| Peer-Reviewed

A Comparative Analysis of Nutritional Status in Adolescents from an Urban Versus a Peri-urban School in Kwazulu-Natal, South Africa

Received: 12 July 2015     Accepted: 24 July 2015     Published: 25 July 2015
Views:       Downloads:
Abstract

With the current nutrition transition occurring in low-to-middle-income countries (LMICs), incidences of both overweight/obesity and underweight/stunting are increasingly observed within the same population. This is an important phenomenon with regards to adolescent health, as poor nutritional status among adolescents may contribute towards susceptibility to both communicable and non-communicable diseases in adulthood. Research has shown that nutritional status can be affected by socioeconomic status (SES). The objective of this study was to conduct a comparative analysis of the anthropometric status of adolescents from two secondary schools in the KwaZulu-Natal province of South Africa that differ according to the SES of the learners. The study was cross-sectional and descriptive; and was carried out in an urban and a peri-urban high school in Hilton, KwaZulu-Natal. Grade nine to 11 learners (n=111) aged 14 to 21 years from the peri-urban high school and the urban high school (n=98) aged 14 to 17 years, volunteered to participate (N= 209). Anthropometric measurements including weight, height and mid-upper-arm circumference (MUAC) were measured and body mass index (BMI) was calculated. Results showed a higher incidence of overweight (> +1SD - 25kg/m2) and obesity (>+2SD - BMI 30 kg/m2) among urban school boys compared to peri-urban school boys (p<0.01) and among peri-urban school girls compared to urban school girls (p<0.01) across all grades. A higher prevalence of stunting (<-2SD and >-3SD) was observed among peri-urban school boys (p<0.01) compared to their urban school counterparts. Albeit a small sample size, results from this study indicates that SES and gender may play a determinant role in overweight, obesity and stunting prevalence, as boys in urban areas and girls in peri-urban areas may be at a higher risk of overweight/obesity, whereas peri-urban boys may be at a higher risk of stunting. It can also be concluded that a double burden of stunting and overweight/obesity may exist among adolescents from peri-urban areas, who were considered to be of low SES.

Published in Central African Journal of Public Health (Volume 1, Issue 2)
DOI 10.11648/j.cajph.20150102.12
Page(s) 21-27
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Stunting, Obesity, Adolescents, Socioeconomic Status

