Body composition in stunted, compared to non-stunted, black South African children, from two rural communities

Abstract

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 boys and girls. SSF was similar in stunted and non-stunted boys, but tended to be greater in non-stunted, rather than stunted girls. In the ELS, stunted boys and girls had significantly higher WHtR than non-stunted children, while similar results were found in the THUSA BANA study, although the difference was not significant in the girls. All stunted groups had a WHtR greater than 0.41, proposed as a cut-off point due to its association with increased risk for high blood pressure in children. Conclusion: More research needs to be carried out on anthropometric indices for the distribution of body fat, independent of age, race, gender, and sexual maturation, in children and adolescents. This study showed inconsistent results, and highlights the complexity of using various adiposity measures in stunted and non-stunted children