Special Issue "The Nutrition Transition and Physical Inactivity and Health Outcomes thereof in Low- and Middle-Income Countries: From Preconception to Adulthood"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: 30 June 2020.

Special Issue Editors

Emeritus Prof. Nelia Steyn
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Guest Editor
Division Human Nutrition, Department of Human Biology, University of Cape Town, P/Bag X3, Observatory, Cape Town 7925, South Africa
Interests: dietary methodology; non-communicable diseases; type 2 diabetes; obesity and the double burden of malnutrition
Special Issues and Collections in MDPI journals
Prof. Dr. Marjanne Senekal
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Guest Editor
Division of Human Nutrition, Department of Human Biology, University of Cape Town, Cape Town 8000, South Africa
Interests: dietary methodology; non-communicable diseases; type 2 diabetes; obesity and the double burden of malnutrition

Special Issue Information

Dear Colleagues,

Globally, non-communicable diseases (NCDs) are major causes of mortality, with cardiovascular diseases, cancer, chronic lung diseases, and diabetes being the most prolific. Almost 40 million people die annually from NCDs, with an estimated 80% of these occurring in low- and middle-income countries. However, most of these diseases can be prevented through limiting exposure to the known shared risk factors such as unhealthy diets, physical inactivity, tobacco use, and harmful use of alcohol.

The underlying drivers of the shift in dietary patterns (nutrition transition) and physical inactivity have been well described by Popkin. The first of these is technology which includes both labor-saving equipment, transport options, increased leisure activities, and food technology in the broadest sense. Urbanization has greatly accelerated in the past century and has resulted in greater access to a greater variety of foods, including processed foods, frequently at the expense of a traditional healthier diet. A shift in income per capita has also resulted in the price of food decreasing exponentially and there has been an enormous expansion of global trade, which makes access to modern technology available on a very large scale.

Another feature of the nutrition transition is the double burden of disease, both over- and undernutrition co-exist. Many countries in Sub-Saharan Africa (SSA), for example, have both a high prevalence of stunting in children and of overweight and obesity in mothers. Obesity in children has also increased globally in the past decade. Obese children are more likely to become obese adults, who in turn appear to be more at risk of developing chronic NCDs in later life.

In recognition of the magnitude of the increasing challenges of the nutrition transition coupled with increased physical inactivity levels in developing countries the International Journal of Environmental Research and Public Health devotes this Special Issue to recent findings in “The Nutrition Transition and Physical Inactivity and the Health Outcomes thereof in Low- and Middle-Income countries: From Preconception to Adulthood”.

You are invited to submit manuscripts to be considered for publication in this Special Issue. We will particularly welcome submissions from Sub-Saharan Africa.

Emeritus Prof. Nelia Steyn
Prof. Dr. Marjanne Senekal
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (4 papers)

