Socio-economic status and body composition outcomes in urban South African children (original) (raw)
Related papers
Public Health Nutrition, 2015
Objective: To investigate the associations of household and neighbourhood socio-economic position (SEP) with indicators of both under-and overnutrition in adolescents and to explore sex differences. Design: Analysis of anthropometric, household and neighbourhood SEP data from the Birth to Twenty Plus cohort born in 1990. Anthropometric outcomes were BMI (thinness, overweight and obesity) and percentage body fat (%BF; low, high). Associations between these and the household wealth index, caregiver education and neighbourhood SEP tertile measures were examined using binary logistic regression. Setting: Johannesburg-Soweto, South Africa. Subjects: Adolescents aged 17-19 years (n 2019; 48·2 % men). Results: Women had a significantly higher combined prevalence of overweight/ obesity (26·2 %) than men (8·2 %) whereas men had a significantly higher prevalence of thinness than women (22·2 % v. 10·6 %, respectively). Having a low neighbourhood social support index was associated with higher odds of high %BF in women (OR = 1·59; 95 % CI 1·03, 2·44). A low household wealth index was associated with lower odds of both overweight (OR = 0·31; 95 % CI 0·12, 0·76) and high %BF in men (OR = 0·28; 95 % CI 0·10, 0·78). A low or middle household wealth index was associated with higher odds of being thin in men (OR = 1·90; 95 % CI 1·09, 3·31 and OR = 1·80; 95 % CI 1·03, 3·15, respectively). For women, a low household wealth index was associated with lower odds of being thin (OR = 0·49; 95 % CI 0·25, 0·96). Conclusions: The study highlights that even within a relatively small urban area the nutrition transition manifests itself differently in men and women and across SEP indicators. Understanding the challenges for different sexes at different ages is vital in helping to plan public health services.
Body fat percentage of urban South African children: implications for health and fitness
The West Indian medical journal, 2013
To explore gender and racial profiling of percentage body fat of 1136 urban South African children attending public schools in Pretoria Central. This is a cross-sectional survey of 1136 randomly selected children (548 boys and 588 girls) aged 9-13 years in urban (Pretoria Central) South Africa. Body mass, stature, skinfolds (subscapular and triceps) were measured. Data were analysed using descriptive statistics (means and standard deviations). Differences in the mean body fat percentage were examined for boys and girls according to their age group/race, using independent t-test samples. Girls had a significantly (p = 0.001) higher percentage body fat (22.7 ± 5.7%, 95% CI = 22.3, 23.2) compared to boys (16.1 ± 7.7%, 95% CI = 15.5, 16.8). Percentage body fat fluctuated with age in both boys and girls. Additionally, girls had significantly (p = 0.001) higher percentage body fat measurements at all ages compared to boys. Viewed racially, black children (20.1 ± 7.5) were significantly (p...
South African Journal of Clinical Nutrition
Background: The objective was to compare the body composition of black stunted, and non-stunted, children, from two rural communities in South Africa, and investigate whether increased total and central adiposity is found in stunted children. The design was a cross-sectional study. The setting was two study populations of children in rural South Africa. The subjects were 351 children aged 10-15 years old [Transition and Health during Urbanisation of South Africans (THUSA BANA) study], and 1 760 children aged 6-13 years old [Ellisras Longitudinal Growth and Health Study (ELS)]. Method: The body mass index (BMI), BMI for age z-score, sum of triceps and subscapular skin folds (SSF), waist circumference (WC), waist:height ratio (WHtR) of stunted, and non-stunted, children, were compared. Results: Almost 10% (n = 203) of children were stunted, and 34% had a BMI for age z-score below -2. After adjustment for age, non-stunted children had significantly higher values for BMI and WC, in both...
The prevalence of malnutrition and growth percentiles for urban South African children
BMC Public Health, 2019
BackgroundLow- and middle-income countries (LMIC) are experiencing a double-burden of malnutrition characterised by high prevalence of both under- and over-nutrition. We set out using data from the mixed-longitudinal Birth-to-Twenty Plus (Bt20+) birth cohort, to evaluate the patterns of malnutrition and growth in a large South African (SA) city by; (i) assessing the prevalence of undernutrition from birth to 5 years of age and overweight and obesity from ages 2 to 21 years in black and white, male and female children, and (ii) determining percentiles for height, weight, BMI, waist and hip circumferences and comparing the centiles to American and Dutch references.MethodsHeight, weight, waist and hip circumferences were measured on urban black and white SA children from the Bt20+. A total of 3273 children born between April and June 1990 in the Greater Johannesburg Metropolitan area were included in the cohort. Z-scores were derived using the WHO 2006 child growth standards (0–5 years), for defining stunting, underweight and wasting. The International Obesity Task Force (IOTF) references were used to define overweight and obesity. Percentiles were developed using the lambda mu sigma (LMS) method and compared to American and Dutch references.ResultsBlack children were consistently shorter and black males lighter than white children and American references. The prevalence of stunting peaked at 2 years and was significantly higher in males than females and in black than white children. Black females had a greater prevalence of overweight and obesity than black males from 10 to 17 years. The percentiles for black females for weight and BMI were similar to those of South African white and American references but both black and white South African females had lower waist circumferences than American references.ConclusionThe growth percentiles show that young South African urban black females are experiencing general but not central obesity due to a secular change which is faster in weight than height. High levels of undernutrition persist alongside high levels of over-nutrition with adolescence being a critical period for the upsurge in obesity in females. Early intervention is needed to combat the rise in obesity.Electronic supplementary materialThe online version of this article (10.1186/s12889-019-6794-1) contains supplementary material, which is available to authorized users.
