IMPACT OF NUTRITIONAL INTERVENTION ON GLOBAL DIETARY RECOMMENDATION SCORE AND DIETARY DIVERSITY SCORE OF ADOLESCENTS IN SECONDARY SCHOOLS IN DHARAN, NEPAL

Abstract

This study evaluated the impact of a 10-week school-based nutritional intervention program on dietary scores, nutritional status, and behavioral outcomes among adolescents in Dharan, Nepal. The quasi-experimental pre-post intervention study, conducted from May to July 2024, involved 119 students aged 10-16 years. The intervention integrated comprehensive nutrition education with holistic wellness principles, focusing on improving dietary behaviors and nutritional awareness. Data collection integrated the use of a standardized Diet Quality Questionnaire (DQQ), along with structured questionnaires, anthropometric assessments, and dietary assessments. Anthropometric data were analyzed using WHO AnthroPlus software, dietary data using DQQ indicators measurements, and statistical analysis were performed to analyze the impact of the intervention with effect size calculations. Results demonstrated statistically significant improvements in the dietary quality scores, with the Dietary Diversity Score (DDS) increasing from 6.059 to 6.689 (P=0.001) and the Global Dietary Recommendation (GDR) Score improving from 9.521 to 10.37 (P=0.013). The intervention achieved meaningful effect sizes of 0.34 and 0.31 for DDS and GDR scores respectively. Notable improvements were observed in wholesome food consumption patterns, with an increment in fruits (76.5% to 87.4%), dairy products (67.2% to 78.2%), and whole grains (20.2% to 56.3%), while daily consumption of highly processed food decreased (40.3% to 16.8%). While anthropometric measurements showed positive trends, with normal BMI-for-age increasing from 67.2% to 72.3%, these changes were not statistically significant (P>0.05), expressing the need for prolonged intervention programs. The study demonstrates the effectiveness of structured school-based nutritional interventions in improving dietary and healthy behaviors among adolescents, while highlighting the need for sustainable interventions with collaborative approach to achieve longevity and holistic well-being.