Sex differences in under and over nutrition among school‐going Black teenagers in South Africa: an uneven nutrition trajectory

Abstract

To investigate the nutritional status of Black South African teenagers by sex and compare it with nutritional profiles of teenagers from other countries. The first South African Youth Risk Behaviour Survey (2002) was adapted to include anthropometric data and this paper reports on the prevalence of under and over nutrition among 5322 Black teenagers, aged 13.0-17.9 years, grades 8-11. Prevalence of over nutrition in this study was compared with other countries using a World Bank country economic classification. Significant sex differences were observed for under and over nutrition. Boys (18.4%) had a higher prevalence of underweight than girls (2.6%) (P < 0.005), who were more at risk of overweight than boys (20.9%vs. 4.2%) (P < 0.005). Boys (21.9%) were more stunted than girls (9.4%) (P < 0.05), but stunted girls were at greater risk of overweight than boys across all levels of stunting. The prevalence of overweight among boys (4.2%) was lower than in other countries while for girls (20.9%) was similar to several upper middle and high income countries. Gender sensitive strategies are required to address both under and over nutrition among South African teenagers to reduce stunting and future chronic disease epidemics in adulthood. This paper suggests that Black South African teenagers are experiencing an uneven nutritional transition across sex, from under nutrition to over nutrition.