References
[1] N. Tathiah, I. Moodley, V. Mubaiwa, and L. Denny, South Africa’s nutritional transition: Overweight, obesity, underweight and stunting in female primary school learners in rural KwaZulu-Natal, South Africa, S Afr Med J, vol. 103(10), pp. 718-723, 2013.
[2] H. F. Delisle, Poverty: the double burden of malnutrition in mothers and the intergenerational impact, Ann N Y Acad Sci, vol. 1136, pp. 172-84, 2008.
[3] P. Shetty, Nutrition transition and its health outcomes, Indian Journal of Pediatrics, vol. 80(1), pp. 21–27, 2013.
[4] K. Lock, R. D. Smith, A. D. Dangour, M. Keogh-Brown, G. Pigatto, C. Hawkes, R. M. Fisberg, and Z. Chalabi, Health, agricultural, and economic effects of adoption of healthy diet recommendations, Lancet, vol. 376(9753), pp. 1699-709, 2010.
[5] N. P. Steyn, D. Labadarios, and J. H. Nel, Factors which influence the consumption of street foods and fast foods in South Africa, Nutrition Journal, vol. 10(104), 2011.
[6] R. Uauy, M. L. Garmendia, and C. Corvalán, Addressing the double burden of malnutrition with a common agenda, Nestle Nutr Inst Workshop Ser, vol. 78, pp. 39-52, 2014.
[7] V. S. Leal, P. I. C. de Lira, R. C. E. de Menezes, J. S. Oliveira, L. A. de Souza, S. L. de Andrade, and M. B. Filho, Factors associated with the decline in stunting among children and adolescents in Pernambuco, Northeastern Brazil, Rev Saúde Pública, vol. 46(2), 2012.
[8] Z.A. Bhutta, and R. A. Salam, Global nutrition epidemiology and trends, Ann Nutr Metab, vol. 61, pp. 19-27, 2013.
[9] L. H. Dekker, M. Mora-Plazas, C. Marín, A. Baylin, and E. Villamor, Stunting associated with poor socioeconomic and maternal nutrition status and respiratory morbidity in Colombian schoolchildren, Food Nutr Bull, vol 31(2), pp. 242-250, 2010.
[10] K. Kahn, Population health in South Africa: Dynamics over the past two decades, Journal of Public Health Policy, vol. 32: 30–36, 2011.
[11] D. Stupar, W. B. Eide, L. Bourne, M. Hendricks, P. O. Iversen, and M. Wandel, The nutrition transition and the human right to adequate food for adolescents in the Cape Town metropolitan area: Implications for nutrition policy, Food Policy, vol. 37, pp. 199–206, 2012.
[12] N. J. Temple, and N. P. Steyn, The cost of a healthy diet: A South African perspective, Nutrition, vol. 27, pp. 505–508, 2011.
[13] P. Amuna, and F. B. Zotor, Epidemiological and nutrition transition in developing countries: impact on human health and development, Proceedings of the Nutrition Society, vol. 67, pp. 82–90, 2008.
[14] R. Kruger, H. S. Kruger, and U. E. MacIntyre, The determinants of overweight and obesity among 10- to 15-year-old schoolchildren in the North West Province, South Africa – the THUSA BANA (Transition and Health during Urbanisation of South Africans; BANA, children) study, Public Health Nutrition, vol. 9(3), pp. 351–358, 2005.
[15] A. Boutayeb, and S. Boutayeb, The burden of non-communicable diseases in developing countries, International Journal for Equity in Health, vol. 4(2), 2005.
[16] World Health Organisation, Global status report on non-communicable diseases. http://www.who.int/nmh/publications/ncd_report_full_en.pdf. Accessed January 13th 2014, 2010.
[17] R. Kanter, and B. Caballero, Global Gender Disparities in Obesity: A Review, Adv Nutr Int Rev J, vol. 3(4), pp. 491–8, 2012.
[18] R. E. Black, C. G. Victoria, S. P. Walker, Z. Bhutta, P. Christian, M. de Onis, M. Ezzati, S. Grantham-McGregor, J. Katz, R. Martorell, and R. Uauy, Maternal and child undernutrition and overweight in low-income and middle-income countries, Lancet, vol. 382, pp. 427–51, 2013.
[19] B. M. Popkin, L. S. Adair, and S. Wen Ng, The global nutrition transition: the pandemic of obesity in developing countries, Nutrition Reviews, vol. 70(1), pp. 3–21, 2012.
[20] S. Willan, A Review of Teenage Pregnancy in South Africa – Experiences of Schooling, and Knowledge and Access to Sexual & Reproductive Health Services. Partners in Sexual Health. http://www.rmchsa.org/wp-content/uploads/2013/08/Teenage-Pregnancy-in-South-Africa-2013.pdf Accessed January 13th 2014, 2013.
