Association between stunting and overweight among 10–15-y-old children in the North West Province of South Africa: the THUSA BANA Study

Mukuddem‐Petersen, J.; Kruger, Herculina S

doi:10.1038/sj.ijo.0802586

Cited by 64 publications

(60 citation statements)

References 21 publications

(38 reference statements)

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“…1 At the same time, overweight and obesity are emerging as major problems among adults [2][3][4] and to some extent among children and adolescents in those countries experiencing the nutrition transition [4][5][6] Cross-sectional studies have shown associations between stunting and overweight, 4,6 although a lack of association has also been reported. 7 It has been suggested that childhood undernutrition predisposes individuals to gain weight later in life. 8,9 However, there are very few prospective studies in which stunted children have been followed from childhood and their later weight determined.…”

Section: Introductionmentioning

confidence: 99%

The association between early childhood stunting and weight status in late adolescence

2006

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Background: Cross-sectional studies have shown associations between stunting and overweight; however, there are few prospective studies of stunted children. Objectives: To determine whether stunting before age 2 years is associated with overweight and central adiposity at 17-18 years and whether growth in height among stunted children predicts body mass index (BMI) in late adolescence. Design: Prospective cohort study. Participants: One-hundred and three participants stunted by age 2 years and 64 non-stunted participants (78% of participants enrolled in childhood). Participants were measured in early childhood and at ages 7, 11 and 17 years. Results: Stunted subjects remained shorter and had lower BMIs, smaller skinfolds and circumferences than non-stunted subjects. Overweight (BMI X25 m 2 ) was not significantly different among stunted and non-stunted male subjects (5.2 and 12.5%) but non-stunted female subjects were more likely to be overweight than those who experienced early childhood stunting (11.1 and 34.4%, P ¼ 0.013). Centralization of fat (waist to hip ratio (WHR), subscapular/triceps skinfold ratio (SSF/TSF)) did not differ between stunted and non-stunted groups (mean WHR 0.77 and mean SSF/TSF 1.18 in both groups). Stunted subjects with greater increases in height-for-age for the intervals 3-7 and 7-11 years had higher BMI at age 17 years (P ¼ 0.04 and P ¼ 0.001, respectively). Conclusion: Participants stunted by age 2 years were less likely to be overweight than those who were never stunted. This suggests that cross-sectional studies of the association between stunting and overweight may be misleading. Among stunted children, greater linear growth during mid-to late childhood was associated with greater BMI at age 17 years.

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Section: Introductionmentioning

confidence: 99%

The association between early childhood stunting and weight status in late adolescence

2006

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“…Because the THUSA study recruited subjects from 15 years and older, and the national food consumption survey children from 1 to 9 years, the THUSABANA (THUSA and BANA for children) study 43 was planned and implemented to gather data on a random sample of children aged 9-15 years in the North West Province.…”

Section: Implementation and Follow-up Actionsmentioning

confidence: 99%

The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study

Vorster

Venter

Wissing

et al. 2005

Public Health Nutr.