American Journal of Human Biology, 2009
Objectives: To compare the variance explained in anthropometric outcomes when using individual measures of socioeconomic status (SES) versus different approaches to creating SES indices within the urban African context. To examine the influence of SES measured during infancy on child anthropometric outcomes at 7/8 years in urban South Africa. Experimental design: Data from the 1990 Birth-to-Twenty cohort study set in Johannesburg-Soweto, South Africa, were used (n=888). Linear regression models were used to investigate the association between SES (individual and index measures) during infancy and anthropometric measures at age 7/8 years, controlling for sex, age, and population group. Principal observations: Both individual and index measures of SES explained similar proportions of the variance for each anthropometric outcome. SES measured during infancy influenced weight more than height at age 7/8 years in Johannesburg-Soweto. Positive associations were found between SES and the anthropometric measures-ownership of a car, telephone, and having an inside flush toilet were the most significant SES variables. Conclusions: The similarities observed in the variance explained relating to the anthropometric outcomes suggest that researchers who want to adjust for SES in analyses could use an SES index to make statistical models more parsimonious. However, using such indices loses information relating to the specific socioeconomic factors that are important for explaining child anthropometrics. If the purpose of the research is to make policy 3 recommendations for the improvement of child growth, individual SES variables would provide more specific information to target interventions.
In urban South Africa, 16 year old adolescents experience greater health equality than children
Economics & Human Biology, 2013
Despite the strongly established link between socioeconomic status (SES) and health across most stages of the life-course, the evidence for a socioeconomic gradient in adolescent health outcomes is less consistent. This paper examines associations between household, school, and neighbourhood SES measures with body composition outcomes in 16 year old South African Black urban adolescents from the 1990 born Birth to Twenty (Bt20) cohort. Multivariable regression analyses were applied to data from a sub-sample of the Bt20 cohort (n = 346, 53% male) with measures taken at birth and 16 years of age to establish socioeconomic , biological, and demographic predictors of fat mass, lean mass, and body mass index (BMI). Results were compared with earlier published evidence of health inequality at ages 9-10 years in Bt20. Consistent predictors of higher fat mass and BMI in fully adjusted models were being female, born post term, having a mother with post secondary school education, and having an obese mother. Most measures of SES were only weakly associated with body composition, with an inconsistent direction of association. This is in contrast to earlier findings with Bt20 9-10 year olds where SES inequalities in body composition were observed. Findings suggest targeting obesity interventions at females in households where a mother has a high BMI.
Overweight, obesity and underweight in rural black South African children
South African Journal of Clinical Nutrition, 2012
A current estimate of childhood overweight and obesity showed that in 2010, 43 million children (35 million in developing countries) were overweight or obese, and 92 million were at risk of becoming overweight. Worldwide, the prevalence of childhood overweight and obesity increased from 4.2% in 1990, to 6.7% in 2010. It is projected that this trend would reach 9.1% or ≈ 60 million in 2020. 1 The estimated prevalence of childhood overweight and obesity in Africa in 2010 was 8.5%, and is expected to reach 12.7% in 2020. 1 In Africa, 2-4 reported increasing rates of overweight and obesity of 17.1%-22.8%, among South African children, is expected. 5 The consequences of childhood obesity are enormous, and include the subsequent development of chronic non-communicable diseases, psychological dysfunction, and excess adiposity in adulthood. 6,7 Adolescence is a critical period for the onset of obesity, 8,9 and for obesity-associated morbidity in later life. 10 Therefore, it is important to study this condition, especially in children and adolescents. However, most studies highlighting the prevalence of overweight and obesity among South African children and adolescents are limited to urban settings, and feature participants from privileged socioeconomic backgrounds. 2,3,11-13 Few studies have been conducted in South Africa on the prevalence of overweight and obesity, and focusing on black or adolescent children, in rural and underpriveleged socioeconomic settings. It is envisaged that findings from this study might inform public policy concerning the design of possible intervention strategies that could help to prevent and manage the surging prevalence of overweight and obesity in South African children. There is no published data concerning the prevalence of overweight, obesity and underweight among rural school children in Mankweng and Toronto, Limpopo province. Therefore, this study aims to fill this research gap by examining the prevalence of overweight, obesity and underweight among rural South African adolescents aged 10-16 years, who attend primary and secondary schools in these regions.
