{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:39:18Z","timestamp":1791200358572,"version":"4.2.0"},"reference-count":54,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1148892"],"award-info":[{"award-number":["OPP1148892"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"World Food Programme","award":["HQ15NF493 - CTR"],"award-info":[{"award-number":["HQ15NF493 - CTR"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Nutritional deficiencies are a leading underlying risk factor contributing to the global burden of disease. In Pakistan, late adolescence is considered a nutritionally vulnerable period, as micronutrient requirements are increased to support maturation, and dietary staples are nutrient poor. However, there has been limited evaluation of micronutrient status beyond anemia and its determinants. Using cross-sectional data from late adolescent and young women (15\u201323 years) at enrolment in the Matiari emPowerment and Preconception Supplementation (MaPPS) Trial, we aimed to describe the prevalence of key micronutrient deficiencies of public health concern, and generate hierarchical models to examine associations with proxies for social determinants of health (SDoH). The prevalence of micronutrient deficiencies was high: 53.6% (95% confidence interval (CI): 53.0\u201354.3%) had anemia; 38.0% (95% CI: 36.4\u201339.6%) iron deficiency anemia; 31.8% (95% CI: 30.2\u201333.3%) vitamin A deficiency; and 81.1% (95% CI: 79.8\u201382.4%) vitamin D deficiency. At least one deficiency was experienced by 91.0% (95% CI: 90.1\u201392.0%). Few SDoH were maintained in the final hierarchical models, although those maintained were often related to socioeconomic status (e.g., education, occupation). To improve the micronutrient status of late adolescent and young women in Pakistan, a direct micronutrient intervention is warranted, and should be paired with broader poverty alleviation methods.<\/jats:p>","DOI":"10.3390\/nu13041237","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T05:52:00Z","timestamp":1618206720000},"page":"1237","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Characterizing Micronutrient Status and Risk Factors among Late Adolescent and Young Women in Rural Pakistan: A Cross-Sectional Assessment of the MaPPS Trial"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4718-0382","authenticated-orcid":false,"given":"Jo-Anna B.","family":"Baxter","sequence":"first","affiliation":[{"name":"Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqub","family":"Wasan","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amjad","family":"Hussain","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-8406","authenticated-orcid":false,"given":"Sajid B.","family":"Soofi","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7425-3113","authenticated-orcid":false,"given":"Imran","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulfiqar A.","family":"Bhutta","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Centre for Global Child Health, Hospital for Sick Children, Toronto, ON M5G 0A4, Canada"},{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1630","DOI":"10.1016\/S0140-6736(12)60072-5","article-title":"Adolescence: A foundation for future health","volume":"379","author":"Sawyer","year":"2012","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/nyas.13336","article-title":"Global and regional trends in the nutritional status of young people: A critical and neglected age group","volume":"1393","author":"Akseer","year":"2017","journal-title":"Ann. 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