Evidence of Concurrent Stunting and Obesity among Children under 2 Years from Socio-Economically Disadvantaged Backgrounds in the Era of the Integrated Nutrition Programme in South Africa

Modjadji, Perpetua; Masilela, Lucy Nomsa; Cele, Lindiwe; Mathibe, Mmampedi; Mphekgwana, Peter M.

doi:10.3390/ijerph191912501

Cited by 9 publications

(16 citation statements)

References 73 publications

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Section: Minimum Dietary Diversity 123 Discussionmentioning

confidence: 99%

“…high in energy-dense food, low in nutrient-dense food) (Popkin et al , 2012). It is suggested that low consumption of animal protein inhibits linear growth, whereas a high-carbohydrate diet may increase fat deposition (Modjadji et al , 2022). In fact, the food cost can be a barrier to implementing a lower energy and nutrient-dense diet for poorer households (Darmon and Drewnowski, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…We categorized the maternal age into < 30 years and ≥ 30 years because the mean maternal age in the present study was 30 years. The use of the mean of maternal age as a cut-off was also used by previous research with similar topics (Modjadji et al , 2022). Other parental factors were parental education (junior high school or below, senior high school, higher degree), maternal working status (not working, working) and paternal occupation type (not working or informal work, formal work).…”

Section: Methodsmentioning

confidence: 99%

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Minimum dietary diversity and the concurrence of stunting and overweight among infants and young children in Yogyakarta, Indonesia

Paramashanti,

Paratmanitya,

Kusumaningtyas

et al. 2023

NFS

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Purpose This study aims to examine the association between minimum dietary diversity (MDD) and the concurrence of stunting and overweight (CSO) among children aged 6–23 months. Design/methodology/approach A cross-sectional study was conducted in Sedayu Subdistrict, Bantul District, Daerah Istimewa Yogyakarta. The authors assessed the concurrence of stunting (height-for-age Z-score below −2 standard deviations SD) and overweight/obesity (Body mass index BMI-for-age Z-score above +2 SD) among a total of 189 children aged 6–23 months as the primary outcome. The authors defined MDD as consuming at least four out of seven food groups using a single 24-h recall. The authors also included other covariates, including sociodemographic characteristics, exclusive breastfeeding history and complementary feeding practices. To identify the factors associated with CSO, this study conducted multiple logistic regression across the study variables using STATA 16.1. Findings In the adjusted model, children who met the MDD criterion were associated with a reduced risk of CSO (adjusted odds ratios [OR]: 0.14; 95%confidence interval CI: 0.03–2.43). Compared to boys, girls were more likely to experience CSO (adjusted OR: 5.23; 95%CI: 1.02–26.9). Middle economic status was a protective factor for CSO (adjusted OR: 0.10; 95%CI: 0.01–0.98). This study did not find a significant relationship between CSO and the child’s age, low birth weight, exclusive breastfeeding, energy intake, protein intake, parental education and parental occupation. Practical implications This study suggests future programs and policies that promote dietary diversity to reduce the risk of CSO. Originality/value This study reveals the association between MDD and the coexistence of stunting and overweight.

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Section: Minimum Dietary Diversity 123 Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Minimum dietary diversity and the concurrence of stunting and overweight among infants and young children in Yogyakarta, Indonesia

Paramashanti,

Paratmanitya,

Kusumaningtyas

et al. 2023

NFS

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“…In the most recent malnutrition estimates, the 2023 Joint Child Malnutrition Estimates produced by the UNICEF, WHO, World Bank collaboration, notes that most of the children who were diagnosed with malnutrition in 2022 lived in Africa and Asia, with two out five children under five experiencing stunting coming from Africa (UNICEF / WHO and The World Bank Group, 2023). Evidence from sub-Saharan African country contexts such as Ghana, Ethiopia, and South Africa shows that children who experience a combination of stunted growth and overweight, otherwise known as concurrent stunting and overweight or the “double burden” of malnutrition, face higher risks of obesity and chronic lifestyle diseases such as diabetes and hypertension in adulthood (Atsu et al, 2017; Farah et al, 2021; Modjadji et al, 2022), once again underscoring the long-term health impacts of childhood malnutrition. Additionally, women who were stunted as children are more likely to give birth to low-weight babies, who, in turn, face a higher risk of childhood illnesses such as pneumonia, diarrhoea, and malnutrition (Khatun et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Social protection as a nutrition-sensitive instrument to address malnutrition in sub-Saharan Africa: Examining the utility of the UNICEF conceptual model of care for maternal and child nutrition