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Research

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Open AccessArticle
Provincial Dietary Intake Study (PDIS): Prevalence and Sociodemographic Determinants of the Double Burden of Malnutrition in A Representative Sample of 1 to Under 10-Year-Old Children from Two Urbanized and Economically Active Provinces in South Africa
Int. J. Environ. Res. Public Health 2019, 16(18), 3334; https://doi.org/10.3390/ijerph16183334 - 10 Sep 2019
Abstract
The objective of this study was to determine the prevalence and socio-demographic predictors of malnutrition in two urbanized economically active provinces (Gauteng N = 733, Western Cape N = 593) in South Africa. A multistage stratified cluster random sampling design was applied. Fieldworkers [...] Read more.
The objective of this study was to determine the prevalence and socio-demographic predictors of malnutrition in two urbanized economically active provinces (Gauteng N = 733, Western Cape N = 593) in South Africa. A multistage stratified cluster random sampling design was applied. Fieldworkers visited homes, measured children aged 1-<10-years old (N = 1326) and administered a questionnaire (mother/primary caregiver). In under-five year old children (N = 674) 21.6% were stunted [height-for-age z-score < −2 SD], 5.6 % underweight [weight-for-age z-score < −2 SD], 10.3% overweight (body mass index-for-age z-score) (BAZ)> +2 SD ≤ +3 SD] and 7.0% obese (BAZ > +3 SD). In 5–<10-year olds (N = 626) 6.7% were stunted, 6.8% underweight, 13.4% overweight and 6.8% obese. Stunting and overweight in the same child was present in 5.7% under-five year olds and 1.7% in 5–<10-year olds. Multiple logistic regression analyses identified having a mother with a post-grade 12 qualification (OR = 0.34) and having an obese mother (OR 0.46) as protectors and being in the under-five age group (OR = 3.73) as a risk factor for stunting. Being in the under-five age group was also a risk factor for a BAZ > 1 (OR 2.39), while being in the third wealth quintile was protective (OR = 0.62). Results indicate that stunting and overweight/obesity are still present at concerning levels, especially in the under-five age group. Full article
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Open AccessArticle
Childhood Undernutrition and Its Predictors in a Rural Health and Demographic Surveillance System Site in South Africa
Int. J. Environ. Res. Public Health 2019, 16(17), 3021; https://doi.org/10.3390/ijerph16173021 - 21 Aug 2019
Abstract
Background: Overweight and obesity are increasing at an alarming rate in South Africa, while childhood undernutrition remains persistently high. This study determined the magnitude and predictors of stunting and underweight among schoolchildren in the Dikgale and Health Demographic Surveillance System Site, a rural [...] Read more.
Background: Overweight and obesity are increasing at an alarming rate in South Africa, while childhood undernutrition remains persistently high. This study determined the magnitude and predictors of stunting and underweight among schoolchildren in the Dikgale and Health Demographic Surveillance System Site, a rural site in South Africa. Methods: A cross sectional study using multistage sampling was conducted among 508 schoolchildren and their mothers. Anthropometric measurements were taken from children and their mothers, while sociodemographic information was obtained from mothers using a questionnaire. The World Health Organization Anthro Plus was used to generate height-for-age and weight-for-age z-scores to indicate stunting and underweight, respectively, among the children. Maternal overweight and obesity were assessed using body mass index. Bivariate and multivariate logistic regression analyses were used to evaluate the predictors of stunting and underweight among schoolchildren. Results: Twenty-two percent (22%) of children were stunted and 27% were underweight, while 27.4% of the mothers were overweight and 42.3% were obese. The odds of being stunted were lower in younger children, whereas having a mother who was overweight/obese and had a short stature increased the odds of stunting. Access to water, having a refrigerator, and having a young mother were protective against being underweight. Having a mother who was overweight/obese increased the odds of being underweight. Conclusions: The study showed a high prevalence of stunting and underweight among children, and overweight and obesity among mothers, indicating a household double burden of malnutrition. The age of the child and maternal overweight/obesity and short stature were predictors of stunting and underweight, while having a younger mother and access to water and a refrigerator were protective against being underweight. The need for an evidence-based and feasible nutrition program for schoolchildren, especially those in rural schools, cannot be over-emphasized. Full article
Open AccessArticle
Attending Informal Preschools and Daycare Centers Is a Risk Factor for Underweight, Stunting and Wasting in Children under the Age of Five Years in Underprivileged Communities in South Africa
Int. J. Environ. Res. Public Health 2019, 16(14), 2589; https://doi.org/10.3390/ijerph16142589 - 20 Jul 2019
Abstract
The study objectives were to determine the nutritional status of children between the ages of 12–60 months and to establish the association between attending preschool and the prevalence of undernutrition. This was a cross-sectional survey conducted in health facilities in Tshwane district in [...] Read more.
The study objectives were to determine the nutritional status of children between the ages of 12–60 months and to establish the association between attending preschool and the prevalence of undernutrition. This was a cross-sectional survey conducted in health facilities in Tshwane district in South Africa, consisting of both a questionnaire and anthropometric measures of 1256 mothers and their children. Weight-for-age (WAZ), height-for age (HAZ) and BMI-for-age (BAZ) were calculated and bivariate and multivariable analysis was performed to establish association. The results showed that child-related factors, namely birthweight, age, gender, and attending preschool increased the risk of undernutrition. Children over the age of 24 months were likely to be stunted and underweight. Maternal education reduced the odds of underweight. Children who stayed at home had reduced odds of underweight and stunting. High birthweight reduced the odds of wasting and underweight. The risks for undernutrition are multifaceted, but children who attend preschool have an increased risk of undernutrition. The risk of undernutrition increased with age and coincided with the time of cessation of breast-feeding and attendance at daycare or preschool. The complementary role of quality childcare in preschools and daycare centers is vital in alleviating the problem of undernutrition in underprivileged communities. Full article

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Open AccessReview
Dietary Sources of Salt in Low- and Middle-Income Countries: A Systematic Literature Review
Int. J. Environ. Res. Public Health 2019, 16(12), 2082; https://doi.org/10.3390/ijerph16122082 - 12 Jun 2019
Cited by 2
Abstract
Rapid urbanization in low- and middle-income countries (LMICs) is transforming dietary patterns from reliance on traditional staples to increased consumption of energy-dense foods high in saturated fats, trans fats, sugars, and salt. A systematic literature review was conducted to determine major food sources [...] Read more.
Rapid urbanization in low- and middle-income countries (LMICs) is transforming dietary patterns from reliance on traditional staples to increased consumption of energy-dense foods high in saturated fats, trans fats, sugars, and salt. A systematic literature review was conducted to determine major food sources of salt in LMICs that could be targeted in strategies to lower population salt intake. Articles were sourced using Medline, Web of Science, Scopus, and grey literature. Inclusion criteria were: reported dietary intake of Na/salt using dietary assessment methods and food composition tables and/or laboratory analysis of salt content of specific foods in populations in countries defined as low or middle income (LMIC) according to World Bank criteria. Of the 3207 records retrieved, 15 studies conducted in 12 LMICs from diverse geographical regions met the eligibility criteria. The major sources of dietary salt were breads, meat and meat products, bakery products, instant noodles, salted preserved foods, milk and dairy products, and condiments. Identification of foods that contribute to salt intake in LMICs allows for development of multi-faceted approaches to salt reduction that include consumer education, accompanied by product reformulation. Full article
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