Household socioeconomic status, dietary diversity, and risk of stunting among South African primary school children.

backgroundChildren in low- and middle-income countries are disproportionately affected by socioeconomic disparities, which might influence access to diverse and nutritious foods, increasing the risk of food insecurity and low dietary quality. Hence, monitoring of these conditions is crucial. This study examined whether children from households with different wealth status vary concerning food insecurity, dietary diversity, consumption of specific food groups, and risk of stunting.

methodsBaseline data were utilized from a multi-country randomized intervention trial. Primary school children (M

resultsOn average, children consumed food items from 5.8±2.0 healthy food groups. One out of 12 children (8.4%) were stunted. Contrast analyses showed that children from low-resourced families were exposed to more food insecurity, consumed fewer different food items, and were more likely to be stunted than children from the highest socioeconomic categories (p < 0.05). The latter were more likely to consume cereals, roots, vitamin A rich vegetables, oil, sweets, and sweet beverages. Although stunting still exists in marginalized areas of South Africa, our findings confirm that children with higher wealth status are less likely to be stunted, but consume more food items from unhealthy food groups.

conclusionOur findings reiterate the need for improving awareness of healthy food consumption in low- resourced areas. Addressing upstream determinants such as food insecurity, poverty, and access to affordable, healthy foods is essential to reduce socioeconomic differentials in food consumption. School-based nutrition programs should be framed as complementary measures within broader government-led actions, including school feeding policies and teacher-focused nutrition education, to improve inadequate dietary quality among school-age children and address socioeconomic inequalities in stunting risk.