title: The challenges of underweight and overweight in South African children: are we winning or losing the battle? A systematic review.
abstract: Underweight and overweight are adverse effects of malnutrition and both are associated with negative health consequences in children and adolescents. In South Africa, the burden of economic and social disparity coexists with malnutrition in children. The purpose of this study was to review available South Africa studies regarding the comprehensive summary of prevalence of underweight and overweight and evaluates government policies in addressing undernutrition and overnutrition in South African children and adolescents. We searched subject-specific electronic bibliographic databases of observational studies published on malnutrition, undernutrition, overnutrition, underweight and overweight in South African boys and girls from birth to 20 years of age in studies published on or after 1990. A total of sixteen cross-sectional, three longitudinal studies and one report met the criteria for inclusion in this review. Descriptive data synthesis revealed the small number of longitudinal studies highlights the dearth of research in tracking undernutrition and overnutrition in South African children. In this review, 0.7%-66% of underweight was reported among children in rural areas compared to a 3.1%-32.4% of overweight in urban areas. All studies reported a higher rate of underweight in boys than girls who were significantly more likely to have higher body fat. The data indicated that both underweight and overweight were positively related with health-related physical activity and psychological health problems such as low activity, low fitness, low self-image and self-esteem. Numerous recommendations were made in the reviewed studies, however effective strategic programs in eradicating both underweight and overweight are minimal. It is evident from the reviewed studies that the burden of underweight and overweight are still a problem in South African children. The most highly affected by underweight are rural children, while children in urban areas in transition are faced with burden of overweight. There is little evidence to suggest that government strategic programs are effective in addressing underweight and overweight in South African children. Based on these findings, sustainable school-based feeding schemes and physical education programmes are needed for optimal benefits in children and adolescents.
authors: Physical Activity, Sport and Recreation Focus Area (PhASRec)North-West University, Potchefstroom 2520, South Africa. andries.monyeki@nwu.ac.za.
authors: Makama Andries
authors: MA
authors: Monyeki
authors: Physical Activity, Sport and Recreation Focus Area (PhASRec)North-West University, Potchefstroom 2520, South Africa. awotidebe.adedapo@gmail.com.
authors: Adedapo
authors: A
authors: Awotidebe
authors: Physical Activity, Sport and Recreation Focus Area (PhASRec)North-West University, Potchefstroom 2520, South Africa. gert.strydom@nwu.ac.za.
authors: Gert L
authors: GL
authors: Strydom
authors: Physical Activity, Sport and Recreation Focus Area (PhASRec)North-West University, Potchefstroom 2520, South Africa. hans.deridder@nwu.ac.za.
authors: J Hans
authors: JH
authors: de Ridder
authors: Department of Nutrition, School of Health Sciences, University of Venda, Thohoyandou 0950, South Africa. ramoteme.mamabolo@univen.ac.za.
authors: Ramoteme Lesly
authors: RL
authors: Mamabolo
authors: VU University Medical Centre, Institute for Research in Health and Care (EMGO), 1081 BT Amsterdam, The Netherlands. hancgkemper@upcmail.nl.
authors: Han C G
authors: HC
authors: Kemper
mesh_terms: D002648:Child; D006801:Humans; D050177:Overweight / Q000453:epidemiology*; D012424:Rural Population; D013019:South Africa / Q000453:epidemiology; D013851:Thinness / Q000453:epidemiology*; D013997:Time Factors
references: Lancet. 2008 Feb 2;371(9610):417-40
references: 18206226
references: Public Health Nutr. 2013 Nov;16(11):2005-13
references: 23034177
references: Lancet. 2012 Sep 1;380(9844):824-34
references: 22770478
references: J Pediatr. 2005 Jun;146(6):732-7
references: 15973308
references: Matern Child Health J. 2011 Nov;15(8):1372-80
references: 20859760
references: Public Health Nutr. 2009 Feb;12(2):203-7
references: 18547451
references: Obesity (Silver Spring). 2006 Nov;14(11):2034-41
references: 17135621
references: Nutrition. 2014 Apr;30(4):393-400
references: 24332523
references: Bull World Health Organ. 2011 Dec 1;89(12):891-9
references: 22271946
references: Am J Hum Biol. 2014 Mar-Apr;26(2):189-97
references: 24375890
references: BMJ. 2010;341:c6224
references: 21109577
references: Am J Hum Biol. 2000 Jan;12(1):42-49
references: 11534003
references: Public Health Nutr. 2005 Aug;8(5):533-43
references: 16153334
references: Health Place. 2013 Jan;19:99-107
references: 23211581
references: Obes Rev. 2007 Sep;8(5):467-73
references: 17716304
references: Int J Obes Relat Metab Disord. 2004 Nov;28 Suppl 3:S21-8
references: 15543215
references: BMC Public Health. 2010;10:158
references: 20338024
references: Int J Obes (Lond). 2008 Jun;32(6):1028-30
references: 18414423
references: Int J Obes Relat Metab Disord. 2000 Nov;24(11):1453-8
references: 11126342
references: Eur J Clin Nutr. 2003 Feb;57(2):358-65
references: 12571672
references: Public Health Nutr. 2005 Aug;8(5):501-8
references: 16153331
references: J Hum Hypertens. 2008 May;22(5):311-9
references: 18273041
references: Lancet. 2008 Jan 19;371(9608):179
references: 18207569
references: BMC Public Health. 2012;12:374
references: 22626033
references: Trop Med Int Health. 2007 Aug;12(8):944-52
references: 17697089
references: S Afr Med J. 2013 Oct;103(10):718-23
references: 24079621
references: Public Health Nutr. 2005 Aug;8(5):480-90
references: 16153329
references: Ann Hum Biol. 2000 May-Jun;27(3):313-9
references: 10834295
references: Lancet. 2008 Jan 19;371(9608):243-60
references: 18207566