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Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Obesity | Research article

The double burden of malnutrition in a rural health and demographic surveillance system site in South Africa: a study of primary schoolchildren and their mothers

Authors: Perpetua Modjadji, Sphiwe Madiba

Published in: BMC Public Health | Issue 1/2019

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Abstract

Background

In South Africa, the occurrence of the double burden of malnutrition is on the rise at a household level predisposing children and their mothers to negative health outcomes. However, few studies have been conducted at a household level. Therefore, we studied a double burden of malnutrition using child-mother pairs in a rural setting.

Methods

A cross-sectional quantitative survey was conducted among 508 child-mother pairs selected from primary schools using a multistage sampling in a rural Dikgale Health and Demographic Site in Limpopo Province, South Africa. Anthropometric measurements of children and mothers, and socio-demographic data were collected. WHO AnthroPlus was used to generate body-mass-index z-scores of children and the BMI was used to indicate overweight and obesity among the mothers. Mann Whitney test was used to compare the means of variables between sexes and age groups, while the prevalence of thinness and overweight/obesity were compared using a chi-square. Multivariate logistic regression with a stepwise backward elimination procedure, controlling for confounding, was used to determine the association between the thinness and overweight/obesity and the covariates.

Results

Twenty five percent (25%) of the children were thin, 4% were overweight and 1% obese, while mothers were overweight (27.4%) and 42.3% obesity (42.3%) were observed among the mothers. The odds of being thin were higher in boys than in girls (AOR = 1.53, 95%CI: 1.01–2.35). Overweight/obese mothers were more likely to have thin children (AOR = 1.48, 95% CI: 1.01–2.18) and less likely to have overweight/obese children (AOR = 0.18, 95%CI: 0.07–0.46).

Conclusion

A double burden of malnutrition was observed on a household level with thinness among children and overweight/obesity among mothers. A need to address the dual problems of undernutrition and rapidly rising trends of overweight/obesity cannot be over-emphasized.
Literature
1.
go back to reference WHO: Double burden of malnutrition policy brief. Geneva: World Health Organization; 2017. WHO: Double burden of malnutrition policy brief. Geneva: World Health Organization; 2017.
2.
go back to reference Popkin BM, Richards MK, Montiero CA. Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J Nutr. 1996;126(12):3009–16.PubMedCrossRef Popkin BM, Richards MK, Montiero CA. Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J Nutr. 1996;126(12):3009–16.PubMedCrossRef
3.
go back to reference Kimani-Murage EW. Exploring the paradox: double burden of malnutrition in rural South Africa. Glob Health Action. 2013;6(1):19249.PubMedCrossRef Kimani-Murage EW. Exploring the paradox: double burden of malnutrition in rural South Africa. Glob Health Action. 2013;6(1):19249.PubMedCrossRef
4.
go back to reference Tzioumis E, Adair LS. Childhood dual burden of under-and overnutrition in low-and middle-income countries: a critical review. Food Nutr Bull. 2014;35(2):230–43.PubMedPubMedCentralCrossRef Tzioumis E, Adair LS. Childhood dual burden of under-and overnutrition in low-and middle-income countries: a critical review. Food Nutr Bull. 2014;35(2):230–43.PubMedPubMedCentralCrossRef
5.
go back to reference Doak CM, Adair LS, Monteiro C, Popkin BM. Overweight and underweight coexist within households in Brazil, China and Russia. J Nutr. 2000;130(12):2965–71.PubMedCrossRef Doak CM, Adair LS, Monteiro C, Popkin BM. Overweight and underweight coexist within households in Brazil, China and Russia. J Nutr. 2000;130(12):2965–71.PubMedCrossRef
6.
go back to reference Doak CM, Adair LS, Bentley M, Monteiro C, Popkin BM. The dual burden household and the nutrition transition paradox. Int J Obes. 2005;29(1):129.CrossRef Doak CM, Adair LS, Bentley M, Monteiro C, Popkin BM. The dual burden household and the nutrition transition paradox. Int J Obes. 2005;29(1):129.CrossRef
7.
go back to reference Shrimpton R, Rokx C: The double burden of malnutrition: a review of global evidence. World Bank; 2012.CrossRef Shrimpton R, Rokx C: The double burden of malnutrition: a review of global evidence. World Bank; 2012.CrossRef
8.
go back to reference UNICEF: Consultant for development of a national school nutrition guideline. 2018. UNICEF: Consultant for development of a national school nutrition guideline. 2018.
