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Dietary diversity and body mass index predict cognitive performance and anaemia risk in Ghanaian adolescent girls

BMC Nutr. 2026 May 4. doi: 10.1186/s40795-026-01344-x. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescence presents an opportunity for nutritional intervention especially among girls whose physical and cognitive development during this period has lifelong implications. In this cross-sectional study, the interrelationship between dietary diversity, nutritional status, anaemia and cognitive performance among 181 adolescent girls in public schools in Southern Ghana were examined.

METHODS: The study employed structured questionnaires to collect sociodemographic data, anthropometric measurements to assess nutritional status, haemoglobin testing to determine anaemia status and Raven’s Coloured Progressive Matrices to evaluate cognitive performance. Data analysis was conducted using R version 4.4.2 to explore the relationship between food quality, nutritional markers and cognitive outcomes.

RESULTS: The mean dietary diversity score was 5.7 ± 1.9, and nearly one in three participants was either underweight or overweight, indicating a double burden of malnutrition. Anaemia affected 18.4% of the participants, primarily in mild or moderate forms, while 14% demonstrated poor cognitive performance. A consistent and significant inverse relationship was observed between dietary diversity and poor cognition. Though not statistically significant, each unit increase in dietary diversity was associated with a 19% reduction in the odds of poor cognitive performance (OR = 0.81, 95% CI: 0.65-1.01, p = 0.056). Mid-adolescents (14-16 years) were significantly less likely to be malnourished compared to early adolescents (10-13 years) (OR = 0.43, 95% CI: 0.21-0.86, p = 0.017). Normal BMI-for-age z-scores (OR = 0.62, 95% CI: 0.23-1.66, p = 0.329) and higher hemoglobin levels (OR = 0.70, 95% CI: 0.46-1.07, p = 0.081) were associated with reduced odds of poor cognitive performance; however, these associations were not statistically significant.

CONCLUSIONS: In contexts where nutrition insecurity and educational inequalities converge, school-based interventions that promote diverse diets and screen for anaemia could improve adolescent health and academic outcomes.

PMID:42071247 | DOI:10.1186/s40795-026-01344-x

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