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Prevalence and determinants of stunting and overweight in 3-year-old black South African children residing in the Central Region of Limpopo Province, South Africa

Published online by Cambridge University Press:  02 January 2007

Ramoteme L Mamabolo ,
Marianne Alberts ,
Nelia P Steyn ,
Henriette A Delemarre-van de Waal  and
Naomi S Levitt
Ramoteme L Mamabolo*
Affiliation:
Medical Sciences Programme, University of Limpopo, Sovenga, South Africa Chronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Tygerberg, Cape Town, 7505, South Africa
Marianne Alberts
Affiliation:
Medical Sciences Programme, University of Limpopo, Sovenga, South Africa
Nelia P Steyn
Affiliation:
Chronic Diseases of Lifestyle Unit, Medical Research Council, PO Box 19070, Tygerberg, Cape Town, 7505, South Africa
Henriette A Delemarre-van de Waal
Affiliation:
Pediatric Endocrinology, Vrije University Medical Centre, Vrije University, Amsterdam, The Netherlands
Naomi S Levitt
Affiliation:
Department of Medicine, University of Cape Town, Cape Town, South Africa
*
*Corresponding author: Email [email protected]
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Abstract

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Objectives

To determine the prevalence of stunting, wasting and overweight and their determinants in 3-year-old children in the Central Region of Limpopo Province, South Africa.

Design

Prospective cohort study.

Setting

Rural villages in the Central Region of the Limpopo Province, South Africa.

Subjects

One hundred and sixty-two children who were followed from birth were included in the study. Anthropometric measurements and sociodemographic characteristics of the children were recorded.

Results

Height-for-age Z-scores were low, with a high prevalence of stunting (48%). The children also exhibited a high prevalence of overweight (22%) and obesity (24%). Thirty-one (19%) children were both stunted and overweight. Gaining more weight within the first year of life increased the risk of being overweight at 3 years by 2.39 times (95% confidence interval (CI) 1.96–4.18) while having a greater length at 1 year was protective against stunting (odds ratio (OR) 0.41; 95% CI 0.17–0.97). Having a mother as a student increased the risk for stunting at 3 years by 18.21 times (95% CI 9.46–34.74) while having a working mother increased the risk for overweight by 17.87 times (95% CI 8.24–38.78). All these factors also appeared as risks or as being protective in children who were both overweight and stunted, as did living in a household having nine or more persons (OR 5.72; 95% CI 2.7–12.10).

Conclusion

The results of this study highlight the importance of evaluating anthropometric status in terms of both stunting and overweight. Furthermore, it is important to realise the importance of normal length and weight being attained at 1 year of age, since these in turn predict nutritional status at 3 years of age.

Keywords

StuntingOverweightDeterminantsRisk factorsSociodemographic factorsChildren
Type
Research Article
Information
Public Health Nutrition , Volume 8 , Issue 5 , August 2005 , pp. 501 - 508
Copyright
Copyright © The Authors 2005