9.
go back to reference Mamabolo RL, Alberts M, Steyn NP, Delemarre-van de Waal HA, Levitt NS. Prevalence and determinants of stunting and overweight in 3-year-old black south African children residing in the central region of Limpopo Province, South Africa. Public Health Nutr. 2005;8(5):501–8.PubMedCrossRef Mamabolo RL, Alberts M, Steyn NP, Delemarre-van de Waal HA, Levitt NS. Prevalence and determinants of stunting and overweight in 3-year-old black south African children residing in the central region of Limpopo Province, South Africa. Public Health Nutr. 2005;8(5):501–8.PubMedCrossRef
10.
go back to reference Modjadji SEP: Nutritional factors involved in development of neural tube defects in offspring of women residing in a high risk area. University of Limpopo (Turfloop campus); 2009. Modjadji SEP: Nutritional factors involved in development of neural tube defects in offspring of women residing in a high risk area. University of Limpopo (Turfloop campus); 2009.
11.
go back to reference Maimela E, Alberts M, Modjadji SE, Choma SS, Dikotope SA, Ntuli TS, Van Geertruyden J-P. The prevalence and determinants of chronic non-communicable disease risk factors amongst adults in the Dikgale health demographic and surveillance system (HDSS) site, Limpopo Province of South Africa. PLoS One. 2016;11(2):e0147926.PubMedPubMedCentralCrossRef Maimela E, Alberts M, Modjadji SE, Choma SS, Dikotope SA, Ntuli TS, Van Geertruyden J-P. The prevalence and determinants of chronic non-communicable disease risk factors amongst adults in the Dikgale health demographic and surveillance system (HDSS) site, Limpopo Province of South Africa. PLoS One. 2016;11(2):e0147926.PubMedPubMedCentralCrossRef
12.
go back to reference Choma SSR, Alberts M, Modjadji SEP. Conflicting effects of BMI and waist circumference on iron status. J Trace Elem Med Biol. 2015;32:73–8.PubMedCrossRef Choma SSR, Alberts M, Modjadji SEP. Conflicting effects of BMI and waist circumference on iron status. J Trace Elem Med Biol. 2015;32:73–8.PubMedCrossRef
13.
go back to reference Mashinya F, Alberts M, Cook I, Ntuli S. Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa. Global health action. 2018;11(sup2):1537613.PubMedPubMedCentralCrossRef Mashinya F, Alberts M, Cook I, Ntuli S. Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa. Global health action. 2018;11(sup2):1537613.PubMedPubMedCentralCrossRef
14.
go back to reference Popkin BM. The nutrition transition in the developing world. Development policy review. 2003;21(5–6):581–97.CrossRef Popkin BM. The nutrition transition in the developing world. Development policy review. 2003;21(5–6):581–97.CrossRef
15.
go back to reference Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3–21.PubMedCrossRef Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012;70(1):3–21.PubMedCrossRef
16.
go back to reference Popkin BM. The shift in stages of the nutrition transition in the developing world differs from past experiences! Public Health Nutr. 2002;5(1A):205–14.PubMedCrossRef Popkin BM. The shift in stages of the nutrition transition in the developing world differs from past experiences! Public Health Nutr. 2002;5(1A):205–14.PubMedCrossRef
17.
go back to reference Kahn K. Population health in South Africa: dynamics over the past two decades. J Public Health Policy. 2011;32(1):S30–6.PubMedCrossRef Kahn K. Population health in South Africa: dynamics over the past two decades. J Public Health Policy. 2011;32(1):S30–6.PubMedCrossRef
18.
go back to reference Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84(2):289–98.PubMedCrossRef Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84(2):289–98.PubMedCrossRef
19.