[21] N. Peer, C. Lombard, K. Steyn, N. Gwebushe, and N. Levitt, Differing Patterns of Overweight and Obesity among Black Men and Women in Cape Town: The CRIBSA Study. PLoS ONE; 9(9). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164661/, 2014.
[22] N. Phaswana-Mafuya, K. Peltzer, W. Chirinda, A. Musekiwa, and Z. Kose, Sociodemographic predictors of multiple non-communicable disease risk factors among older adults in South Africa, Glob Health Action, 2013; Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3776324/.
[23] E. W. Kimani-Murage, K. Kahn, J. M. Pettifor, S. M. Tollman, D. B. Dunger, X. F. Gómez-Olivé, and S. A. Norris, The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural South African children, BioMed Central Public Health, vol. 10(158) http://www.biomedcentral.com/1471-2458/10/158 -Accessed February 10th 2014, 2010.
[24] E. Kimani-Murage, Exploring the paradox double burden of malnutrition in rural South Africa, Glob Health Action, vol. 6(19249), pp. 193-205, 2013.
[25] B. M. Mayosi, A. J. Flisher, U. G. Lalloo, F. Sitas, S. M. Tollman, and D. Bradshaw, The burden of non-communicable diseases in South Africa, Lancet, vol. 374, pp. 934–947, 2009.
[26] J. L. Baker, L. W. Olsen, and T. I. Sorensen, Childhood body-mass index and the risk of coronary heart disease in adulthood, New England Journal of Medicine, vol. 357(23), pp. 2329–2337, 2007.
[27] Grace College Outreach Programme, http://www.grace-college.co.za/about-us/outreach/masihambisane Accessed November 4th 2013.
[28] UNICEF, Nutrition training: Adolescents. http://www.unicef.org/nutrition/training/3.3/6.html Accessed September 9th 2013.
[29] Y. Youfa Wang, and H. J. Chen, Use of Percentiles and Z -Scores in Anthropometry. In: Preedy VR (Ed) Handbook of Anthropometry: Physical Measures of Human Form in Health and Disease, Springer Science+Business Media, 2012 DOI 10.1007/978-1-4419-1788-1_2.
[30] E. Craig, R. Bland, J. Ndirangu, and J. J. Reilly, Use of mid-upper arm circumference for determining overweight and overfatness in children and adolescents, Arch Dis Child, vol. 99(8), pp. 763, 2014.
[31] M. M. Mazcoglu, N. Hatipoglu, A. Ozturk, B. Cicek, H. B. Ustunbas, and S. Kurtoglu, Waist Circumference and Mid-Upper Arm Circumference in Evaluation of Obesity in Children Aged Between 6 and 17 Years, J Clin Res Pediatr Endocrinol, vol. 2(4), pp. 144–50, 2010.
[32] V. Swami, D. A. Frederick, T. Aavik, L. Alcalay, J. Allik, D. Anderson, S. Andrianto, A. Arora, A. Brännström, J. Cunningham, D. Danel, K. Doroszewicz, G. B. Forbes, A. Furnham, C. U. Greven, J. Halberstadt, S. Hao, T. Haubner, C. S. Hwang, M. Inman, J. L. Jaafar, J. Johansson, J. Jung, A. Keser, U. Kretzschmar, L. Lachenicht, Li. NP, K. Locke, J. E. Lönnqvist, C. Lopez, L. Loutzenhiser, N. C. Maisel, M. P. McCabe, D. R. McCreary, W. F. McKibbin, A. Mussap, F. Neto, C. Nowell, L. P. Alampay, S. K. Pillai, A. Pokrajac-Bulian, R. T. Proyer, K. Quintelier, L. A. Ricciardelli, M. Rozmus-Wrzesinska, T. Ruch, W. Russo, A. Schütz, T. K. Shackelford, S. Shashidharan, F. Simonetti, D. Sinniah, M. Swami, G. Vandermassen, M. van Duynslaeger, M. Verkasalo, M. Voracek, C. K. Yee, E. X. Zhang, X. Zhang, and I. Zivcic-Becirevic, The Attractive Female Body Weight and Female Body Dissatisfaction in 26 Countries Across 10 World Regions: Results of the International Body Project I, Pers Soc Psychol Bull, vol. 36(3), pp. 309–25, 2010.
[33] L. Malete, K. Motlhoiwa, S. Shaibu, B. H. Wrotniak, S. D. Maruapula, and J. Jackson, Body Image Dissatisfaction Is Increased in Male and Overweight/Obese Adolescents in Botswana, J Obes, Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619546/,2013.
[34] C. C. Jinabhai, M. Taylor, P. Reddy, D. Monyeki, N. Kamabaran, R. Omardien, and K. R. Sullivan, Sex differences in under and over nutrition among school-going Black teenagers in South Africa: an uneven nutrition trajectory, Tropical Medicine and International Health, vol. 12(8), pp. 944–952, 2007.
[35] O. Y. Addo, and J. H. Himes, Reference curves for triceps and subscapular skinfold thicknesses in US children and adolescents, Am J Clin Nutr, Mar 1 vol. 91(3), pp. 635–642, 2010.
Cite This Article
  • APA Style