References

1Frongillo, EA Jr, de Onis, M, Hanson, KMP. Socioeconomic and demographic factors are associated with worldwide patterns of stunting and wasting of children. Journal of Nutrition 1997; 127: 2302–9.CrossRefGoogle ScholarPubMed
2Bourne, LT, Lambert, EV, Steyn, K. Where does the black population of South Africa stand on the nutrition transition?. Public Health Nutrition 2001; 5: 157–62.CrossRefGoogle Scholar
3Monteiro, CA, Conde, WL, Popkin, BM. Is obesity replacing or adding to undernutrition? Evidence from different social classes in Brazil. Public Health Nutrition 2002; 5: 105–12.CrossRefGoogle ScholarPubMed
4Adair, LS, Guilkey, DK. Age specific determinants of stunting in Filipino children. Journal of Nutrition 1997; 127: 314–20.Google ScholarPubMed
5Saleemi, MA, Ashraf, RN, Mellander, L, Zaman, S. Determinants of stunting at 6, 12, 24 and 60 months and postnatal linear growth in Pakistani children. Acta Paediatrica 2001; 90: 1304–8.CrossRefGoogle Scholar
6Vella, V, Tomkins, A, Borghesi, A, Migliori, GB, Oryem, VY. Determinants of stunting and recovery from stunting in Northwest Uganda. International Journal of Epidemiology 1994; 23: 782–6.CrossRefGoogle ScholarPubMed
7Zamiliah, MM, Kandian, M, Lin, KG, Siong, TE. Socioeconomic profile and nutritional status of children in rubber smallholdings. Asia Pacific Journal of Clinical Nutrition 2002; 11: 133–41.Google Scholar
8Delpeuch, F, Traissac, P, Martin-Prevel, Y, Massamba, JP, Maire, B. Economic crisis and malnutrition: socioeconomic determinants of anthropometric status of preschool children and their mothers in an African urban area. Public Health Nutrition 2000; 3: 39–47.CrossRefGoogle Scholar
9Ukwuani, FA, Suchindran, CM. Implications of women's work for child nutritional status in sub-Saharan Africa: a case study of Nigeria. Social Science & Medicine 2003; 56: 2109–21.CrossRefGoogle ScholarPubMed
10Hernandez-Diaz, S, Peterson, KE, Dixit, S, Hernandez, B, Parra, S, Barquera, S, et al. Association of maternal short stature with stunting in Mexican children: common genes vs common environment. European Journal of Clinical Nutrition 1999; 53: 938–45.CrossRefGoogle Scholar
11de Onis, M, Frongillo, EA, Blossner, M. Is malnutrition declining? An analysis of changes in levels of child malnutrition since 1980. Bulletin of the World Health Organization 2000; 78: 1222–33.Google ScholarPubMed
12Hautvast, JLA, Tolboom, JJM, Kafwembe, EM, Musonda, RM, Mwanakasale, V, van Staveren, WA, et al. Severe linear growth retardation in rural Zambian children: the influence of biological variables. American Journal of Clinical Nutrition 2000; 71: 550–9.CrossRefGoogle ScholarPubMed
13Faber, M, Jogessar, VB, Benade, AJS. Nutritional status and dietary intakes of children aged 2–5 years and their caregivers in a rural South African community. International Journal of Food Sciences and Nutrition 2001; 52: 401–11.Google Scholar
14Monyeki, KD, van Lenthe, FJ, Steyn, NP. Obesity; does it occur in African children in a rural community in South Africa?. International Journal of Epidemiology 1999; 28: 287–92.CrossRefGoogle Scholar
15Mamabolo, RL, Alberts, M, Mbenyane, GX, Steyn, NP, Nthangeni, NG, Delemarre-van, de Waal HA, et al. Feeding practices and growth of infants from birth to 12 months in the central region of the Limpopo Province of South Africa. Nutrition 2004; 20: 327–33.CrossRefGoogle ScholarPubMed
16Steyn, NP, Labadarios, D, Maunder, E, Nel, J, Lombard, C. Directors of the National Food Consumption Survey. Secondary anthropometric data analysis of the National Food Consumption Survey in South Africa: the double burden. Nutrition 2005; 21: 4–13.CrossRefGoogle ScholarPubMed
17Patel, DN, Pettifor, JM. Malnutrition in South Africa. South African Journal of Food Science and Nutrition 1992; 4: 22.Google Scholar