go back to reference Srivastava A, Mahmood SE, Srivastava PM, Shrotriya VP, Kumar B. Nutritional status of school-age children-a scenario of urban slums in India. Archives of Public Health. 2012;70(1):8.PubMedPubMedCentralCrossRef Srivastava A, Mahmood SE, Srivastava PM, Shrotriya VP, Kumar B. Nutritional status of school-age children-a scenario of urban slums in India. Archives of Public Health. 2012;70(1):8.PubMedPubMedCentralCrossRef
20.
go back to reference Melaku YA, Zello GA, Gill TK, Adams RJ, Shi Z. Prevalence and factors associated with stunting and thinness among adolescent students in northern Ethiopia: a comparison to World Health Organization standards. Archives of Public Health. 2015;73(1):44.PubMedPubMedCentralCrossRef Melaku YA, Zello GA, Gill TK, Adams RJ, Shi Z. Prevalence and factors associated with stunting and thinness among adolescent students in northern Ethiopia: a comparison to World Health Organization standards. Archives of Public Health. 2015;73(1):44.PubMedPubMedCentralCrossRef
21.
go back to reference Jehn M, Brewis A. Paradoxical malnutrition in mother–child pairs: untangling the phenomenon of over-and under-nutrition in underdeveloped economies. Econ Hum Biol. 2009;7(1):28–35.PubMedCrossRef Jehn M, Brewis A. Paradoxical malnutrition in mother–child pairs: untangling the phenomenon of over-and under-nutrition in underdeveloped economies. Econ Hum Biol. 2009;7(1):28–35.PubMedCrossRef
23.
go back to reference Van Niekerk S-M, Grimmer K, Louw Q. The prevalence of underweight, overweight and obesity in a multiracial group of urban adolescent schoolchildren in the cape metropole area of Cape Town. South Afr J Clin Nutr. 2014;27(1):18–24.CrossRef Van Niekerk S-M, Grimmer K, Louw Q. The prevalence of underweight, overweight and obesity in a multiracial group of urban adolescent schoolchildren in the cape metropole area of Cape Town. South Afr J Clin Nutr. 2014;27(1):18–24.CrossRef
24.
go back to reference Shisana O LD, Rehle T, et al.: South African National Health and nutrition examination survey (SANHNES-1). . Edited by Press H Cape Town; 2013. Shisana O LD, Rehle T, et al.: South African National Health and nutrition examination survey (SANHNES-1). . Edited by Press H Cape Town; 2013.
25.
go back to reference Kruger G, Pienaar AE, Coetzee D, Kruger SH. Prevalence of stunting, wasting and underweight in grade 1-learners: the NW-CHILD study. Health SA Gesondheid (Online). 2014;19(1):1–7. Kruger G, Pienaar AE, Coetzee D, Kruger SH. Prevalence of stunting, wasting and underweight in grade 1-learners: the NW-CHILD study. Health SA Gesondheid (Online). 2014;19(1):1–7.
26.
go back to reference GlobalNutritionReport: From Promise to Impact: Ending Malnutrition by 2030. 2016. GlobalNutritionReport: From Promise to Impact: Ending Malnutrition by 2030. 2016.
27.
go back to reference Alberts M, Dikotope SA, Choma SR, Masemola ML, Modjadji SE, Mashinya F, Burger S, Cook I, Brits SJ, Byass P. Health & demographic surveillance system profile: the Dikgale health and demographic surveillance system. Int J Epidemiol. 2015;44(5):1565–71.PubMedCrossRef Alberts M, Dikotope SA, Choma SR, Masemola ML, Modjadji SE, Mashinya F, Burger S, Cook I, Brits SJ, Byass P. Health & demographic surveillance system profile: the Dikgale health and demographic surveillance system. Int J Epidemiol. 2015;44(5):1565–71.PubMedCrossRef
28.
go back to reference Sankoh O, Byass P. The INDEPTH network: filling vital gaps in global epidemiology: Oxford University Press; 2012. Sankoh O, Byass P. The INDEPTH network: filling vital gaps in global epidemiology: Oxford University Press; 2012.
29.
go back to reference ASS: Lerners enrollment number per primary school in Dimamo circuit, Limpopo Province. 2016. ASS: Lerners enrollment number per primary school in Dimamo circuit, Limpopo Province. 2016.
