Diet is a fundamental ingredient of a successful education, and the extremes of undernutrition and obesity in youngsters can not only hinder their ability to learn, but can also be life-threatening.
Thandi Puoane is a nutrition researcher and lectures at the School of Public Health at the University of the Western Cape (UWC). She has spent many years conducting research in this field and has focused on both ends of the nutrition scale — undernutrition in infants and young children, and over-nutrition (or obesity) in adolescent girls and women.
Puoane views proper nutrition as essential to promoting growth and development among school children, whose cognitive functions should be developing rapidly. Children who are not properly fed or are undernourished in the long-term manifest with impaired mental development, low levels of concentration, dulled motivation and low productivity. Where physical activity is required, they may avoid involvement in order to conserve their energy.
Apart from supplying energy, there are other health-related factors that result from nutrition: it is a means of protecting children against illness, which is very important in the classroom where many children are clustered together, some with undiagnosed, even infectious diseases. So nutrition also plays an important protective and preventive function.
David Sanders, director of the School of Public Health at UWC, says that those who are mildly or moderately undernourished might betray no outward signs to a casual observer, and their undernutrition remains largely invisible. Well-conducted studies reveal that between 11- and 17-million South Africans can be considered food insecure (or without a stable source of food in the home), with 38% of African households often or sometimes going hungry. This, points out Sanders, is the situation in a country with food surpluses and abundant resources.
It is therefore critical that teachers play a part in addressing this problem, in addition to the government’s initiatives such as the Primary School Nutrition Programme (PSNP). Sanders notes that the PSNP does benefit the very many needy families, but does not fundamentally address the problem of child undernutrition; nor is the provision of food at schools sustainable in the long term. Sanders believes that tackling the issue of undernutrition meaningfully requires a comprehensive, integrated and sustainable response to the complex factors underlying it in different settings.
Schools constitute an important setting within this situation and the involvement of teachers and parents is critical to addressing undernutrition. One way of doing this is through a workshop aimed primarily at the parents where they are involved in analysing the causes of undernutrition and fashioning a sustainable programme to address it within local contexts.
Food insecurity is widespread and may arise from factors such as poor home food production, lack of jobs or inadequate income in a family. These situations are usually hard to change in the short term, but the resulting undernutrition may have devastating results on children. Through such a workshop, parents could be made aware of immediate solutions such as the under-exploited child support grant, better agricultural production methods or ways of generating income. This could propel a community demand for these services and resources that would make it more sustainable.
Puone emphasises that a child’s health is directly related to the mother’s level of education, and that there is congruence between poverty and poor education. In this way, the cycle of poverty is perpetuated. The issue must, however, be sensitively dealt with, and teachers should be careful not to blame the victim or make parents feel inadequate as parents.
At the other end of the spectrum, over-nutrition is just as important. Puoane has recently been involved in a collaborative study with the Medical Research Council and the School of Public Health at UWC to examine the perceptions of black African schoolgirls between the ages of 11 and 18 about body weight, body image and a healthy lifestyle, and how these perceptions differ among girls of different ages. Data were collected from 340 girls who attend primary and high schools in a black township in the Western Cape (Khayelitsha), and in Model C schools in the region.
Puoane says that obesity is a common problem among this group. However, preliminary findings indicate a sense of confusion among the girls as to whether it is more desirable to be fat or to be thin. While the typical image of women in the media as thin represents for many the ideal, there are also associations of disease with thinness, like HIV/Aids and tuberculosis. Also, body fat could indicate social status and affluence.
Information from this study will be used to develop culturally appropriate interventions to address the public health problem of obesity in black African women — interventions that are important, given the health risks associated with obesity, such as type-two diabetes, hypertension and other cardiovascular diseases.
Lucy Alexander is an education analyst and researcher at the School of Public Health at UWC