    Keiron A. Audain, Frederick J. Veldman, Susanna M. Kassier. (2015). A Comparative Analysis of Nutritional Status in Adolescents from an Urban Versus a Peri-urban School in Kwazulu-Natal, South Africa. Central African Journal of Public Health, 1(2), 21-27. https://doi.org/10.11648/j.cajph.20150102.12

    Copy | Download

    ACS Style

    Keiron A. Audain; Frederick J. Veldman; Susanna M. Kassier. A Comparative Analysis of Nutritional Status in Adolescents from an Urban Versus a Peri-urban School in Kwazulu-Natal, South Africa. Cent. Afr. J. Public Health 2015, 1(2), 21-27. doi: 10.11648/j.cajph.20150102.12

    Copy | Download

    AMA Style

    Keiron A. Audain, Frederick J. Veldman, Susanna M. Kassier. A Comparative Analysis of Nutritional Status in Adolescents from an Urban Versus a Peri-urban School in Kwazulu-Natal, South Africa. Cent Afr J Public Health. 2015;1(2):21-27. doi: 10.11648/j.cajph.20150102.12

    Copy | Download

  • @article{10.11648/j.cajph.20150102.12,
      author = {Keiron A. Audain and Frederick J. Veldman and Susanna M. Kassier},
      title = {A Comparative Analysis of Nutritional Status in Adolescents from an Urban Versus a Peri-urban School in Kwazulu-Natal, South Africa},
      journal = {Central African Journal of Public Health},
      volume = {1},
      number = {2},
      pages = {21-27},
      doi = {10.11648/j.cajph.20150102.12},
      url = {https://doi.org/10.11648/j.cajph.20150102.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20150102.12},
      abstract = {With the current nutrition transition occurring in low-to-middle-income countries (LMICs), incidences of both overweight/obesity and underweight/stunting are increasingly observed within the same population. This is an important phenomenon with regards to adolescent health, as poor nutritional status among adolescents may contribute towards susceptibility to both communicable and non-communicable diseases in adulthood. Research has shown that nutritional status can be affected by socioeconomic status (SES). The objective of this study was to conduct a comparative analysis of the anthropometric status of adolescents from two secondary schools in the KwaZulu-Natal province of South Africa that differ according to the SES of the learners. The study was cross-sectional and descriptive; and was carried out in an urban and a peri-urban high school in Hilton, KwaZulu-Natal. Grade nine to 11 learners (n=111) aged 14 to 21 years from the peri-urban high school and the urban high school (n=98) aged 14 to 17 years, volunteered to participate (N= 209). Anthropometric measurements including weight, height and mid-upper-arm circumference (MUAC) were measured and body mass index (BMI) was calculated. Results showed a higher incidence of overweight (> +1SD - 25kg/m2) and obesity (>+2SD - BMI 30 kg/m2) among urban school boys compared to peri-urban school boys (p-3SD) was observed among peri-urban school boys (p<0.01) compared to their urban school counterparts. Albeit a small sample size, results from this study indicates that SES and gender may play a determinant role in overweight, obesity and stunting prevalence, as boys in urban areas and girls in peri-urban areas may be at a higher risk of overweight/obesity, whereas peri-urban boys may be at a higher risk of stunting. It can also be concluded that a double burden of stunting and overweight/obesity may exist among adolescents from peri-urban areas, who were considered to be of low SES.},
     year = {2015}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - A Comparative Analysis of Nutritional Status in Adolescents from an Urban Versus a Peri-urban School in Kwazulu-Natal, South Africa
    AU  - Keiron A. Audain
    AU  - Frederick J. Veldman
    AU  - Susanna M. Kassier
    Y1  - 2015/07/25
    PY  - 2015
    N1  - https://doi.org/10.11648/j.cajph.20150102.12
    DO  - 10.11648/j.cajph.20150102.12
    T2  - Central African Journal of Public Health
    JF  - Central African Journal of Public Health
    JO  - Central African Journal of Public Health
    SP  - 21
    EP  - 27
    PB  - Science Publishing Group
    SN  - 2575-5781
    UR  - https://doi.org/10.11648/j.cajph.20150102.12
    AB  - With the current nutrition transition occurring in low-to-middle-income countries (LMICs), incidences of both overweight/obesity and underweight/stunting are increasingly observed within the same population. This is an important phenomenon with regards to adolescent health, as poor nutritional status among adolescents may contribute towards susceptibility to both communicable and non-communicable diseases in adulthood. Research has shown that nutritional status can be affected by socioeconomic status (SES). The objective of this study was to conduct a comparative analysis of the anthropometric status of adolescents from two secondary schools in the KwaZulu-Natal province of South Africa that differ according to the SES of the learners. The study was cross-sectional and descriptive; and was carried out in an urban and a peri-urban high school in Hilton, KwaZulu-Natal. Grade nine to 11 learners (n=111) aged 14 to 21 years from the peri-urban high school and the urban high school (n=98) aged 14 to 17 years, volunteered to participate (N= 209). Anthropometric measurements including weight, height and mid-upper-arm circumference (MUAC) were measured and body mass index (BMI) was calculated. Results showed a higher incidence of overweight (> +1SD - 25kg/m2) and obesity (>+2SD - BMI 30 kg/m2) among urban school boys compared to peri-urban school boys (p-3SD) was observed among peri-urban school boys (p<0.01) compared to their urban school counterparts. Albeit a small sample size, results from this study indicates that SES and gender may play a determinant role in overweight, obesity and stunting prevalence, as boys in urban areas and girls in peri-urban areas may be at a higher risk of overweight/obesity, whereas peri-urban boys may be at a higher risk of stunting. It can also be concluded that a double burden of stunting and overweight/obesity may exist among adolescents from peri-urban areas, who were considered to be of low SES.
    VL  - 1
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Department of Dietetics and Human Nutrition, University of Kwa Zulu-Natal, Pietermaritzburg, South Africa

  • Department of Dietetics and Human Nutrition, University of Kwa Zulu-Natal, Pietermaritzburg, South Africa

  • Department of Dietetics and Human Nutrition, University of Kwa Zulu-Natal, Pietermaritzburg, South Africa

  • Sections