International Symposium on Understanding the Double Burden of Malnutrition for Effective Interventions

The dual burden of maternal and child malnutrition – evidence from national surveys in South Africa over a decade

Not scheduled

15m

Boardroom A (IAEA, Vienna)

Poster Epidemiology Poster Session 7

Speaker

Prof. Muhammad Ali Dhansay (South African Medical Research Council)

Description

Introduction: There is evidence that overweight or obesity in women relate to the nutritional status of their offspring such that maternal nutritional status remains an important determinant of child health and nutritional status. South Africa (SA) has an increasing burden of overweight and obesity among women of reproductive age (WRA; 15 – 49 yr), while the prevalence of stunting among preschoolers remains high (over 25%). The Key Indicator Report (KIR) of the South Africa Demographic and Health Survey 2016 (SADHS 2016) shows that the prevalence of maternal overweight and obesity has increased to 26% and 36%, respectively, while child overweight (13%) is more than underweight (6%). The aim of the study was to determine trends in anthropometric status in relation to the overall prevalence of maternal and child malnutrition among participants in four national surveys in South Africa. Methods: Secondary analysis of data from the SADHS 2003, the National Food Consumption Survey-Fortification Baseline 2005 (NFCS 2005), and the South African National Health and Nutrition Examination Survey 2012 (SANHANES 2012) was performed. Maternal BMI values and standard BMI categories were determined and child anthropometric indicators were calculated using the WHO 2006 Growth Standard (Table 1). Published data (percentages on maternal and child anthropometry) from the SADHS 2016 KIR, allowed the inclusion of data from the most recently conducted national survey. No adjustments were made for differences in the sampling strategies of the four surveys. Results: In the 2003 to 2016 period, maternal BMI increased, as did overweight and obesity, while the prevalence of underweight decreased. Among the children, while stunting prevalence remained high (>26%) despite an initial drop, wasting and underweight decreased with a concomitant increase in overweight. Conclusion: In South Africa, the prevalence of undernutrition (underweight and wasting) among under-fives has decreased from 2003 to 2016 but chronic undernutrition (stunting) rates have remained stubbornly above 26%. Disconcertingly, overweight has increased among the preschoolers over the same period, with the prevalence of overweight now double that of underweight, emphasizing the double burden of malnutrition faced by SA. Among WRA, there has been a worrisome increase in overweight and obesity. SA, therefore, has some way to go to meet the WHO Global Nutrition Targets for 2025 of decreasing stunting by 40% and preventing further increases in overweight.