Adolescence, defined as the period between 10 and 19 years of age, represents a critical transitional phase between childhood and adulthood. This stage is characterized by rapid physical, cognitive, emotional, and social development, making it a crucial window for establishing the foundations of lifelong health. During this period, adolescents undergo significant biological and psychosocial changes that influence their thoughts, behaviors, decision-making abilities, and interactions with their surroundings. Although adolescence is generally considered a healthy phase of life, a substantial proportion of morbidity and mortality occurs during these years, much of which is preventable or amenable to timely intervention. Behaviors adopted during adolescence—such as dietary practices, physical activity patterns, substance use, and sexual behavior—can have long-lasting effects on health, either protecting individuals or predisposing them to future health risks.¹ In India, adolescents constitute approximately one-fifth of the total population, with adolescent girls recognized as a particularly vulnerable subgroup. Puberty in females is marked by the onset of menarche, signifying the transition from childhood to reproductive maturity. This period is often associated with physical discomfort and psychological stress, especially among girls who are inadequately informed or supported. The average age at menarche varies across populations and serves as a sensitive indicator of nutritional status, environmental influences, socioeconomic conditions, and overall health of the community. Menstrual abnormalities—such as irregular cycles, altered cycle length, excessive or scanty bleeding, and dysmenorrhea—are commonly reported during adolescence, particularly in the initial years following menarche. Abnormal uterine bleeding, including intermenstrual and heavy menstrual bleeding, may further complicate adolescent health and contribute to school absenteeism and reduced quality of life.² Beyond gynecological concerns, adolescent girls frequently experience a range of other health problems. Psychological issues, refractive errors, eating disorders, and fluctuations in body weight are increasingly observed in this age group. Dysmenorrhea and clinical pallor are among the most common clinical presentations in menstruating adolescents. These health issues are influenced not only by individual biological factors but also by broader social, cultural, and economic determinants. Malnutrition remains a major public health concern among adolescent girls, despite national programs focusing largely on children under five years of age. There is comparatively limited data on the nutritional status of adolescents, particularly in eastern India. The pubertal growth spurt is associated with rapid physical and biological changes, resulting in increased nutritional demands. Inadequate nutrition during this phase can adversely affect growth, reproductive health, and future maternal outcomes. As adolescent girls represent the next generation of mothers, their nutritional status warrants careful monitoring and timely intervention.³ Health education plays a pivotal role in addressing the multidimensional health needs of adolescent girls. Awareness regarding general health, menstrual hygiene, balanced nutrition, and mental well-being is essential for empowering adolescents to recognize health problems early and seek appropriate care. Providing accurate information and counseling can help girls understand the physiological changes occurring in their bodies and develop healthy coping mechanisms. In this context, the present study was undertaken at MKCG Medical College and Hospital, Berhampur, Odisha, to assess the prevalence of malnutrition, nutritional status, gynecological problems, and psychological issues among adolescent girls. The findings of this study are expected to contribute to a better understanding of adolescent health problems and support the development of targeted health education and counseling strategies. Objectives General Objective To assess the health and nutritional status of adolescent girls attending MKCG Medical College and Hospital, Berhampur, Odisha. Specific Objectives 1. To determine the prevalence of malnutrition among adolescent girls aged 10–17 years. 2. To assess the nutritional status of adolescent girls using Body Mass Index (BMI) based on standard growth charts. 3. To identify common gynecological problems, including menstrual irregularities and dysmenorrhea, among adolescent girls. 4. To assess the presence of selected psychological and general health problems in the study population. 5. To generate evidence that may aid in planning health education, counseling, and adolescent-friendly health services.

A hospital-based cross-sectional study was conducted among school-going adolescent girls aged 10–17 years attending the Paediatric Outpatient Department (OPD) and inpatient wards of MKCG Medical College and Hospital, Berhampur, Odisha. The study was carried out over a period of one year, from October 2019 to October 2020. The study included adolescent girls in the age group of 10–17 years who visited the Paediatric OPD or were admitted to the paediatric wards during the study period. A total of 374 adolescent girls fulfilling the inclusion criteria were enrolled in the study. Inclusion Criteria • Adolescent girls aged 10–17 years • School-going girls attending Paediatric OPD or ward • Willing to participate in the study • Written informed consent obtained from parents or guardians Exclusion Criteria • Adolescent girls aged below 10 years or above 17 years • Girls with known chronic illnesses or genetic disorders • Girls whose parents or guardians did not provide consent Data were collected using a pre-designed and pre-tested structured proforma. The purpose of the study and instructions for filling the proforma were clearly explained to the participants. Information regarding demographic details, menstrual history, dietary habits, and health-related complaints was recorded. All participants underwent a general clinical examination. Height and weight were measured using standard techniques with calibrated instruments. Body Mass Index (BMI) was calculated for each participant using the formula: BMI (kg/m²) = Weight (kg) / Height² (m²) The nutritional status of the adolescent girls was classified according to the Revised Indian Academy of Pediatrics (IAP) 2015 BMI growth charts for 5–18-year-old Indian girls. Data were entered into Microsoft Excel and analyzed using R statistical software. Descriptive statistics such as frequencies, percentages, mean, and standard deviation were used to summarize the data. Results were presented in the form of tables and graphs.

