Nutritional status of children on the National School Nutrition Programme in Capricorn District, Limpopo Province, South Africa

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Abstract

BACKGROUND. School feeding programmes are intended to alleviate short-term hunger, improve nutrition and cognition of children, and provide incomes to families. OBJECTIVES. To assess the nutritional status of children receiving meals provided by the National School Nutrition Programme (NSNP) in Capricorn Municipality, Limpopo Province, South Africa. METHODS. The setting was 18 randomly selected schools on the NSNP in Capricorn District. The total sample comprised 602 randomly selected schoolchildren from grades 4 to 7, aged 10 (26.6%), 11 (35.4%) and 12 (35.4%). Socioeconomic characteristics, anthropometric measurements, dietary patterns and school attendance were determined. Children were interviewed to assess their nutritional status using a validated questionnaire. Descriptive statistics such as means, standard deviations (SDs) and ranges were used for socioeconomic parameters and dietary patterns, and z-scores for anthropometric data. RESULTS. The results showed that boys (9.5%) and girls (7.8% ) were underweight. The prevalence of stunting in the sample was 11.3% for boys and 7.4% for girls, whereas boys (3.6%) and girls (4.2%) were wasted, with a z-score of -2 SD. School attendance was good. CONCLUSION. The nutritional status of most subjects in the study was within the acceptable range as indicated by the assessment of growth using anthropometric measurements.

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Most cited references 30

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Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee.

M. de Onis, J P Habicht (1996)

The World Health Organization (WHO) convened an Expert Committee to reevaluate the use of anthropometry at different ages for assessing health, nutrition, and social wellbeing. The Committee's task included identifying reference data for anthropometric indexes when appropriate, and providing guidelines on how the data should be used. For fetal growth, the Committee recommended an existing sex-specific multiracial reference. In view of the significant technical drawbacks of the current National Center for Health Statistics (NCHS)/WHO reference and its inadequacy for assessing the growth of breast-fed infants, the Committee recommended the development of a new reference concerning weight and length/height for infants and children, which will be a complex and costly undertaking. Proper interpretation of midupper arm circumference for preschoolers requires age-specific reference data. To evaluate adolescent height-for-age, the Committee recommended the current NCHS/WHO reference. Use of the NCHS body mass index (BMI) data, with their upper percentile elevations and skewness, is undesirable for setting health goals; however, these data were provisionally recommended for defining obesity based on a combination of elevated BMI and high subcutaneous fat. The NCHS values were provisionally recommended as reference data for subscapular and triceps skinfold thicknesses. Guidelines were also provided for adjusting adolescent anthropometric comparisons for maturational status. Currently, there is no need for adult reference data for BMI; interpretation should be based on pragmatic BMI cutoffs. Finally, the Committee noted that few normative anthropometric data exist for the elderly, especially for those > 80 y of age. Proper definitions of health status, function, and biologic age remain to be developed for this group.

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The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural South African children

Elizabeth W. Kimani-Murage, Kathleen Kahn, John Pettifor … (2010)

Background Low- to middle-income countries are undergoing a health transition with non-communicable diseases contributing substantially to disease burden, despite persistence of undernutrition and infectious diseases. This study aimed to investigate the prevalence and patterns of stunting and overweight/obesity, and hence risk for metabolic disease, in a group of children and adolescents in rural South Africa. Methods A cross-sectional growth survey was conducted involving 3511 children and adolescents 1-20 years, selected through stratified random sampling from a previously enumerated population living in Agincourt sub-district, Mpumalanga Province, South Africa. Anthropometric measurements including height, weight and waist circumference were taken using standard procedures. Tanner pubertal assessment was conducted among adolescents 9-20 years. Growth z-scores were generated using 2006 WHO standards for children up to five years and 1977 NCHS/WHO reference for older children. Overweight and obesity for those <18 years were determined using International Obesity Task Force BMI cut-offs, while adult cut-offs of BMI ≥ 25 and ≥ 30 kg/m2 for overweight and obesity respectively were used for those ≥ 18 years. Waist circumference cut-offs of ≥ 94 cm for males and ≥ 80 cm for females and waist-to-height ratio of 0.5 for both sexes were used to determine metabolic disease risk in adolescents. Results About one in five children aged 1-4 years was stunted; one in three of those aged one year. Concurrently, the prevalence of combined overweight and obesity, almost non-existent in boys, was substantial among adolescent girls, increasing with age and reaching approximately 20-25% in late adolescence. Central obesity was prevalent among adolescent girls, increasing with sexual maturation and reaching a peak of 35% at Tanner Stage 5, indicating increased risk for metabolic disease. Conclusions The study highlights that in transitional societies, early stunting and adolescent obesity may co-exist in the same socio-geographic population. It is likely that this profile relates to changes in nutrition and diet, but variation in factors such as infectious disease burden and physical activity patterns, as well as social influences, need to be investigated. As obesity and adult short stature are risk factors for metabolic syndrome and Type 2 diabetes, this combination of early stunting and adolescent obesity may be an explosive combination.

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School feeding programs in developing countries: impacts on children's health and educational outcomes.

Jill McDonnell, Claudia Probart, H Jomaa (2011)

School feeding programs (SFPs) are intended to alleviate short-term hunger, improve nutrition and cognition of children, and transfer income to families. The present review explores the impact of SFPs on nutritional, health, and educational outcomes of school-aged children in developing countries. Peer-reviewed journal articles and reviews published in the past 20 years were identified and screened for inclusion. Analysis of the articles revealed relatively consistent positive effects of school feeding in its different modalities on energy intake, micronutrient status, school enrollment, and attendance of the children participating in SFPs compared to non-participants. However, the positive impact of school feeding on growth, cognition, and academic achievement of school-aged children receiving SFPs compared to non-school-fed children was less conclusive. This review identifies research gaps and challenges that need to be addressed in the design and implementation of SFPs and calls for theory-based impact evaluations to strengthen the scientific evidence behind designing, funding, and implementing SFPs. © 2011 International Life Sciences Institute.

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Author and article information

Contributors

F Malongane: Role: ND

X G Mbhenyane: Role: ND

Journal

Journal ID (publisher-id): sajch

Title: South African Journal of Child Health

Abbreviated Title: S. Afr. j. child health

Publisher: Health & Medical Publishing Group (Cape Town, Western Cape Province, South Africa )

ISSN (Print): 1994-3032

ISSN (Electronic): 1999-7671

Publication date (Print and electronic): March 2017

Volume: 11

Issue: 1

Pages: 11-15

Affiliations

[03] Cape Town orgnameTygerberg Academic Hospital South Africa

[01] Pretoria orgnameUniversity of South Africa orgdiv1College of Agriculture and Environmental Sciences orgdiv2Department of Life and Consumer Sciences South Africa

[02] orgnameStellenbosch University orgdiv1Faculty of Medicine and Health Sciences orgdiv2Department of Interdisciplinary Health Sciences