Abstract
BackgroundIn South Africa, the occurrence of the double burden of malnutrition is on the rise at a household level predisposing children and their mothers to negative health outcomes. However, few studies have been conducted at a household level. Therefore, we studied a double burden of malnutrition using child-mother pairs in a rural setting.MethodsA cross-sectional quantitative survey was conducted among 508 child-mother pairs selected from primary schools using a multistage sampling in a rural Dikgale Health and Demographic Site in Limpopo Province, South Africa. Anthropometric measurements of children and mothers, and socio-demographic data were collected. WHO AnthroPlus was used to generate body-mass-index z-scores of children and the BMI was used to indicate overweight and obesity among the mothers. Mann Whitney test was used to compare the means of variables between sexes and age groups, while the prevalence of thinness and overweight/obesity were compared using a chi-square. Multivariate logistic regression with a stepwise backward elimination procedure, controlling for confounding, was used to determine the association between the thinness and overweight/obesity and the covariates.ResultsTwenty five percent (25%) of the children were thin, 4% were overweight and 1% obese, while mothers were overweight (27.4%) and 42.3% obesity (42.3%) were observed among the mothers. The odds of being thin were higher in boys than in girls (AOR = 1.53, 95%CI: 1.01–2.35). Overweight/obese mothers were more likely to have thin children (AOR = 1.48, 95% CI: 1.01–2.18) and less likely to have overweight/obese children (AOR = 0.18, 95%CI: 0.07–0.46).ConclusionA double burden of malnutrition was observed on a household level with thinness among children and overweight/obesity among mothers. A need to address the dual problems of undernutrition and rapidly rising trends of overweight/obesity cannot be over-emphasized.
Highlights
In South Africa, the occurrence of the double burden of malnutrition is on the rise at a household level predisposing children and their mothers to negative health outcomes
In an earlier study conducted among children and adolescents aged 1–20 years, in a rural health and demographic surveillance site, the results showed the double burden of malnutrition through the presence of undernutrition at an early age, with marked level of overweight/obesity in adolescents [3]
Distribution of schoolchildren A representative sample of 508 schoolchildren was obtained from the five largest primary schools in Dikgale Health and Demographic Surveillance System Site (DHDSSS)
Summary
In South Africa, the occurrence of the double burden of malnutrition is on the rise at a household level predisposing children and their mothers to negative health outcomes. We studied a double burden of malnutrition using child-mother pairs in a rural setting. The coexistence of undernutrition (i.e. thinness, stunting and underweight) and over-nutrition (i.e. overweight and obesity) or diet-related non-communicable diseases is known as the double burden of malnutrition [1]. An individual child often manifests as stunting or micronutrient deficiencies co-occurring with overweight or obesity. When a mother is overweight and a child is underweight. Studies conducted in LMICs, such as Brazil, China and Russia reported high prevalence of underweight or stunting and overweight in the same population, or on household levels with both obese and stunted or underweight individuals [5, 6]
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