Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Pediatric Highlight
  • Published:

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

International Journal of Obesity volume 28, pages 842–851 (2004)Cite this article

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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Popkin BM, Richards MK, Monteiro CA . Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J Nutr 1996; 126: 3009–3016.

    Article  CAS  Google Scholar 

  2. Sawaya AL, Grillo LP, Verreschi I, Carlos Da Silva A, Roberts SB . Mild stunting is associated with higher susceptibility to the effects of high-fat diets; studies in a shantytown population in the city of Sao Paulo, Brazil. J Nutr 1998; 128 (Supplement): S415–S420.

    Article  Google Scholar 

  3. WHO. Consultation on Obesity. Preventing and Managing the Global Epidemic. World Health Organization: Geneva; 1998.

  4. Puoane T, Steyn K, Bradshaw D, Laubscher R, Fourie J, Lambert V, Mbananga N . Obesity in South Africa: the South African demographic and health survey. Obes Res 2002; 10: 1038–1048.

    Article  Google Scholar 

  5. Aristimuno GG, Foster TA, Voors AW, Srinivasan SR, Berenson GS . Influence of persistent obesity in children on cardiovascular risk factors. Circ 1984; 69: 895–904.

    Article  CAS  Google Scholar 

  6. Dipietro L, Mossenberg HO, Stunkard AJ . A 40-year history of overweight children in Stockholm: lifetime overweight, morbidity and mortality. Int J Obes 1994; 18: 585–590.

    CAS  Google Scholar 

  7. Dietz WH . Critical periods in childhood for the development of obesity. Am J Clin Nutr 1994; 59: 955–959.

    Article  CAS  Google Scholar 

  8. Martorell R, Khan LK, Schroeder DG . Reversibility of stunting: epidemiological finding in children from developing countries. Eur J Clin Nutr 1994; 48 (1): S45–S57.

    PubMed  Google Scholar 

  9. Waterlow JC . Causes and mechanisms of linear growth retardation (stunting). Eur J Clin Nutr 1994; 481 (Supplement): S1–S4.

    Google Scholar 

  10. Trowbridge FL, Marks JS, Romana GL, Mandrid S, Boutton TW, Klein PD . Body composition of Peruvian children with short stature and high weight-for-height II. Implications for the interpretation for weight-for-height as an indicator of nutritional status. Am J Clin Nutr 1987; 45: 513–525.

    Article  Google Scholar 

  11. Waterlow JC . Protein Energy Malnutrition. Edward Arnold: London; 1992. p 407.

    Google Scholar 

  12. Sawaya AL, Dallal G, Solymos G . Obesity and malnutrition in a shantytown population in the city of Sao Paulo, Brazil. Obes Res 1995; 3 (Supplement): S107–S115.

    Article  Google Scholar 

  13. Trowbridge FL . Prevalence of growth stunting and obesity. Pediatric nutrition surveillance system. CDC Surveillance Summ 1982; 32: 23SS–27SS.

    Google Scholar 

  14. Norton K, Olds T . Anthropometrica. A Textbook of Body Measurement for Sports and Health Courses. University of New South Wales Press: Sydney; 1996. p 411.

    Google Scholar 

  15. Ross WD, Marfell-Jones MJ . Kinantropometry. In: Macbougal JD, Wenger HA, Green HJ (eds). Physiological Testing of the High Performance Athlete. Human kinetics: Champaign; 1991. pp 223–308.

    Google Scholar 

  16. Centers of Disease Control. 2000 CDC growth charts: United States. Hyattsville, MD. National Center for Health Statistics. 2000, http://www.cdc.gov/growthcharts.

  17. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 2000; 320: 1240–1243.

    Article  CAS  Google Scholar 

  18. Thomas JR, Nelson JK . Research Methods in Physical Activity. Human kinetics publishers: Champaign; 1996. p 485.

    Google Scholar 

  19. Cohen J . Statistical Power Analysis for the Behavioral Sciences, revised edn. Academic Press Inc: New York; 1977.

    Google Scholar 

  20. Bland JM, Altman DG . The odds ratio. Br Med J 2000; 320: 1468.

    Article  CAS  Google Scholar 

  21. Pretoria Stats SA . Living in North West. Selected Findings of the 1995 October Household Survey. Statistics South Africa: Pretoria; 1985. pp 7.