18Steyn, NP, Badenhorst, CJ, Nel, JH, Ladzani, R. Breast-feeding and weaning practices of Pedi mothers and the dietary intakes of their preschool children. South African Journal of Food Science and Nutrition 1993; 5: 10–13.Google Scholar
19Dannhauser, A, Bester, CJ, Joubert, G, Badenhorst, PN, Slabber, M, Badenhorst, AM, et al. Nutritional status of preschool children in informal settlement areas near Bloemfontein, South Africa. Public Health Nutrition 2000; 3: 303–12.CrossRefGoogle ScholarPubMed
20Fourie, J, Steyn, K. Chronic Diseases of Lifestyle in South Africa. MRC Technical Report. Cape Town: Medical Research Council, 1995.Google Scholar
21Bourne, LT, Langenhoven, ML, Steyn, K, Jooste, PL, Laubscher, JA, Bourne, DE. Nutritional status of 3–6 year-old children in the Cape Peninsula. The BRISK study. East African Medical Journal 1994; 7: 695–702.Google Scholar
22Yanovski, JA, Yanovski, SZ. Treatment of pediatric and adolescent obesity. Journal of the American Medical Association 2003; 289: 1851–3.CrossRefGoogle ScholarPubMed
23Mamabolo, RL, Alberts, M, Steyn, NP, Delemarre-van de Waal, HA, Nthangeni, NG, Levitt, NS. Evaluation of the effectiveness of iron and folate supplementation during pregnancy in a rural area of Limpopo province. South African Journal of Clinical Nutrition 2004; 17: 15–21.Google Scholar
24Hamill, PV, Dritz, TA, Johnson, CL, Reed, RB, Roche, AF. NCHS Growth Curves for Children Birth–18 years. DEHW Publications No. (PHS) 78-1650, Series 11, No. 165. Washington, DC: DEHW Publishers, 1977.Google ScholarPubMed
25Cole, TJ, Bellizzi, MC, Flegal, KM, Dietz, WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. British Medical Journal 2000; 320: 1–6.CrossRefGoogle ScholarPubMed
26Ong, KK, Ahmed, ML, Emmett, PM, Preece, MA, Dunger, DB. The ALSPAC Study Team. Association between postnatal catch-up growth and obesity in childhood: prospective cohort study. British Medical Journal 2000; 320: 967–71.CrossRefGoogle Scholar
27Centers for Disease Control and Prevention (CDC). Epi-Info 2002, A, Database and Statistics Program for Public Health Professionals. Atlanta, GA: CDC, 2003.Google Scholar
28SPSS Inc. SPSS for Windows Base System User's Guide,Release 12.0. Chicago,IL: SPSS Inc, 2003;.Google Scholar
29Labadarios, D, Steyn, N, Maunder, E, MacIntyre, U, Swart, R, Gericke, G, et al. The National Food Consumption Survey (NFCS): Children aged 1–9 years, South Africa, 1999. Stellenbosch: Stellenbosch University Press, 2000.Google Scholar
30James, WPT, Ferro-Luzzi, A, Sette, S, Mascie-Taylor, CGN. The potential use of maternal size in priority setting when combating childhood malnutrition. European Journal of Clinical Nutrition 1999; 53: 112–9.CrossRefGoogle ScholarPubMed
31Lei, DLM, Chaves, SP, Paes, AT, Escuder, MM, Ribeiro, AB, Freire, RD et al. Risk of linear growth retardation during the first two years of life: a new approach. European Journal of Clinical Nutrition 1999; 53: 456–60.CrossRefGoogle ScholarPubMed
32Shah, SM, Selwyn, BJ, Luby, S, Merchant, A, Bano, R. Prevalence and correlates of stunting among children in rural Pakistan. Pediatrics International 2003; 45: 49–53.CrossRefGoogle ScholarPubMed
33Sanchez-Castillo, CP, Lara, JL, Villa, AR, Aguirre, J, Escobar, M, Gutierrez, H, et al. Unusually high prevalence rates of obesity in four Mexican rural communities. European Journal of Clinical Nutrition 2001; 55: 833–40.CrossRefGoogle ScholarPubMed
34Martorell, R, Khan, LK, Hughes, ML, Grummer-Strawn, LM. Overweight and obesity in preschool children from developing countries. International Journal of Obesity and Related Metabolic Disorders 2001; 24: 959–67.CrossRefGoogle Scholar
35Zere, E, McIntyre, D. Inequities in under-five child malnutrition in South Africa. International Journal for Equity in Health 2003; 2 7.CrossRefGoogle ScholarPubMed