30.
go back to reference Dass S, Rinquest A: School fees. Basic education rights handbook: Education rights in South Africa Johannesburg, South Africa: SECTION27 Available at http://section27 org za/wpcontent/uploads/2017/02 2017. Dass S, Rinquest A: School fees. Basic education rights handbook: Education rights in South Africa Johannesburg, South Africa: SECTION27 Available at http://​section27 org za/wpcontent/uploads/2017/02 2017.
31.
go back to reference Hightower C, Scott K. Infer more, describe less: more powerful survey conclusions through easy inferential tests; 2012. Hightower C, Scott K. Infer more, describe less: more powerful survey conclusions through easy inferential tests; 2012.
32.
go back to reference UNICEF: CONCEPTUAL FRAMEWORKS in UNICEF M&E Training resources. 1998. UNICEF: CONCEPTUAL FRAMEWORKS in UNICEF M&E Training resources. 1998.
33.
go back to reference WHO: WHO AnthroPlus for Personal Computers Software for assessing growth of the world's children and adolescents 2009. WHO: WHO AnthroPlus for Personal Computers Software for assessing growth of the world's children and adolescents 2009.
34.
go back to reference WHO: Obesity: preventing and managing the global epidemic. World Health Organization Technical Report. 894: i-xii.; 2000. WHO: Obesity: preventing and managing the global epidemic. World Health Organization Technical Report. 894: i-xii.; 2000.
35.
go back to reference Bahwere P. Anthropometric cut-off points for older children and adolescents in Syria. Field Exchange. 2017;54:44. Bahwere P. Anthropometric cut-off points for older children and adolescents in Syria. Field Exchange. 2017;54:44.
36.
go back to reference Kruger R, Kruger H, Macintyre U. 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 Nutr. 2006;9(3):351–8.PubMedCrossRef Kruger R, Kruger H, Macintyre U. 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 Nutr. 2006;9(3):351–8.PubMedCrossRef
37.
go back to reference WHO: WHO AnthroPlus for personal computers Manual: Software for assessing growth of the world's children and adolescents. Geneva; 2009. WHO: WHO AnthroPlus for personal computers Manual: Software for assessing growth of the world's children and adolescents. Geneva; 2009.
38.
go back to reference National Department of Health (NDoH) S, SAMRC and ICF: South Africa Demographic and Health Survey 2016. Pretoria, South Africa and Rockville, USA; 2019. National Department of Health (NDoH) S, SAMRC and ICF: South Africa Demographic and Health Survey 2016. Pretoria, South Africa and Rockville, USA; 2019.
39.
go back to reference Hazell: Report on the Implementation Evaluation of the National School Nutrition Programme. Edited by Services JE. Pretoria; 2016. Hazell: Report on the Implementation Evaluation of the National School Nutrition Programme. Edited by Services JE. Pretoria; 2016.
40.
go back to reference SAVACG: Children aged 6 to 71months in South Africa, 1994: Their anthropometric, vitamin A, iron and immunisation coverage status. 1995:Johannesburg. SAVACG: Children aged 6 to 71months in South Africa, 1994: Their anthropometric, vitamin A, iron and immunisation coverage status. 1995:Johannesburg.
41.
go back to reference Labadarios D, Steyn N, Maunder E, MacIntryre U, Gericke G, Swart R, Huskisson J, Dannhauser A, Vorster H, Nesmvuni A. The national food consumption survey (NFCS): South Africa, 1999. Public Health Nutr. 2005;8(5):533–43.PubMedCrossRef Labadarios D, Steyn N, Maunder E, MacIntryre U, Gericke G, Swart R, Huskisson J, Dannhauser A, Vorster H, Nesmvuni A. The national food consumption survey (NFCS): South Africa, 1999. Public Health Nutr. 2005;8(5):533–43.PubMedCrossRef
42.
