UNICEF urges action to break gender barriers in adolescent nutrition

Adolescent girls in South Asia are facing a high burden of nutrition imbalance, warns UNICEF. Nutrition Insight speaks with an expert from the humanitarian organization, who underscores the need for gender-responsive strategies based on the latest research across Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka.

Zivai Murira, regional adviser of Nutrition at UNICEF South Asia tells us girls in these countries face a dual burden of malnutrition and rising obesity, which are driven by gender norms, weak food regulations, and the unchecked influence of food advertising.

South Asia is dealing with malnutrition and rising obesity among adolescent girls. What’s driving this, and how is UNICEF addressing it?
Murira: One-third of the world’s 600 million adolescent girls (10–19 years of age) — about 172 million — live in South Asia, forming the largest cohort of adolescent girls globally. A considerable number of these girls are affected by one or more forms of malnutrition, including undernutrition, micronutrient deficiencies, and overweight or obesity.

Obesity rates among adolescent girls are rising, fueled by unhealthy food environments, heavy marketing of ultra-processed foods, and weak food regulations. Healthy options are often unaffordable, unavailable, or overshadowed by aggressive marketing of ultra-processed foods.

UNICEF has been supporting countries in South Asia to integrate a package of 12 evidence-based interventions across five areas: fortified, nutritious meals; micronutrient supplementation and deworming; nutrition and lifestyle education; advertising, product labeling, marketing, and taxation policies that reduce consumption of unhealthy foods; and periodic nutrition screening and special social safety net services to women and girls who are mothers, underweight, or anemic. This work was captured through 19 case studies from eight countries.

Healthy foods are often unaffordable, unavailable, or overshadowed by aggressive marketing of ultra-processed foodsBy February 2025, five regional countries (Bangladesh, Bhutan, India, Nepal, and Sri Lanka) had implemented programs covering at least six of the twelve interventions. However, not all policies addressing other interventions are being implemented, and regulations concerning the food environment are noticeably weak across the region. Furthermore, not all policies have been converted into nationwide programs. For instance, only India and Sri Lanka have instituted nationwide bans on the marketing and selling of junk foods in schools.

What are governments’ biggest challenges when tackling gender norms and food environments to improve adolescent nutrition?
Murira: Gender inequalities entrenched systemic barriers and policy gaps persistently affect the health and nutrition of girls in South Asia. The limited focus on food environments and the food industry’s influence also exacerbate these issues. To effectively tackle these problems, we need gender-responsive strategies and robust policy initiatives.

Moreover, we need to establish supportive legislation and policy measures that empower girls and confront damaging gender norms through behavioral and community-based practices. Weak implementation and enforcement of policies — stemming from insufficient resources, training, and frameworks — pose significant challenges. Deep-seated gender norms hinder local community support, making it challenging to garner backing for implementing progressive policies for girls.

The power and influence of large local and transnational food and beverage companies significantly impact the nutrition of adolescent girls in South Asia. Their extensive marketing campaigns and strong lobbying efforts make unhealthy foods and drinks easily accessible and widely consumed in homes, schools, and other settings. UNICEF urges South Asia governments to take action to implement evidence-based policies and regulations that safeguard children against the harmful effects of ultra-processed foods and these aggressive marketing strategies.

To tackle these challenges with healthy food policies and regulations, we need stronger commitment and collaboration among government bodies, leaders, and experts. Multi-sector action comes with political challenges, resulting in fragmented decision-making and potentially conflicting actions.

With cuts in foreign aid, how is UNICEF ensuring nutrition initiatives for adolescent girls in South Asia stay on track?
Murira: UNICEF remains deeply committed to ensuring nutrition initiatives for adolescent girls in South Asia despite reductions in foreign aid. We are evaluating the comprehensive effects of these funding cuts on our programs and acknowledge that millions of children across the region will be impacted. This is a critical moment for unified action.

Gender inequalities entrench systemic barriers and policy gaps persistently affect the health and nutrition of girls in South Asia.With backing from governments, donors, the private sector, and individuals, we can continue offering transformative nutrition programs that enable adolescent girls to grow, learn, and fulfill their potential. Throughout our history, our collective efforts have saved countless lives and fostered brighter futures for children. We are committed to continuing this legacy, ensuring every girl has the nutrition she requires to succeed. 