Journal of Developmental Origins of Health and Disease, 2012
With South Africa mirroring worldwide obesity and nutrition-related chronic disease trends, 10 it is important to assess changing dietary habits and eating practices, 11,12 with specific emphasis on fastfood consumption. Children and adolescents living in urban areas (townships, settlements, towns and cities) are increasingly exposed to the influences of the Western lifestyle, and therefore to foods that are relatively high in fat, carbohydrates and salt and low in fibre.
Public Health Nutrition, 2006
Aim: To investigate the determinants of overweight and obesity among 10-to 15-yearold schoolchildren in a population in the transitional phase in the North West Province of South Africa. Methods: A cross-sectional survey was used to investigate weight status (anthropometric indicators) and determinants of overweight/obesity including dietary intake, physical activity and socioeconomic status. A single, random sample (n ¼ 1257), stratified for gender, type of school and ethnic group, was used. Data were collected on demographics, family circumstances, habitual physical activity, dietary intake and anthropometry to evaluate weight status and body fat content. One-way analysis of variance, the generalised linear models procedure of SAS and the Tukey post hoc honest significant difference test were used to analyse the data. Results: Few children were overweight or obese (7.8%) according to International Obesity Task Force (IOTF) standards (body mass index (BMI)-forage). These standards were compared with other accepted standard values. Both Cole's IOTF/BMI-forage standard and the sum of skinfold thicknesses standard classified normal-weight status similarly at a level of 92% (P , 0.01) and were found to be useful in determining overweight/obesity. The prevalence rate was higher in females and white children, and was more apparent in urban areas, smaller households and children of parents with low-or high-income occupations. Boys and pre-menarcheal girls had mean body fat percentage in the normal/optimal range, whereas that of post-menarcheal girls was moderately high. Few variables showed a significant association with high body fat percentage: in boys, only the number of members in the household and physical activity levels over the weekend; in girls, only age. The overweight/obese boys mostly lived in smaller households, and the overweight/obese post-menarcheal girls were most inactive on both weekdays and weekends, and more overweight with increasing age. Conclusion: Smaller households, inactivity and increasing age for girls were found to be determinants that influence the development of overweight/obesity, while female gender and age post-menarche were identified as determinants of higher body fat content. For overweight/obesity prevention, the focus should be on pre-menarcheal girls, aged 10-13 years, using these determinants to identify overweight/obesity risk. Preventive programmes should aim to increase the physical activity of children to improve their current and future weight status. Keywords Overweight Obesity Determinants Adolescents Dietary intake Body mass index Body fat percentage Overweight and obesity are considered a rapidly growing threat to the health and well-being of populations in countries worldwide, and are emerging as a public health problem in developed countries 1-3. The prevalence of overweight/obesity in children has doubled in the last two decades, becoming one of the most prevalent nutritional problems in the USA 4. Similarly, there has been a rise in the prevalence of obesity among British, European and Australian children, although patterns may vary 2,5,6. However, obesity is emerging in developed and developing countries alike; taking on the proportions of an obesity epidemic among adults and children 1,6,7. Modern lifestyles
South African Journal of Child Health
Background. South African (SA) children from disadvantaged communities are plagued by a double burden of under-and over-nutrition. The resulting overweight and obesity on the one hand, and stunting on the other, are risk factors for chronic diseases in adulthood. Objective. To determine the effect of school-based interventions on body composition of grade-4 children from lower socioeconomic communities in the Gqeberha region, SA. Methods. A cluster-randomised controlled trial was carried out with children from 8 schools. Schools were randomly assigned, either to a 10-week school-based intervention (4 schools) or a control condition (4 schools). The intervention comprised several arms, with each intervention school receiving a different combination of the following measures: physical activity, health and hygiene education, and nutrition education with supplementation. Effects on children's body composition were evaluated using standardised, quality-controlled methods. Height and weight were assessed to calculate body mass index (BMI), and percentage body fat was measured via thickness of skinfolds (triceps and subscapular). Results. Overall, 898 children (458 boys and 440 girls) aged 8-11 years participated in the trial. Children's BMI, BMI-forage and percentage body fat increased significantly over time. Increases were similar in boys and girls. Body fat remained unchanged in underweight children, whereas increases occurred in normal weight and (particularly) overweight/obese peers. In normal-weight children, the physical activity intervention (either alone or combined with health education) mitigated increments in body fat levels. A similar pattern was observed in overweight/obese children, but only in the physical activity intervention cohort alone. Conclusion. Our study shows that normal-weight children are at risk of becoming overweight and children who are already overweight/ obese are at even greater risk of gaining weight. The physical activity intervention (alone or in combination with health education) can mitigate increases in body fat in normal-weight children as well as in overweight/obese children. Our findings reveal that school-based physical activity, nutrition and health and hygiene interventions can have beneficial effects on children's body composition. Further analyses are needed to examine how (school-based) physical activity interventions should be designed to improve children's health in lower socioeconomic areas.