go back to reference Best C, Neufingerl N, Van Geel L, van den Briel T, Osendarp S. The nutritional status of school-aged children: why should we care? Food Nutr Bull. 2010;31(3):400–17.PubMedCrossRef Best C, Neufingerl N, Van Geel L, van den Briel T, Osendarp S. The nutritional status of school-aged children: why should we care? Food Nutr Bull. 2010;31(3):400–17.PubMedCrossRef
43.
go back to reference Mekonnen H, Tadesse T, Kisi T. Malnutrition and its correlates among rural primary school children of Fogera district, Northwest Ethiopia. Journal of Nutritional Disorders and Therapy S. 2013;12:2161–0509. Mekonnen H, Tadesse T, Kisi T. Malnutrition and its correlates among rural primary school children of Fogera district, Northwest Ethiopia. Journal of Nutritional Disorders and Therapy S. 2013;12:2161–0509.
44.
go back to reference Mandal GC, Bose K. Thinness among primary school children of the migrated Santals of Arambag, West Bengal, India. International Journal of Food Safety, Nutrition and Public Health. 2014;5(1):46–53.CrossRef Mandal GC, Bose K. Thinness among primary school children of the migrated Santals of Arambag, West Bengal, India. International Journal of Food Safety, Nutrition and Public Health. 2014;5(1):46–53.CrossRef
45.
go back to reference Karim KMR, Tasnim T. Nutritional status, dietary food and nutrient consumption patterns in Monga affected area of the northern part of Bangladesh. Asian Journal of Clinical Nutrition. 2015;7:55–63.CrossRef Karim KMR, Tasnim T. Nutritional status, dietary food and nutrient consumption patterns in Monga affected area of the northern part of Bangladesh. Asian Journal of Clinical Nutrition. 2015;7:55–63.CrossRef
46.
go back to reference FAO I, UNICEF, WFP and WHO: The State of Food Security and Nutrition in the World 2018. In Building climate resilience for food security and nutrition Volume CC BY-NC-SA 3.0 IGO. Rome, FAO; 2018. FAO I, UNICEF, WFP and WHO: The State of Food Security and Nutrition in the World 2018. In Building climate resilience for food security and nutrition Volume CC BY-NC-SA 3.0 IGO. Rome, FAO; 2018.
47.
go back to reference Kimani-Murage EW, Kahn K, Pettifor JM, Tollman SM, Dunger DB, Gómez-Olivé XF, Norris SA. The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural south African children. BMC Public Health. 2010;10(1):158.PubMedPubMedCentralCrossRef Kimani-Murage EW, Kahn K, Pettifor JM, Tollman SM, Dunger DB, Gómez-Olivé XF, Norris SA. The prevalence of stunting, overweight and obesity, and metabolic disease risk in rural south African children. BMC Public Health. 2010;10(1):158.PubMedPubMedCentralCrossRef
48.
go back to reference Vorster HHE. The link between poverty and malnutrition: a south African perspective. Health SA Gesondheid. 2010;15(1):1–6.CrossRef Vorster HHE. The link between poverty and malnutrition: a south African perspective. Health SA Gesondheid. 2010;15(1):1–6.CrossRef
49.
go back to reference Manyike PC, Chinawa JM, Ubesie A, Obu HA, Odetunde OI, Chinawa AT. Prevalence of malnutrition among pre-school children in, south-East Nigeria. Ital J Pediatr. 2014;40(1):75.PubMedPubMedCentralCrossRef Manyike PC, Chinawa JM, Ubesie A, Obu HA, Odetunde OI, Chinawa AT. Prevalence of malnutrition among pre-school children in, south-East Nigeria. Ital J Pediatr. 2014;40(1):75.PubMedPubMedCentralCrossRef
50.
go back to reference Galgamuwa LS, Iddawela D, Dharmaratne SD, Galgamuwa G. Nutritional status and correlated socio-economic factors among preschool and school children in plantation communities, Sri Lanka. BMC Public Health. 2017;17(1):377.PubMedPubMedCentralCrossRef Galgamuwa LS, Iddawela D, Dharmaratne SD, Galgamuwa G. Nutritional status and correlated socio-economic factors among preschool and school children in plantation communities, Sri Lanka. BMC Public Health. 2017;17(1):377.PubMedPubMedCentralCrossRef
51.
