The relationship between stunting and overweight among children from South Africa: Secondary analysis of the National Food Consumption Survey--Fortification Baseline I.

BACKGROUND Globally, in children the prevalence of overweight and obesity is increasing, and this is associated with an increased risk of non-communicable diseases in adulthood. There is a need to examine the growing trends of overweight and obesity in children and their consequences in low- and middle-income countries. OBJECTIVES To describe the prevalence of, and determine the relationship between, stunting and overweight among children in two provinces of South Africa. METHODS Secondary data analysis was conducted on anthropometric measurements of 36-119-month-old children from Gauteng and Mpumalanga provinces (N=519) participating in the South African National Food Consumption Survey--Fortification Baseline I (2005). The International Obesity Task Force (IOTF) body mass index (BMI) reference percentiles were used to determine overweight and obesity. The World Health Organization standards were used to derive z-scores. RESULTS The prevalence of overweight was 12.0% (IOTF BMI≥25 kg/m2), including 3.7% obesity (IOTF BMI≥30 kg/m2). The predominantly urban Gauteng Province had a significantly higher prevalence of overweight children (14.1%) compared with Mpumalanga (6.3%) (p=0.0277). The prevalence of stunting was 17.0% (16.5% Gauteng, 18.2% Mpumalanga; p>0.05). There was a significant correlation (r=-0.32) between BMI and height-for-age z-scores (p<0.0001). In the obese group, 68.4% were stunted, while in the normal and underweight group only 13.6% were stunted. CONCLUSIONS Stunted children were more likely to be obese. Further research is necessary for clarity on the physiological mechanisms of this relationship. In the interim, prevention of stunting requires priority.