125

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Objective: To describe how urbanisation influences the nutrition and health transition in South Africa by using data from the THUSA (Transition and Health during Urbanisation of South Africans) study. Design: The THUSA study was a cross-sectional, comparative, population-based survey. Setting: The North West Province of South Africa. Subjects: In total, 1854 apparently healthy volunteers, men and women aged 15 years and older, from 37 randomly selected sites. Pregnant and lactating women, those with diagnosed chronic diseases and taking medication, with acute infections or inebriated were excluded but screened for hypertension and diabetes mellitus. Subjects were stratified into five groups representing different levels of urbanisation in rural and urban areas: namely, deep rural, farms, squatter camps, townships and towns/cities. Outcome measures and methods: Socio-economic and education profiles, dietary patterns, nutrient intakes, anthropometric and biochemical nutrition status, physical and mental health indicators, and risk factors for non-communicable diseases (NCDs) were measured using questionnaires developed or adapted and validated for this population, as well as appropriate, standardised methods for the biochemical analyses of biological samples. Results: Subjects from the rural groups had lower household incomes, less formal education, were shorter and had lower body mass indices than those in the urban groups. Urban subjects consumed less maize porridge but more fruits, vegetables, animal-derived foods and fats and oils than rural subjects. Comparing women from rural group 1 with the urban group 5, the following shifts in nutrient intakes were observed: % energy from carbohydrates, 67.4 to 57.3; from fats, 23.6 to 31.8; from protein, 11.4 to 13.4 (with an increase in animal protein from 22.2 to 42.6 g day 21 ); dietary fibre, 15.8 to 17.7 g day 21 ; calcium, 348 to 512 mg day 21 ; iron from 8.4 to 10.4 mg day 21 ; vitamin A from 573 to 1246 mg retinol equivalents day 21; and ascorbic acid from 30 to 83 mg day 21. Serum total cholesterol, low-density lipoprotein cholesterol and plasma fibrinogen increased significantly across groups; systolic blood pressure . 140 mmHg was observed in 10.4 -34.8% of subjects in different groups and diabetes mellitus in 0.8-6.0% of subjects. Women in groups 1 to 5 had overweight plus obesity rates of 48, 53, 47, 61 and 61%, showing an increase with urbanisation. Subjects from group 2 (farm dwellers) showed the highest scores of psychopathology and the lowest scores of psychological well-being. The same subjects consistently showed the lowest nutrition status. Conclusions: Urbanisation of Africans in the North West Province is accompanied by an improvement in micronutrient intakes and status, but also by increases in overweight, obesity and several risk factors for NCDs. It is recommended that intervention programmes to promote nutritional health should aim to improve micronutrient status further without leading to obesity. The role of psychological strengths i...

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“…Studies indicate that stunting is highly prevalent in developing countries undergoing nutritional transition 1,2 . Stunting is defined as height-for-age below the 5th percentile on the Centers for Disease Control/World Health Organization (WHO) reference growth charts or a height-for-age Z-score (HAZ) of 2 2.0 standard deviation (SD) or less, and is traditionally used as an indicator of nutritional status 3,4 .…”

mentioning

confidence: 99%

“…It should be noted that reasons for any given growth impairment may be complex. The literature suggests a complex interaction of nutritional, environmental and socio-economic factors 5 , but other contributing factors include chronic or recurrent infections 2 . Stunted children tend to gain more fat than their non-stunted counterparts during the adolescent growth phase 2,6,7 , but on the other hand it is known that in addition to both nutritional habits and puberty, the individual's genetic make-up also plays a role in this phenomenon.…”

mentioning

confidence: 99%

Habitual physical activity and body composition of black township adolescents residing in the North West Province, South Africa

Mamabolo

Kruger

Lennox

et al. 2007

Public Health Nutr.

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Objective: It is known that stunting and obesity affect a large proportion of children in the world, and these can be affected by the physical activity levels of the children. In the present study, we evaluated the association between physical activity, physical development and body composition in black adolescent children. Design: Cross-sectional study. Setting: Black township schools in the North West Province, South Africa. Methods: Three-hundred and thirteen grade 8 children were included in the Physical Activity in Youth study. Anthropometric measurements, body composition measures and maturity level as assessed by Tanner stages were determined in these children. In addition, Previous Day Physical Activity Recall questionnaires were administered on the children to record the various activities they undertake daily. Results: The demographic characteristics of the children showed a high level of homogeneity. A high prevalence of stunting (16.3%) was observed in the children, which was higher in boys than in girls (21.6 vs. 12.3%). Also prevalent was overweight/obesity (8.6%), but this was higher in girls than in boys (13.4 vs. 1.6%). The children also showed a reduction in levels of physical activity with advancement in maturity; furthermore, boys showed a more central form of fat deposition whilst girls showed more gynoid deposition. Conclusions: The study revealed that physical activity plays a role in determining body composition, and further indicated that physical activity is associated with favourable body composition measures. Children who were more active were likely to have less fat deposits.

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Association between stunting and overweight among 10–15-y-old children in the North West Province of South Africa: the THUSA BANA Study

Cited by 64 publications

References 21 publications

The association between early childhood stunting and weight status in late adolescence

The association between early childhood stunting and weight status in late adolescence

The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study

Habitual physical activity and body composition of black township adolescents residing in the North West Province, South Africa

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