go back to reference Senbanjo IO, Oshikoya KA, Odusanya OO, Njokanma OF. Prevalence of and risk factors for stunting among school children and adolescents in Abeokuta, Southwest Nigeria. J Health Popul Nutr. 2011;29(4):364.PubMedPubMedCentralCrossRef Senbanjo IO, Oshikoya KA, Odusanya OO, Njokanma OF. Prevalence of and risk factors for stunting among school children and adolescents in Abeokuta, Southwest Nigeria. J Health Popul Nutr. 2011;29(4):364.PubMedPubMedCentralCrossRef
52.
go back to reference Abdel Wahed WY, Hassan SK, Eldessouki R. Malnutrition and its associated factors among rural school children in Fayoum governorate Egypt. J Environ Public Health. 2017;2017:4783791.PubMedPubMedCentralCrossRef Abdel Wahed WY, Hassan SK, Eldessouki R. Malnutrition and its associated factors among rural school children in Fayoum governorate Egypt. J Environ Public Health. 2017;2017:4783791.PubMedPubMedCentralCrossRef
53.
go back to reference Ayogu RN, Afiaenyi IC, Madukwe EU, Udenta EA. Prevalence and predictors of under-nutrition among school children in a rural south-eastern Nigerian community: a cross sectional study. BMC Public Health. 2018;18(1):587.PubMedPubMedCentralCrossRef Ayogu RN, Afiaenyi IC, Madukwe EU, Udenta EA. Prevalence and predictors of under-nutrition among school children in a rural south-eastern Nigerian community: a cross sectional study. BMC Public Health. 2018;18(1):587.PubMedPubMedCentralCrossRef
54.
go back to reference Modjadji S, Alberts M, Mamabolo R. Folate and iron status of south African non-pregnant rural women of childbearing age, before and after fortification of foods South African. J Clin Nutr. 2007;20(3):89–93. Modjadji S, Alberts M, Mamabolo R. Folate and iron status of south African non-pregnant rural women of childbearing age, before and after fortification of foods South African. J Clin Nutr. 2007;20(3):89–93.
55.
go back to reference Dieffenbach S, Stein AD. Stunted child/overweight mother pairs represent a statistical artifact, not a distinct entity. J Nutr. 2012;142(4):771–3.PubMedCrossRef Dieffenbach S, Stein AD. Stunted child/overweight mother pairs represent a statistical artifact, not a distinct entity. J Nutr. 2012;142(4):771–3.PubMedCrossRef
56.
go back to reference Roemling C, Qaim M: Dual burden households and nutritional inequality in Indonesia. GlobalFood Discussion Papers; 2012. Roemling C, Qaim M: Dual burden households and nutritional inequality in Indonesia. GlobalFood Discussion Papers; 2012.
57.
go back to reference Tathiah N, Moodley I, Mubaiwa V, Denny L, Taylor M. Overweight, obesity, underweight and stunting in female primary school learners in rural KwaZulu-Natal South Africa. South African Medical Journal. 2013;103(10):718–23.PubMedCrossRef Tathiah N, Moodley I, Mubaiwa V, Denny L, Taylor M. Overweight, obesity, underweight and stunting in female primary school learners in rural KwaZulu-Natal South Africa. South African Medical Journal. 2013;103(10):718–23.PubMedCrossRef
58.
go back to reference Reddy S, Resnicow K, James S, Kambaran N, Omardien R, Mbewu A. Underweight, overweight and obesity among south African adolescents: results of the 2002 National Youth Risk Behaviour Survey. Public Health Nutr. 2009;12(2):203–7.PubMedCrossRef Reddy S, Resnicow K, James S, Kambaran N, Omardien R, Mbewu A. Underweight, overweight and obesity among south African adolescents: results of the 2002 National Youth Risk Behaviour Survey. Public Health Nutr. 2009;12(2):203–7.PubMedCrossRef
59.
go back to reference Gupta N, Goel K, Shah P, Misra A. Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev. 2012;33(1):48–70.PubMedCrossRef Gupta N, Goel K, Shah P, Misra A. Childhood obesity in developing countries: epidemiology, determinants, and prevention. Endocr Rev. 2012;33(1):48–70.PubMedCrossRef
60.
go back to reference StatsSA: National Household Travel Survey Provincial - Limpopo profile, 2014 / Statistics South Africa 2015. StatsSA: National Household Travel Survey Provincial - Limpopo profile, 2014 / Statistics South Africa 2015.
