Hydro-climatic anomalies and livelihoods associated with thinness among children and adolescents in Mount Meru, Tanzania
File(s)
Published online version
Author(s)
Ceppi, Silvia
Mshanga, Naelijwa
Mkindi, Angela
Manuela, Straneo
Pirani, Monica
Type
Journal Article
Abstract
Background
School-aged children and adolescents face significant nutritional challenges in sub-Saharan Africa yet remain understudied compared to under-five populations. Climate variability increasingly threatens food security in rural communities, but evidence on climate-nutrition relationships beyond early childhood is limited. We investigated associations between hydro-climatic anomalies, livelihood strategies, demographic characteristics, and thinness among school-aged children and adolescents on the slopes and surrounding plains of Mount Meru, northern Tanzania.
Methods
We analysed five waves of anthropometric data from 26,009 records of children and adolescents aged 6–18 years attending 18 public primary schools in the Mount Meru ecosystem between 2010 and 2015. Thinness was defined as BMI-for-age Z-score < -2 using the World Health Organisation (WHO) 2007 growth references. Bayesian logistic mixed-effects models were used with school-level and temporal random effects to examine associations of thinness with sex, age, dominant livelihood (farming, agropastoralism, pastoralism), and standardized anomalies in precipitation, evapotranspiration, and land-surface temperature.
Results
Overall thinness prevalence ranged from 61.2% in 2010 to 72.7% in 2015. Girls had lower odds of undernutrition than boys (odds ratio [OR]: 0.58, 95% credible interval [CrI]: 0.54–0.61), but age-sex interactions revealed complex developmental patterns. Girls showed peak vulnerability at age 12 years followed by sharp decline, while boys demonstrated more sustained risk through mid-adolescence. Children and adolescents from pastoralist communities had substantially higher undernutrition odds compared to farming communities (OR: 2.21, 95%CrI: 1.31–3.50). Above-normal precipitation was protective (OR: 0.34, 95% CrI: 0.20–0.54), while elevated evapotranspiration increased the odds of thinness (OR: 2.18, 95%CrI: 1.41–3.24).
Conclusions
The odds of thinness among school-age children and adolescents vary substantially by livelihood strategy and respond dynamically to hydro-climatic anomalies. Age- and sex-specific vulnerability patterns reveal critical windows requiring targeted interventions. Evapotranspiration emerged as a particularly informative climate indicator for nutritional surveillance. These findings support integrating climate monitoring into school-based nutrition programs and developing livelihood-specific adaptation strategies for climate-vulnerable communities.
School-aged children and adolescents face significant nutritional challenges in sub-Saharan Africa yet remain understudied compared to under-five populations. Climate variability increasingly threatens food security in rural communities, but evidence on climate-nutrition relationships beyond early childhood is limited. We investigated associations between hydro-climatic anomalies, livelihood strategies, demographic characteristics, and thinness among school-aged children and adolescents on the slopes and surrounding plains of Mount Meru, northern Tanzania.
Methods
We analysed five waves of anthropometric data from 26,009 records of children and adolescents aged 6–18 years attending 18 public primary schools in the Mount Meru ecosystem between 2010 and 2015. Thinness was defined as BMI-for-age Z-score < -2 using the World Health Organisation (WHO) 2007 growth references. Bayesian logistic mixed-effects models were used with school-level and temporal random effects to examine associations of thinness with sex, age, dominant livelihood (farming, agropastoralism, pastoralism), and standardized anomalies in precipitation, evapotranspiration, and land-surface temperature.
Results
Overall thinness prevalence ranged from 61.2% in 2010 to 72.7% in 2015. Girls had lower odds of undernutrition than boys (odds ratio [OR]: 0.58, 95% credible interval [CrI]: 0.54–0.61), but age-sex interactions revealed complex developmental patterns. Girls showed peak vulnerability at age 12 years followed by sharp decline, while boys demonstrated more sustained risk through mid-adolescence. Children and adolescents from pastoralist communities had substantially higher undernutrition odds compared to farming communities (OR: 2.21, 95%CrI: 1.31–3.50). Above-normal precipitation was protective (OR: 0.34, 95% CrI: 0.20–0.54), while elevated evapotranspiration increased the odds of thinness (OR: 2.18, 95%CrI: 1.41–3.24).
Conclusions
The odds of thinness among school-age children and adolescents vary substantially by livelihood strategy and respond dynamically to hydro-climatic anomalies. Age- and sex-specific vulnerability patterns reveal critical windows requiring targeted interventions. Evapotranspiration emerged as a particularly informative climate indicator for nutritional surveillance. These findings support integrating climate monitoring into school-based nutrition programs and developing livelihood-specific adaptation strategies for climate-vulnerable communities.
Date Issued
2026-06-01
Date Acceptance
2026-05-19
Citation
BMC Nutrition, 2026
ISSN
2055-0928
Publisher
BMC
Journal / Book Title
BMC Nutrition
Copyright Statement
© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Publication Status
Published online
Date Publish Online
2026-06-01