Association of Body Mass Index and Dietary Diversity with Anemia among Adolescent Girls: A Meta Analysis
Keywords:
anemia, adolescent girls, body mass index, dietary diversity, meta-analysisAbstract
Anemia among adolescent girls remains a major public health problem with long-term implications for growth, cognitive development, and reproductive health. Nutritional status, particularly body mass index (BMI) and dietary diversity score (DDS), has been identified as an important determinant of anemia; however, findings from primary studies are inconsistent. This study aimed to estimate the pooled association between BMI, dietary diversity, and anemia among adolescent girls through a systematic review and meta-analysis following the PRISMA guidelines. A meta-analysis was conducted using the PICO framework with adolescent girls as the population. Underweight BMI and low DDS were defined as exposures, while normal BMI and adequate DDS served as comparators. Anemia was the outcome of interest. Articles published between 2015 and 2025 were retrieved from PubMed, ScienceDirect, and Google Scholar. Eligible studies were cross-sectional, reported adjusted odds ratios (aOR), and were analyzed using RevMan 5.3. Fifteen studies involving 9,654 adolescent girls from six countries were included. Underweight adolescents had a significantly higher risk of anemia compared with those with normal BMI (aOR = 1.91; 95% CI = 1.63–2.25; p < 0.001). Low dietary diversity was also significantly associated with anemia (aOR = 1.71; 95% CI = 1.18–2.50; p = 0.005). Underweight BMI and low dietary diversity significantly increase the risk of anemia among adolescent girls.
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