61.
go back to reference Bénéfice E, Garnier D, Ndiaye G. Nutritional status, growth and sleep habits among Senegalese adolescent girls. Eur J Clin Nutr. 2004;58(2):292.PubMedCrossRef Bénéfice E, Garnier D, Ndiaye G. Nutritional status, growth and sleep habits among Senegalese adolescent girls. Eur J Clin Nutr. 2004;58(2):292.PubMedCrossRef
62.
go back to reference Prista A, Nhantumbo L, Saranga S, Lopes V, Maia J. Seabra ae, Vinagre J, conn CA, Beunen G: physical activity assessed by accelerometry in rural African school-age children and adolescents. Pediatr Exerc Sci. 2009;21(4):384–99.PubMedCrossRef Prista A, Nhantumbo L, Saranga S, Lopes V, Maia J. Seabra ae, Vinagre J, conn CA, Beunen G: physical activity assessed by accelerometry in rural African school-age children and adolescents. Pediatr Exerc Sci. 2009;21(4):384–99.PubMedCrossRef
63.
go back to reference Sagbo H, Ekouevi DK, Ranjandriarison DT, Niangoran S, Bakai TA, Afanvi A, Dieudonné S, Kassankogno Y, Vanhems P, Khanafer N. Prevalence and factors associated with overweight and obesity among children from primary schools in urban areas of Lomé, Togo. Public Health Nutr. 2018;21(6):1048–56.PubMedCrossRef Sagbo H, Ekouevi DK, Ranjandriarison DT, Niangoran S, Bakai TA, Afanvi A, Dieudonné S, Kassankogno Y, Vanhems P, Khanafer N. Prevalence and factors associated with overweight and obesity among children from primary schools in urban areas of Lomé, Togo. Public Health Nutr. 2018;21(6):1048–56.PubMedCrossRef
64.
go back to reference Mamun S, Mascie-Taylor CGN. Double burden of malnutrition (DBM) and Anaemia under the same roof: a Bangladesh perspective. Medical Sciences. 2019;7(2):20.PubMedCentralCrossRef Mamun S, Mascie-Taylor CGN. Double burden of malnutrition (DBM) and Anaemia under the same roof: a Bangladesh perspective. Medical Sciences. 2019;7(2):20.PubMedCentralCrossRef
65.
go back to reference Lenhart CM, Hanlon A, Kang Y, Daly BP, Brown MD, Patterson F. Gender disparity in structured physical activity and overall activity level in adolescence: evaluation of youth risk behavior surveillance data ISRN. Public Health. 2012;2012. Lenhart CM, Hanlon A, Kang Y, Daly BP, Brown MD, Patterson F. Gender disparity in structured physical activity and overall activity level in adolescence: evaluation of youth risk behavior surveillance data ISRN. Public Health. 2012;2012.
66.
go back to reference DALI WPEW, MOHAMED HJJ, Yusoff H: Nutrient intakes status and physical inactivity among overweight and obese school children in Kota Bharu, Kelantan, Malaysia. Iran J Public Health 2018, 47(8):1098. DALI WPEW, MOHAMED HJJ, Yusoff H: Nutrient intakes status and physical inactivity among overweight and obese school children in Kota Bharu, Kelantan, Malaysia. Iran J Public Health 2018, 47(8):1098.