    Google Scholar 

  22. Harris NS, Crawford PB, Yangzom Y, Pinzo L, Gylatsen P, Hudes M . Nutritional and health status of Tibetan children living at high altitudes. N Eng J Med 2001; 344/5: 341–347.

    Article  Google Scholar 

  23. Freedman DS, Srinvasan SR, Webber LS, Burke GL, Berenson GS . Black–white differences in serum lipoproteins during sexual maturation: the Bogalusa Heart Study. J Chr Dis 1987; 40: 309–318.

    Article  CAS  Google Scholar 

  24. The National Heart, Lung and Blood Institute growth and health study research group (NHLBI). Obesity and cardiovascular disease risk factors in black and white girls; the NHLBI growth and health study. Am J Publ Health 1992; 82/12: 1613–1620.

  25. O'Dea J, Abrahams S . Should body mass index be used in young adolescents? Lancet 1995; 345: 657.

    Article  CAS  Google Scholar 

  26. Bini V, Celi F, Bertioli MG, Bacosi ML, Stella P, Giglio P, Tosti L, Falorni A . Body mass index in children and adolescents according to age and pubertal stage. Eur J Clin Nutr 2000; 54: 214–218.

    Article  CAS  Google Scholar 

  27. Freedman DS, Serdula MK, Srinivasan SR, Berenson GS . Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 1999; 69: 308–317.

    Article  CAS  Google Scholar 

  28. Asayama K, Oguni T, Hayashi K, Dobashi K, Fukunaga Y, Kodera K, Tamai H, Nakazawa S . Critical value for the index of body fat distribution based on waist and hip circumference and stature in obese girls. Int J Obes Relat Metab Disord 2000; 24: 1026–1031.

    Article  CAS  Google Scholar 

  29. Musaiger AO, Gregory WB . Profile of body composition of school children (6–18 y) in Bahrain. Int J Obes Relat Metab Disord 2000; 24: 1093–1096.

    Article  CAS  Google Scholar 

  30. Asayama K, Hayashi K, Hayashibe H, Uchida N, Kodera K, Nakazawa S . Relationships between an index of body fat distribution (based on waist and hip circumferences) and stature, and biochemical complications in obese children. Int J Obes Relat Metab Disord 1988; 22: 1209–1216.

    Article  Google Scholar 

  31. Steyn NP, Wicht CL, Rossouw JE, Van Wyk Kotze TJ, Van Eck M . Nutritional status of 11-year-old children in the Western Cape. II. Anthropometry. SA J Food Sci Nutr 1989; 1: 21–27.

    Google Scholar 

  32. Hoffman DJ, Sawaya AL, Coward WA, Wright A, Martins PA, De Nascimento C, Tucker KL, Roberts SB . Energy expenditure of stunted and non-stunted boys and girls living in the shantytowns of Sao Paulo, Brazil. Am J Clin Nutr 2000; 72: 1025–1031.

    Article  CAS  Google Scholar 

  33. Jinabhai CC, Taylor M, Sullivan KR . Implications of the prevalence of stunting, overweight and obesity amongst South African primary school children: a possible nutritional transition? Eur J Clin Nutr 2003; 57: 358–365.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The guidance given by Dr NP Steyn of the Medical Research Council, South Africa and Dr NF Butte of the Children's Nutrition Research Center, Houston, Texas and the advice on the statistical analysis given by Professor HS Steyn of the Potchefstroom University for CHE are acknowledged. We express our sincere gratitude to all the members and subjects of the THUSA BANA team in particular, to Professor JH de Ridder and Dr Colette Underhay, who supervised the anthropometric measurements. This study was made possible by grants from the SA Sugar Association, the Medical Research Council of South Africa, Potchefstroom University for CHE and the Department of Trade and Industry through the THRIP system.

Author information

Authors and Affiliations

  1. School of Physiology, Nutrition and Consumer Science, Potchefstroom University, Potchefstroom, South Africa

    J Mukuddem-Petersen & H Salome Kruger

Authors
  1. J Mukuddem-Petersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H Salome Kruger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J Mukuddem-Petersen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mukuddem-Petersen, J., Kruger, H. Association between stunting and overweight among 10–15-y-old children in the North West Province of South Africa: the THUSA BANA Study. Int J Obes 28, 842–851 (2004). https://doi.org/10.1038/sj.ijo.0802586

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802586

Keywords

This article is cited by

Search

Advanced search

Quick links