BMI-based nutritional assessment of children aged 11–17 years in rural Ellisras, Limpopo province

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Abstract
Background: Childhood malnutrition, including both undernutrition and overnutrition, remains a significant public health concern in many low- and middle-income countries, including South Africa. Understanding the anthropometric characteristics and obesity predictors among rural South African adolescents is crucial for informing targeted public health interventions. Aim: This study aimed to assess the nutritional status of children in rural Ellisras, South Africa, aged 11–17 years, and to identify predictors of obesity. Setting: The study was conducted in Ellisras, a rural area in South Africa, between January 2021 and December 2021. Methods: A total of 1217 adolescents (612 boys, 605 girls) participated in the study. Anthropometric measurements, including height, weight and body mass index (BMI), were collected. Multivariate regression analysis was used to identify factors associated with obesity. Results: The findings indicated that 43.10% of children were classified as underweight, with a higher prevalence among boys (64.57%) than girls (35.43%). The overall prevalence of overweight and obesity was low (0.41%), with girls (80%) being more affected than boys (20%). Boys had a slightly higher average height (154.79 cm) than girls (154.60 cm), while girls had a higher average BMI (16.41 kg/m2) compared to boys (15.81 kg/m2). Multivariate regression analysis revealed that adolescents aged 15–16 years had significantly higher odds of obesity (adjusted odds ratio [AOR] = 2.10, p < 0.001) compared to 11–12-year-olds. Additionally, girls had significantly higher odds of obesity than boys (AOR = 2.80, p < 0.001). Conclusion: The study highlights the dual burden of malnutrition among rural South African adolescents, with a high prevalence of underweight and emerging obesity, particularly among girls. Contribution: These findings emphasise the need for targeted nutritional interventions, with special attention to adolescents aged 15–16 years and girls, who are at a higher risk of obesity.

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