Association between stunting and overweight among 10-15-y-old children in the North West Province of South Africa: the THUSA BANA Study

Abstract

Objective: To investigate the relationship between stunting and overweight among 10-15-y-old children of the North West Province in South Africa.

Design: A single cross-sectional study design was used. The study formed part of the THUSA BANA project.

Subjects: The total study population of the THUSA BANA project comprised of 1257 randomly selected subjects, aged 10-15 y.

Measurements: Stunting was described as the height below the 5th percentile for age using the CDC standard percentiles. Furthermore, the definitions of overweight and obesity according to the International Obesity Task Force (IOTF) were used, where the cutoff points for body mass index (BMI) corresponds with the adult BMI of 25 and 30, respectively. Anthropometrical variables namely triceps (TSF) and subscapular skinfolds (SSF), waist circumference, weight, height and BMI of the 10-15-y-old subjects were analysed.

Results: Stunting was most prevalent in the rural areas (girls 23.7% and boys 26.7%) compared with urban areas (girls 11.6%, boys 17.1%). The odds ratio and the 95% CI for the association between stunting and overweight in boys and girls were 0.45 (CI 0.16, 1.30) and 0.50 (CI 0.21, 1.19) respectively. Stunted children, 10-14-y-old and living in rural areas and informal settlements, had significantly lower mean BMI and skinfold thicknesses than nonstunted children. The mean BMI and sum of TSF and SSF (TSF+SSF) were similar in stunted and nonstunted children living in urban areas.

Conclusion: There is no significant association between stunting and overweight in 10-15-y-old children in the North West Province. However, there is a tendency for girls older than 14 y to start to gain subcutaneous fat, even though at these ages they were still stunted and underweight. Stunted girls in established urban areas had a higher mean TSF+SSF than stunted girls in informal townships. This tendency in urban stunted girls is evident at the onset of menarche and could predict possible problems of overweight as they get older.