Browsing by Subject "stunting"

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    Growth and determinants at two years of age in a South African birth cohort
    (2025) Itzikowitz, Raphaela; Zar, Heather
    Aim: Early childhood is a critical period for optimal growth but there are limited data from low- and middle-income countries (LMICs) on the determinants of growth during this time. This study aimed to investigate growth and its determinants in children at 2 years of age in a South African birth cohort in a resource-limited region. Methods: Mother-child pairs enrolled in a South African birth cohort, the Drakenstein Child Health Study (DCHS), were followed from birth to two years. Comprehensive socio-demographic and psychosocial data collected during the antenatal period and nutritional information, intercurrent illness and immunisation data collected longitudinally in the first 2 years was used. Anthropometric data, measured at 2 years, were analysed as z-scores adjusted for child age, sex, and prematurity, and used to classify undernutrition (wasting, underweight for age and or stunting), overweight for age or obesity. Logistic regression was done to identify predictors of undernutrition, overweight or obesity at 2 years. Results: Anthropometric data from 897 children (51% male; 22% HIV-exposed, uninfected) were included. 69 (8%) were underweight, 20 (2%) were wasted and stunting occurred in 167 (19%) children; 116 children were overweight (13%), and 42 were (5%) obese. Overall, 351 (39%) had some form of growth impairment. Higher birth weight, or length, higher maternal height or better maternal education were associated with lower odds of undernutrition or stunting at 2 years. Male sex, antenatal maternal smoking or prematurity were associated with increased odd of undernutrition or stunting. Higher birth weight was associated with increased odds of being overweight for age. Better maternal education was associated with increased odds of obesity, but antenatal smoke exposure reduced the risk. Conclusion: There is a substantial burden of malnutrition in South African children during early childhood encompassing both undernutrition and obesity. Stunting, indicative of chronic growth impairment, is most prevalent. Antenatal risk factors are important predictors of poor growth outcomes. Strengthened strategies to improve childhood nutrition and address modifiable factors in the antenatal and early childhood periods are needed.
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    Has Food Security and Nutritional Status Improved in Children 1–<10 Years in Two Provinces of South Africa between 1999 (National Food Consumption Survey) and 2018 (Provincial Dietary Intake Study (PDIS))
    (Multidisciplinary Digital Publishing Institute, 2022-01-18) Steyn, Nelia P.; Nel, Johanna H.; Drummond, Linda; Malczyk, Sonia; Senekal, Marjanne
    The 1999 National Food Consumption Survey in South Africa showed that food insecurity (hunger) was prevalent in households with children aged one to <10 years. A repeat of the survey in two provinces: Gauteng (GTG) and the Western Cape (WC) was undertaken in 2018. Results showed that in all domains (living areas) in GTG, food shortage prevalence decreased between 1999 and 2018, from 55.0% to 29.6% in urban informal areas, from 34.1% to 19.4% in urban formal areas and from 42.1% to 15.6% in rural areas. While the prevalence of food shortage in urban formal areas in the WC remained similar in 2018, prevalence decreased from 81.8% to 35.7% in urban informal areas and from 38.3% to 20.6% in rural areas. Energy and macronutrient intakes improved significantly in GTG between 1999 and 2018 but not in the WC; intakes were significantly higher in the WC at both time points. The only significant change in stunting, wasting, overweight and obesity prevalence was that 7–<10-year-olds in GTG were significantly more likely to be wasted (BAZ < 2SD) in 2018 than in 1999 (20.2% versus 6.9% respectively). In the WC, 1–3-year-olds were significantly more likely to be obese in 2018 than in 1999 (8.1% versus 1.7% respectively) and 7–<10-year-olds were less likely to be stunted (14.5% versus 4.9% respectively). There were significant negative correlations between the hunger score and dietary variables in both provinces in 1999. In GTG in 2018, only the correlation with fat intake remained while there were still several significant correlations in WC in 2018. Changes in top 12 energy contributors reflect a shift to high or moderate energy foods low in nutrients from 1999 to 2018. Nutrient dense (high micronutrients, low energy/g) foods (e.g., fruit) fell off the list in 2018. Logistic regression analyses reflect the importance for food security of having a parent as head of the household and/or caregiver, and parents having grade 12 or higher education and being employed. We conclude that food security nutritional status indicators improved amongst 1–<10-year-old children especially in GTG between 1999 and 2018. However, the shift to poorer food choices and increase in wasting in older children and overweight in younger children are of concern.
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    Overweight, obesity, underweight and stunting in female primary school learners in rural KwaZulu-Natal, South Africa
    (2013) Tathiah, N; Moodley, I; Mubaiwa, V; Denny, L; Taylor, M
    Background. Malnutrition substantially impacts the health outcomes of children. Globally, the childhood prevalence of overweight and obesity has increased, while underweight and stunting (though decreasing) continues to pose a major public health challenge. In low- to middle-income countries, a mixed pattern of over- and undernutrition (nutritional transition) can exist in communities. Objective. To describe the prevalence of malnutrition among female learners in the Nongoma and Ceza districts in Zululand, KwaZulu-Natal (KZN). Methods. We performed a secondary analysis of anthropometric data collected during the 2011 HPV Vaccination Demonstration Project. School health teams, comprising trained nurses, measured the height (in cm) and weight (in kg) of 963 female learners in 31 primary schools. Internationally accepted standardised measures were used as cut-offs for defining overweight, obesity, underweight and stunting. Results. We found evidence of both under- and overnutrition. Overall, 9% of female learners were overweight, 3.8% obese, 4% underweight and 9.2% stunted (using WHO/NCHS criteria). The highest levels of stunting were in the 11 - 12-year age groups, of underweight in the 10-year age group, of overweight and obesity in the 9 - 10-year age groups. Moreover, a proportion of underweight (17.4%), overweight (11.1%) and obese (22.9%) learners were also stunted. Conclusion. Our study describes the prevalence of overweight and obesity, wasting and stunting of female learners in KZN and suggests the presence of a nutritional transition in these rural communities; however, further studies are needed. Our findings emphasise the need for health promotion and education programs in schools.