Zembe-Mkabile

2023

J. int. comp. soc. policy

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Child nutrition, health and development are closely tied to maternal nutrition, health and well-being. The underlying drivers of poor maternal and child nutritional outcomes in sub-Saharan Africa are structural in nature. These risks include social, economic, and environmental factors that together compound vulnerability to poor outcomes. Poverty, as a driver of poor maternal and child health outcomes, is an important determinant that is both a cause and a consequence of malnutrition. The United Nations’ Children’s Fund (UNICEF)’s conceptual model for determinants of maternal and child nutrition outcomes released in 2020, is the agency’s latest iteration of child nutrition frameworks. The model identifies the underlying causes of malnutrition as extending beyond food and diets, to include household level dynamics, maternal factors, and the external environment. The manuscript discusses UNICEF’s conceptual model and its applicability in sub-Saharan Africa. It also considers the evidence on interventions aimed at addressing maternal and child nutrition in the region and the location of social protection among these policy tools, with a special focus on the extent to which these resonate with the conceptual model. It concludes by considering the conditions required for social protection instruments to work in the region and similar settings in the Global South. In this way, the manuscript provides a critical reflection about the role of social protection as a nutrition-sensitive instrument in sub-Saharan Africa, in the context of maternal and child nutrition outcomes.

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“…In the context of economic and demographic transition, stunting remains one of the persistent concerns with alarming rates of overweight and obesity in South Africa [ 29 , 30 , 31 , 32 , 33 , 34 ], giving rise to a double burden of malnutrition [ 35 , 36 ]. This rationalized use of a convergent parallel mixed methods design allows to best understand the magnitude of malnutrition through multilevel influences in a rural area.…”

Section: Introductionmentioning

confidence: 99%

The Multidimension of Malnutrition among School Children in a Rural Area, South Africa: A Mixed Methods Approach

Modjadji

Madiba

2022

Nutrients

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To address childhood malnutrition, the use of multifaceted methodologies, such as mixed methods research, is required to inform effective and contextual interventions. However, this remains limited in studying malnutrition among school children in a South African context, notwithstanding its persistence. We adopted a convergent parallel mixed methods design to best understand the magnitude of malnutrition through multilevel influences in a rural area. A quantitative survey determined the magnitude of malnutrition and associated factors among school children and their mothers (n = 508), parallel to a qualitative study, which explored mothers’ insights into the influences of child growth and nutrition in interviews using seven focus group discussions. Mixed methods integration was achieved through convergence of the quantitative constructs developed from measured variables for malnutrition and related factors with ten emergent qualitative themes using a joint display analysis to compare the findings and generate meta-inferences. Qualitative themes on food unavailability and affordability, poor feeding beliefs and practices, and decision to purchase foods were consistent with the quantified poor socio-demographic status of mothers. Furthermore, the qualitative data explained the high prevalence of undernutrition among children but did not corroborate the high estimated households’ food security in the quantitative survey. The misperceptions of mothers on child growth agreed with limited food knowledge as well as lack of knowledge on child growth gathered during the survey. Moreover, mothers believed that their children were growing well despite the high presence of childhood undernutrition. Mothers further overrated the effectiveness of school feeding programmes in providing healthy food to children as compared to their household food. They reported high incidence of food allergies, diarrhea, and vomiting caused by food consumed at school which resulted in children not eating certain foods. This might have impacted on the nutritional status of children since mothers depended on the school feeding program to provide food for their children. The ambiguity of cultural influences in relation to child growth was evident and substantiated during qualitative interview. Mixed methods integration offered a better understanding of malnutrition from empirical findings on interrelated factors at child, maternal, household, and school levels. This study points to a need for multilevel, informed, and contextual multidimensional interventions to contribute towards addressing childhood malnutrition in South Africa.

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Evidence of Concurrent Stunting and Obesity among Children under 2 Years from Socio-Economically Disadvantaged Backgrounds in the Era of the Integrated Nutrition Programme in South Africa

Cited by 9 publications

References 73 publications

Minimum dietary diversity and the concurrence of stunting and overweight among infants and young children in Yogyakarta, Indonesia

Minimum dietary diversity and the concurrence of stunting and overweight among infants and young children in Yogyakarta, Indonesia

Social protection as a nutrition-sensitive instrument to address malnutrition in sub-Saharan Africa: Examining the utility of the UNICEF conceptual model of care for maternal and child nutrition

The Multidimension of Malnutrition among School Children in a Rural Area, South Africa: A Mixed Methods Approach

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