36Baughcum, AE, Powers, SW, Johnson, SB, Chamberlin, LA, Deeks, CM, Jain, A, et al. Maternal feeding practices and beliefs and their relationships to overweight in early childhood. Journal of Developmental and Behavioral Pediatrics 2001; 22: 391–408.CrossRefGoogle ScholarPubMed
37Baughcum, AE, Chamberlin, LA, Deeks, CM, Powers, SW, Whitaker, RC. Maternal perceptions of overweight preschool children. Pediatrics 2000; 106: 1380–5.CrossRefGoogle ScholarPubMed
38Kruger, R, Gericke, GJ. A qualitative exploration of rural feeding and weaning practices, knowledge and attitudes on nutrition. Public Health Nutrition 2003; 6: 217–23.CrossRefGoogle ScholarPubMed
39Faith, MS, Keller, KL, Matz, P, Johnson, SL, Lewis, R, Jorge, MA, et al. Project Grow-2-Gether: a study of the genetic and environmental influences on child eating and obesity. Twin Research 2002; 5: 472–5.CrossRefGoogle ScholarPubMed
40Engel, PL. Influences of mother's and father's income on child's nutritional status in Guatemala. Social Science & Medicine 1993; 37: 1303–12.CrossRefGoogle Scholar
41Popkin, B, Richards, M, Monteiro, C. Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. Journal of Nutrition 1996; 126: 3009–16.CrossRefGoogle ScholarPubMed
42Delport, SD, Becker, PJ, Bergh, A. Growth, feeding practices and infections in black infants. South African Medical Journal 1997; 87: 57–61.Google ScholarPubMed
43Steyn, NP, Nel, JH, Kunnene, E, Tichelaar, HY, Oelofse, A, Prinsloo, JF, et al. Differences between underweight and normal weight rural preschool children in terms of infant feeding practices and socio-economic factors. South African Medical Journal 1998; 5: 641–6.Google Scholar
44Ladzani, R, Steyn, NP, Nel, JH. Infant feeding practices of Pedi women in six semi-rural areas of Northern Province. South African Journal of Epidemiology and Infection 1998; 13: 63–5.Google Scholar
45Kagamimori, S, Yamagami, T, Sokejima, S, Numata, N, Handa, K, Nanri, S, et al. The relationship between lifestyle, social characteristics and obesity in 3-year-old Japanese children. Child: Care, Health and Development 1999; 25: 235–46.CrossRefGoogle ScholarPubMed
46Dietz, WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101: 518–25.CrossRefGoogle ScholarPubMed
47Serdula, MK, Ivery, D, Coates, RJ, Freedman, DS, Williamson, DF, Byers, T. Do obese children become obese adults? A review of the literature. Preventive Medicine 1993; 22: 167–77.CrossRefGoogle ScholarPubMed
48Whitaker, RC, Wright, JA, Pepe, MS, Siedel, KD, Dietz, WH. Predicting obesity in young adulthood from childhood and parental obesity. New England Journal of Medicine 1997; 337: 869–73.CrossRefGoogle ScholarPubMed
49Steyn, NP, Badenhorst, CJ, Nel, JH. The nutritional status of Pedi preschool children in two rural areas of Lebowa. South African Journal of Food Science Nutrition 1992; 4: 24–8.Google Scholar
50Badenhorst, CJ, Steyn, NP, Jooste, PL. Nutritional status of Pedi school children aged 6–14 years in two rural areas in Lebowa: a comprehensive nutritional survey of dietary intake, anthropometric and clinical measurements. South African Journal of Food Science and Nutrition 1993; 5: 112–5.Google Scholar
51Dietz, WH. Critical periods in childhood for the development of obesity. American Journal of Clinical Nutrition 1994; 59: 955–9.CrossRefGoogle ScholarPubMed
52Popkin, BM. The nutrition transition and obesity in the developing world. Journal of Nutrition 2001; 131 871S–3S.CrossRefGoogle ScholarPubMed
53Law, CM, Shiell, AW, Newsome, CA, Syddall, HE, Shinebourne, EA, Fayers, PM, et al. Fetal, infant, and chzildhood growth and adult blood pressure: a longitudinal study from birth to 22 years of age. Circulation 2002; 105: 1088–92.CrossRefGoogle ScholarPubMed
54Cameron, N, Pettifor, J, De Wet, T, Norris, S. The relationship of rapid weight gain in infancy to obesity and skeletal maturity in childhood. Obesity Research 2003; 1: 457–60.CrossRefGoogle Scholar