School environment, socioeconomic status and weight of children in Bloemfontein, South Africa

BACKGROUND: The continued existence of undernutrition, associated with a steady increase in the prevalence of overweight and obesity in children and adolescents, necessitates identification of factors contributing to this double burden of disease, in order for effective treatment and prevention programmes to be planned. AIM: To determine the nutritional status of 13–15-year-old children in Bloemfontein and its association with socioeconomic factors. SETTING: Bloemfontein, Free State Province, South Africa (2006). METHODS: This was a cross-sectional analytical study. Randomly selected children (n = 415) completed structured questionnaires on socioeconomic status. The children's weight and height were measured and body mass index-for-age and height-for-age z-scores were computed according to World Health Organization growth standards in order to determine the prevalence of underweight, overweight, obesity and stunting. Waist circumference was measured to classify the children as having a high or very high risk for metabolic disease. RESULTS: Of the 415 children who consented to participate in the study, 14.9% were wasted and 3.4% were severely wasted. Only 6% of the children were overweight/obese. Significantly more boys (23.0%) were wasted than girls (10%) and severe stunting was also significantly higher in boys than in girls (10.3% and 4.2%, respectively). Children whose parents had graduate occupations were significantly more overweight/obese than those with parents working in skilled occupations. Stunting was significantly higher in low (31.4%) and medium (30.4%) socioeconomic groups compared to the high socioeconomic group (18.1%). CONCLUSION: A coexistence of underweight and overweight was found and gender and parental occupation were identified as being predictors of nutritional status.