67.
go back to reference Pabayo R, Gauvin L, Barnett TA, Nikiéma B, Séguin L. Sustained active transportation is associated with a favorable body mass index trajectory across the early school years: findings from the Quebec longitudinal study of child development birth cohort. Prev Med. 2010;50:S59–64.PubMedCrossRef Pabayo R, Gauvin L, Barnett TA, Nikiéma B, Séguin L. Sustained active transportation is associated with a favorable body mass index trajectory across the early school years: findings from the Quebec longitudinal study of child development birth cohort. Prev Med. 2010;50:S59–64.PubMedCrossRef
68.
go back to reference Leatherdale ST. A cross-sectional examination of school characteristics associated with overweight and obesity among grade 1 to 4 students. BMC Public Health. 2013;13(1):982.PubMedPubMedCentralCrossRef Leatherdale ST. A cross-sectional examination of school characteristics associated with overweight and obesity among grade 1 to 4 students. BMC Public Health. 2013;13(1):982.PubMedPubMedCentralCrossRef
69.
go back to reference Kulasekaran RA. Influence of mothers' chronic energy deficiency on the nutritional status of preschool children in Empowered Action Group states in India. International Journal of Nutrition, Pharmacology, Neurological Diseases. 2012;2(3):198.CrossRef Kulasekaran RA. Influence of mothers' chronic energy deficiency on the nutritional status of preschool children in Empowered Action Group states in India. International Journal of Nutrition, Pharmacology, Neurological Diseases. 2012;2(3):198.CrossRef
70.
go back to reference Tigga PL, Sen J. Maternal body mass index is strongly associated with children-scores for height and BMI. J Anthropol. 2016;2016. Tigga PL, Sen J. Maternal body mass index is strongly associated with children-scores for height and BMI. J Anthropol. 2016;2016.
71.
go back to reference Kimani-Murage EW, Muthuri SK, Oti SO, Mutua MK, van de Vijver S, Kyobutungi C. Evidence of a double burden of malnutrition in urban poor settings in Nairobi Kenya. PLoS One. 2015;10(6):e0129943.PubMedPubMedCentralCrossRef Kimani-Murage EW, Muthuri SK, Oti SO, Mutua MK, van de Vijver S, Kyobutungi C. Evidence of a double burden of malnutrition in urban poor settings in Nairobi Kenya. PLoS One. 2015;10(6):e0129943.PubMedPubMedCentralCrossRef
72.
go back to reference Liu E, Balasubramaniam D, Hunt A. Does access to water matter? A study on the nutritional status of primary-aged children in India. J Public Health. 2016;38(4):e419–24. Liu E, Balasubramaniam D, Hunt A. Does access to water matter? A study on the nutritional status of primary-aged children in India. J Public Health. 2016;38(4):e419–24.
73.
go back to reference Dearden KA, Schott W, Crookston BT, Humphries DL, Penny ME, Behrman JR. Children with access to improved sanitation but not improved water are at lower risk of stunting compared to children without access: a cohort study in Ethiopia, India, Peru, and Vietnam. BMC Public Health. 2017;17(1):110.PubMedPubMedCentralCrossRef Dearden KA, Schott W, Crookston BT, Humphries DL, Penny ME, Behrman JR. Children with access to improved sanitation but not improved water are at lower risk of stunting compared to children without access: a cohort study in Ethiopia, India, Peru, and Vietnam. BMC Public Health. 2017;17(1):110.PubMedPubMedCentralCrossRef
74.
go back to reference Bain R, Cronk R, Wright J, Yang H, Slaymaker T, Bartram J. Fecal contamination of drinking-water in low-and middle-income countries: a systematic review and meta-analysis. PLoS Med. 2014;11(5):e1001644.PubMedPubMedCentralCrossRef Bain R, Cronk R, Wright J, Yang H, Slaymaker T, Bartram J. Fecal contamination of drinking-water in low-and middle-income countries: a systematic review and meta-analysis. PLoS Med. 2014;11(5):e1001644.PubMedPubMedCentralCrossRef
75.
go back to reference WorldMedicalAssociation: Declaration of Helsinki. Ethical principles for medical research involving human subjects. In Bulletin of the World Health Organization. Volume 79. 2001:373. WorldMedicalAssociation: Declaration of Helsinki. Ethical principles for medical research involving human subjects. In Bulletin of the World Health Organization. Volume 79. 2001:373.
Metadata
Title
The double burden of malnutrition in a rural health and demographic surveillance system site in South Africa: a study of primary schoolchildren and their mothers
Authors
Perpetua Modjadji
Sphiwe Madiba
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7412-y

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