%。最近清楚的是，青春期是人生中实现人类潜力的关键阶段，在此期间，成年人健康的身体、心理、行为、社会和经济基础得到巩固。最近的《柳叶刀》青少年健康委员会指出，在生命课程的这个阶段进行投资，有可能产生三重红利，使青少年现在受益，进入他们未来的成人生活，并惠及他们孩子的生活。终生收入价值的不平等有一半是由青春期结束前决定的因素造成的。尽管青春期很重要，但在健康和社会政策方面，青春期在很大程度上被忽视了；最近的联合国妇女、儿童和青少年健康全球战略承认了这一现象。尤其是对青少年营养的研究不足，导致了巨大的知识差距。目前还没有关于不同人群和环境中营养状况和体力活动的全面研究。关于营养和体力活动在青春期期间是如何变化的，是什么决定了这些变化，以及它们如何影响生长、当前的健康、未来的疾病风险和下一代的健康，人们知之甚少。我们不了解青少年饮食和活动行为的驱动因素，以及如何改变这些行为以利于健康。我们的申请汇集了来自英国、印度和撒哈拉以南非洲不同地区的对青少年健康感兴趣的多学科研究人员网络，他们拥有开展大规模营养研究的集体专业知识。我们的长期目标是：1)深入研究这些国家弱势群体中青少年的饮食行为、营养状况、身体成分和身体活动，以及这些在青春期期间如何变化；2)通过定性研究，了解决定青少年每个阶段饮食和活动行为的因素；3)制定和测试针对具体情况的干预措施，通过营养改善青少年健康。为筹备这项雄心勃勃的未来工作，目前的启动应用是：1)通过举办两个讲习班巩固新的网络，一个在印度，一个在非洲；2)开展定性研究方法培训，并进行试点定性数据收集，以探索不同环境对青少年饮食和活动行为的影响；3)对有关青少年营养状况的现有数据和所涉国家青少年营养的现行政策进行文献审查；4)利用该小组现有队列的数据进行二次分析，以检查青春期营养与青少年成长和成人非传染性疾病风险标记之间的关系；5)共同开发未来项目的设计，并在2018年准备更大规模的拨款申请。泵启动工作和未来更大规模研究的一个主要目标是在这些国家职业生涯早期和中期的研究人员中建立严谨和尖端营养研究的能力。

Our proposed project will focus on the nutrition and health of adolescent boys and girls. Adolescence is the stage of life, from 10 to 19 years of age, when children transition into adults. It is characterized by rapid growth, sexual maturation, widespread 're-wiring' and re-organisation of the brain, and an increase in the scope and complexity of social interactions. We currently have the largest generation of 10 to 19 year olds in human history, more than 1 billion worldwide, and half of these grow up in countries characterised by high levels of poor quality nutrition and rising rates of non-communicable disease (NCDs: obesity, heart disease and diabetes). In sub-Saharan Africa and South Asia, adolescents form 20-35% of the population. It has recently become clear that adolescence is a critical phase in life for achieving human potential, and during which the physical, psychological, behavioural, social and economic foundations of adult health are consolidated. The recent Lancet commission on adolescent health points out that investment in this stage of the lifecourse has the potential to produce a 'triple dividend' benefiting adolescents now, into their future adult life, and into the lives of their children. Half of the inequality in the value of lifetime earnings is due to factors determined before the end of adolescence.Despite its significance, adolescence has been largely neglected in health and social policy terms; a phenomenon recognised by the recent UN Global strategy for women's, children's and adolescents' health. Adolescent nutrition has, in particular, been under-researched, leading to large knowledge gaps. There have been no comprehensive studies of nutritional status and physical activity across different populations and settings. Little is known about how nutrition and physical activity change through adolescence, what determines these changes, and how they influence growth, current health, future disease risk, and the health of the next generation. We do not understand the drivers of dietary and activity behaviours among adolescents, and how these could be changed to benefit health.Our application brings together a multi-disciplinary network of researchers interested in adolescent health from the UK, India and different regions of sub-Saharan Africa, with the collective expertise to carry out large-scale nutrition research. Our long-term vision is to 1) conduct in-depth studies of the dietary behaviour, nutritional status, body composition and physical activity of adolescents in vulnerable populations in these countries, and how these change through adolescence; 2) to understand, through qualitative research, the factors which determine their diet and activity behaviour at each stage of adolescence; and 3) develop and test context-specific interventions to improve adolescent health through nutrition. In preparation for this ambitious future work, the current pump-priming application is to 1) consolidate the new network by holding two workshops, one in India, one in Africa; 2) conduct training in qualitative research methods and carry out pilot qualitative data collection to explore influences on dietary and activity behaviour in adolescents across multiple settings; 3) carry out literature reviews of existing data on the nutritional status of adolescents and existing policies for adolescent nutrition in the countries represented; 4) carry out secondary analyses using data from existing cohorts within the group, to examine how nutrition in young adolescence relates to adolescent growth and adult NCD risk markers; and 5) work together to develop the design of the future project, and prepare a larger grant application in 2018. A major objective of both the pump-priming work and the future larger study is to build capacity among early-and mid-career researchers in these countries for rigorous and cutting-edge nutrition research.