United, we can convert challenges into opportunities, ensuring no child is overlooked. UNICEF will continue supporting the world’s children and delivering hope, health, and a brighter future. 

How do early marriage and pregnancy affect adolescent nutrition, and what can be done to break this cycle?
Murira: Child marriage and adolescent pregnancy are serious violations of children’s rights, severely impacting the nutrition and well-being of adolescent girls and their children. Alarmingly, 26% of girls in the region are affected by child marriage. Three out of four child brides give birth during their teenage years. Pregnancy can adversely affect the nutritional health of adolescent girls, hindering their growth and raising the risk of underweight and anemia during this critical developmental stage. Infants born to adolescent mothers are more likely to be premature and have low birth weight compared to those born to adult mothers, which leads to poor growth and development and perpetuates the cycle of undernutrition across generations.

In countries like Afghanistan, girls face severe restrictions on their voice, choice, and mobility, limiting their access to nutrition and healthcare. These societal norms not only compromise girls’ immediate access to necessary nutrition and health services but also contribute to systemic inequities that maintain cycles of adolescent malnutrition.

To disrupt these cycles, interventions must confront deeply ingrained societal norms as a crucial step toward achieving gender equity and enhancing nutrition outcomes for adolescent girls. A comprehensive life course approach is required to improve access to nutritious diets, essential nutrition services, and care for adolescent girls.

Pregnancy can adversely affect the nutritional health of adolescent girls, hindering their growth and raising the risk of underweight and anemia during this critical developmental stage.UNICEF calls on governments to implement a comprehensive package of 12 evidence-based interventions across five key areas: fortified and nutritious meals; micronutrient supplementation and deworming; nutrition and lifestyle education; regulations on advertising; product labeling; marketing; and taxation policies that limit the consumption of unhealthy foods; as well as regular nutrition screenings along with special social safety net services for women and girls who are mothers, underweight, or anemic. 

With social media shaping diet choices, should stronger measures be taken to regulate marketed food?
Murira: There is increasing evidence of a link between the use of digital platforms and a broad range of food consumption behaviors. Significant online marketing efforts by major food and beverage brands dominate the food and nutrition space. Still, many other brands utilize diverse strategies — from celebrity endorsements to “nudging” and contests — to promote their products while occasionally sharing health-related information.

Our research identified three groups of “influencers” (the general public, social media influencers, and major brands) that guide various subjects: weight loss, healthy eating, spirituality, diets, food-related illnesses, and eating disorders. Their advice may be fact-based, educational (certified), or rooted in personal stories.

For instance, a recent investigation in South Asia, which included interviews with policymakers from Bhutan, Maldives, Sri Lanka, and Nepal, revealed that the food and beverage industry often lobbies against food environment policies, emphasizing the need for robust conflict of interest regulations to prioritize health over industry profits.

Frameworks regulating food environments and the online marketing of ultra-processed foods are increasingly seen as critical public health issues. Legal regulations and their enforcement need to be evaluated, particularly in light of the rapid growth of mobile phone accessibility and social media impacts.

Significant online marketing efforts by major food and beverage brands dominate the food and nutrition space.One significant observation is that South Asia has the largest gender gap in mobile internet access worldwide. Adolescent boys are 1.5 times more likely to own a mobile phone than girls and nearly double as likely to have a smartphone. This disparity in access between boys and girls intensifies information gaps and health inequalities. Therefore, it is crucial to address the gender gap in digital access to enhance the health and nutrition of adolescent girls.

With the Nutrition for Growth Summit coming up, what commitments do you hope for improving adolescent nutrition?
Murira: We call on governments, policymakers, program designers, implementers, and researchers to:  

• Enforce stronger laws and regulations to curb the food industry’s predatory practices that harm adolescent girls’ nutrition.
• Conduct system bottleneck analyses with decision-makers at sub-national levels to unmask gaps and define priorities
• Move beyond treating the effects of adolescent malnutrition to tackling the gender norms that perpetuate it.
• Elevate adolescent girls’ voices and leadership to drive demand for legal action and develop more effective policies and programs.