A total of 350 school-going adolescent girls aged 10–17 years were included in the study. The age distribution revealed that the largest proportion of participants belonged to the 14-year age group (approximately 22%), followed by 13-year-olds (about 19%). The least representation was observed among 17-year-olds (around 2%). The mean age of the study participants was 13.1 ± 1.7 years (Table 1). Table 1: Distribution of participants according to age (n = 350) Age (years) N % 10 18 5.1 11 62 17.7 12 56 16.0 13 67 19.1 14 77 22.0 15 42 12.0 16 21 6.0 17 7 2.0 Mean age 13.1 ± 1.7 years Most participants belonged to the upper-lower socioeconomic class (approximately 39%), followed by the lower-middle class (about 32%). A very small proportion belonged to the upper socioeconomic class (around 3%). The majority of the adolescents lived in nuclear families (nearly 90%), while the remaining belonged to joint families. Most fathers were engaged in semi-skilled occupations, and a considerable proportion of mothers were involved in clerical work, small businesses, or farming. Clinical examination showed that almost all participants had normal pulse rates, with only a small fraction (around 3%) having pulse rates above 100 beats per minute. A statistically significant association was observed between nutritional status and socioeconomic status (p < 0.001), with undernutrition being more prevalent among adolescents from lower socioeconomic groups (Table 2). Table 2: Association between nutritional status and socioeconomic status (n = 350) Nutritional status Upper class Upper middle Lower middle Upper lower Lower class χ² test Underweight 9 36 56 101 14 χ² = 132.6 Normal 0 36 10 36 6 df = 8 Overweight & obese 0 0 43 1 0 p < 0.001 A significant association was found between nutritional status and maternal occupation (p = 0.008), with undernutrition being more common among adolescents whose mothers were homemakers. Nutritional status also showed a significant association with family type, with a higher proportion of underweight adolescents belonging to nuclear families (p < 0.001). Dietary pattern was significantly associated with nutritional status, as all overweight and obese adolescents were consuming a mixed diet (p = 0.001) (Table 3). Table 3: Association of nutritional status with maternal occupation, family type, and diet Mother’s occupation Nutritional status Working mother (n) Homemaker (n) χ² test Normal 154 64 χ² = 9.52 Underweight 58 31 df = 2 Overweight & obese 22 21 p = 0.008 Family type Nutritional status Joint family (n) Nuclear family (n) χ² test Normal 19 199 χ² = 22.4 Underweight 4 85 df = 2 Overweight & obese 13 30 p < 0.001 Dietary pattern Nutritional status Mixed diet (n) Vegetarian diet (n) χ² test Normal 188 30 χ² = 14.1 Underweight 67 22 df = 2 Overweight & obese 43 0 p = 0.001 Respiratory rate was within the range of 12–16 breaths/min in approximately 59% of participants, while the remaining had rates between 17–22 breaths/min. Systolic blood pressure was below 110 mmHg in about 84%, and all participants had diastolic blood pressure within normal limits. The mean height of the adolescents was 1.28 m, the mean weight was 27.9 kg, and the mean BMI was 17.4 kg/m². Based on BMI classification, approximately 62% of adolescents had normal nutritional status, while 38% were malnourished. Among the malnourished group, about 25% were underweight, 9% were overweight, and 4% were obese. Pallor was observed in about one-fifth of participants (19%), indicating a substantial burden of anemia-related manifestations. Approximately 71% of the adolescents had attained menarche, with a mean age at menarche of 13.2 ± 0.1 years. Most participants reported menstrual cycles lasting 5–6 days (64%). Irregular menstrual cycles were reported by around 54%, and scanty menstrual flow was noted in about 43%. Refractive errors were observed in approximately one-fourth of the participants (25%). Dysmenorrhea was reported by nearly 29% of adolescents. Headache and psychological problems were reported by around 3% and 2%, respectively. The majority of participants followed a mixed diet (86%), while the remaining consumed a vegetarian diet.

