/ 1 October 2015

Malnutrition rises despite social grants

A diet of pap and bread stunts the physical and mental growth of children in poor families.
Children who are too short for their age are likely to reach less than half of their full potential, if they are lucky.

More than one in five children in South Africa are stunted because of malnutrition, according to the Global Nutrition Report 2015 released on Friday.

Experts warn that this will get worse as food prices rise.

Childhood stunting is the significant impairment of a child’s growth. The child is very short compared with their population and age average because of malnutrition or chronic disease.

“South Africa is one of 12 countries in the world [where data was available] where stunting rates went up in the millennium development goal period,” says Sheryl Hendriks, the director of the Institute for Food, Nutrition and Wellbeing at the University of Pretoria.

This occurred despite South Africa having a strong social grant system and dozens of food security programmes.

The institute hosted the report’s launch as part of the department of science and technology and the National Research Foundation’s (NRF) Centre of Excellence for Food Security.

“Physical stunting is only one aspect. There is also mental [cognitive] stunting, and that has long-term consequences,” Hendriks says.

Stunting, once it has manifested itself, is considered irreversible, she adds. The report also assesses wasting, overweight children under five, exclusive breastfeeding of infants, and adult obesity. Although South Africa is “on course” to reduce wasting from severe malnutrition, only 8% of women exclusively breast-feed, something that is linked to improved child health.

But the data used is problematic: the stunting and wasting data is from 2008, the breast-feeding data from 2003, and there is no data for the prevalence of overweight children under five or birth weight data. There is more up-to-date data available in the South African National Health and Nutrition Examination Survey, which was published in 2013, but that refers only to stunting, which is in line with the Global Nutrition Report 2015.

The report highlights the lack of data as a general problem. “Missing and poor data present a significant challenge to the accountability of food systems for nutrition, health and sustainability. Few surveys collect data in all three of these domains: food consumption, agricultural production, and nutrition behaviours and status.”

“Nutrition data is expensive to collect, especially at a national level,” Hendriks says. “Through the Centre of Excellence in Food Security, we’re doing a systematic review of the subnational-level food security studies that have been done.”

In a paper published this month in the journal Nutrients, several South African academics write: “One serious concern of health policymakers in South Africa is the fact that there is no national data on the dietary intake of adults. The only national dietary study was done in children in 1999. Hence, it becomes difficult to plan intervention and strategies to combat malnutrition without national data on adults.”

Hettie Schonfeldt, who is an associate at the University of Pretoria’s institute and one of the authors of the paper, says that low-income consumers in South Africa “are eating a bleak diet, mostly containing starch, mealie pap and bread, with a little bit of milk, sugar and tea”.

Schonfeldt and a team of researchers from five universities, working through the NRF centre and the Bureau for Food and Agricultural Policy, are developing “national nutritious food baskets”.

“It’s a new project … [about] how we can guide poor people or our marginalised consumers to make better food choices,” she says.

“The consumer price index is currently at 27% … The price of food is escalating at an enormous speed, and that feeds into why we are doing this: to have a more balanced food basket available.”

Good nutrition, according to the Global Nutrition Report 2015, “is an essential driver of sustainable development … It helps break the intergenerational cycle of poverty, generates broad-based economic growth and leads to a host of positive consequences for individuals, families, communities and countries.”

The department of health had not responded to questions about its nutrition programmes at the time of going to press.