Provincial Dietary Intake Study (PDIS): Prevalence and Sociodemographic Determinants of the Double Burden of Malnutrition in A Representative Sample of 1 to Under 10-Year-Old Children from Two Urbanized and Economically Active Provinces in South Africa

Abstract

The objective of this study was to determine the prevalence and socio-demographic predictors of malnutrition in two urbanized economically active provinces (Gauteng N = 733, Western Cape N = 593) in South Africa. A multistage stratified cluster random sampling design was applied. Fieldworkers visited homes, measured children aged 1-<10-years old (N = 1326) and administered a questionnaire (mother/primary caregiver). In under-five year old children (N = 674) 21.6% were stunted [height-for-age z-score < −2 SD], 5.6 % underweight [weight-for-age z-score < −2 SD], 10.3% overweight (body mass index-for-age z-score) (BAZ)> +2 SD ≤ +3 SD] and 7.0% obese (BAZ > +3 SD). In 5–<10-year olds (N = 626) 6.7% were stunted, 6.8% underweight, 13.4% overweight and 6.8% obese. Stunting and overweight in the same child was present in 5.7% under-five year olds and 1.7% in 5–<10-year olds. Multiple logistic regression analyses identified having a mother with a post-grade 12 qualification (OR = 0.34) and having an obese mother (OR 0.46) as protectors and being in the under-five age group (OR = 3.73) as a risk factor for stunting. Being in the under-five age group was also a risk factor for a BAZ > 1 (OR 2.39), while being in the third wealth quintile was protective (OR = 0.62). Results indicate that stunting and overweight/obesity are still present at concerning levels, especially in the under-five age group.

Provincial Dietary Intake Study (PDIS): Energy and Macronutrient Intakes of Children in a Representative/Random Sample of 1–<10-Year-Old Children in Two Economically Active and Urbanized Provinces in South Africa

“…In the most recent Lancet Series on the double burden of malnutrition, the fact that low-and middle-income countries face a double burden of malnutrition as a result of a global nutrition transition is reiterated [42]. This is also true for the two provinces in South Africa we investigated, as was reported in the paper by Senekal et al [9]. Popkin et al [42] mention that a key factor in this transition over and above the transition from more traditional to Western diets is the change in the global food system, that makes less nutritious food cheaper and more accessible.…”

“…The number of HHS per sampling stratum (province and residential area), taking non-response into account was calculated to be N (=175); where the design effect (Deft = 1.3), the estimated proportion of children classified as stunted (p = 0.21), and the desired relative standard error (a = 0.2) are based on estimations from previous surveys. The p value for stunting was used, since the current study formed part of a larger study, which also looked at anthropometric status [9]. The individual response rate (R 1 = 0.96) was expected to be higher than the expected household gross response rate (R 2 = 0.89).…”

“…non-communicable diseases (NCDs) [6,7]. Rapid weight gain in infancy is also associated with long-term risk of adult weight gain and development of NCDs [8].In a recent publication of the same children whose dietary results are studied here, nutritional status by means of anthropometry was determined [9]. Stunting was found to be 39% and 23% in 1and 2-year-olds, respectively.…”

“…In a recent publication of the same children whose dietary results are studied here, nutritional status by means of anthropometry was determined [9]. Stunting was found to be 39% and 23% in 1and 2-year-olds, respectively.…”

Provincial Dietary Intake Study (PDIS): Micronutrient Intakes of Children in a Representative/Random Sample of 1- to <10-Year-Old Children in Two Economically Active and Urbanized Provinces in South Africa

“…In 2018 a provincially representative dietary intake study (PDIS) of 1- to <10-year-old children was undertaken in Gauteng (GTG) and in the Western Cape (WC) [ 8 ]. These are regarded as being the two most economically active and urbanized provinces in South Africa.…”