The present hospital-based cross-sectional study assessed the health and nutritional profile of adolescent girls aged 10–17 years attending MKCG Medical College and Hospital, Berhampur. The age distribution indicated that a larger proportion of participants belonged to early and mid-adolescence, which is consistent with observations reported by Nair et al. and Phuljhele et al., where adolescents in this age group formed the majority of study populations.⁴˒⁵ Early adolescence is a critical period marked by rapid physical and psychological changes, making this group particularly vulnerable to nutritional and health-related problems. In the current study, most participants belonged to lower socioeconomic strata, with a predominance of upper-lower and lower-middle socioeconomic classes. A similar socioeconomic distribution has been reported by Kumar et al. and Patanwar et al., where adolescent girls from economically disadvantaged families constituted a major share of study participants.⁶˒⁷ The predominance of nuclear families observed in our study further reflects changing family structures in both urban and semi-urban Indian settings, which may influence dietary patterns, supervision, and health-seeking behavior among adolescents. Menstrual characteristics observed in the study were comparable to earlier findings. Approximately three-fourths of the adolescents had attained menarche, with a mean age at menarche of 13.2 ± 0.1 years. This closely aligns with reports by Omidvar et al. and Singh et al., who documented similar mean ages at menarche among Indian adolescents.⁸˒⁹ Tarannum et al. also reported a comparable proportion of girls attaining menarche, reinforcing the consistency of these findings across different regions.¹⁰ Menstrual irregularities and dysmenorrhea were common, highlighting the need for focused menstrual health education and counseling. Dysmenorrhea was reported by nearly one-third of the participants, which is comparable to the prevalence reported by Sharma et al.¹¹ However, studies such as that by Jampana et al. have documented substantially higher prevalence rates, suggesting regional and methodological variations.¹² Clinical pallor, indicative of anemia, was observed in about one-fifth of the adolescents, a finding similar to that reported by Siva et al., emphasizing the persistent burden of anemia among adolescent girls.¹³ Psychological problems were reported by a small proportion of participants. The prevalence observed in this study is comparable to findings from Trivandrum, where severe and extreme depression were reported in a similar range among adolescent girls.¹⁴ Although the proportion appears low, it may reflect underreporting or limited recognition of mental health issues in hospital-based settings. Assessment of nutritional status revealed that approximately two-thirds of the adolescents had normal BMI, while more than one-third were malnourished. Undernutrition was the predominant form of malnutrition, followed by overweight and obesity. These findings are comparable to those reported by Chandrashekarappa et al., where a similar proportion of adolescents were malnourished.¹⁵ The prevalence of undernutrition in our study was also comparable to that reported by Srivastav et al.¹⁶ Overweight and obesity were observed in a smaller yet significant proportion of adolescents, reflecting the emerging dual burden of malnutrition. The association between poor socioeconomic status and undernutrition observed in this study reinforces earlier evidence that social and economic deprivation significantly influences adolescent nutritional outcomes.³ The study also demonstrated significant associations between nutritional status and maternal occupation, family type, and dietary pattern. Adolescents from nuclear families and those consuming mixed diets showed higher prevalence of undernutrition and overweight, respectively. These findings suggest that household dynamics and dietary practices play a crucial role in shaping adolescent health outcomes. Despite its strengths, the study has certain limitations. Being hospital-based, the findings may not be generalizable to the broader community. Nutritional status was assessed solely using BMI, which does not capture micronutrient deficiencies or body composition. Although the sample size was adequate, larger community-based studies would provide a more comprehensive understanding of adolescent health issues.

The study highlights that adolescent girls attending MKCG Medical College and Hospital experience a substantial burden of health problems, with malnutrition (38%), refractive errors, menstrual irregularities, dysmenorrhea, overweight, obesity, and psychological issues being commonly observed. Low socioeconomic status, dietary habits, family structure, and parental occupation were important factors influencing these health outcomes. The findings emphasize the need for early identification, nutritional interventions, menstrual health education, and adolescent-friendly counseling services, particularly for girls from socioeconomically disadvantaged backgrounds. Community-based studies with larger sample sizes are recommended to further validate these findings and support the development of targeted adolescent health programs.

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