Changing patterns of under- and over-nutrition in South African children—future risks of non-communicable diseases

Abstract

Under- and over-nutrition in children in KwaZulu-Natal, South Africa was investigated comparing data collected from primary school children in a rural district (643 children aged 8–11 years in 1994) with secondary data from the National Schools Study (16,179 children, 4–11 years in 1994), the Vitamin A Consultative Group Study (408 children, 2–5 years in 1994) and the Income Dynamics Study (1,593 children, 2–11 years in 1998). Stunting and wasting (WHO/NCHS guidelines) and overweight and obesity (International Obesity Task Force guidelines) were retrospectively analysed from these studies and compared in the children aged 4–5 and 8–11 years. There was moderate stunting in 10–25%, wasting in 1–6%, 5–24% were overweight and 1–10% obese. Girls in the National Schools Study (p<0.005) and in the primary datasets (p=0.02) had a significantly higher prevalence of overweight than boys; girls (1.4%) were also more obese than boys (0.9%) in the Schools Study (p=0.002), and the boys significantly more stunted (p<0.005) and wasted (p<0.005). An increasing prevalence of overweight and obesity was seen in both the 4–5- and 8–11-year age-groups. The finding that moderate stunting co-exists with overweight and obesity suggests that patterns of under- and over-nutrition in South African children are changing and might indicate the early stages of a complex nutritional transition. Action is required to prevent the future risk of non-communicable diseases.