Stunting of children

Stunting of children begins in the uterus and continues with how the newborn infant is fed.

Physically it is defined as being in the low height for age bracket.

This page was last updated by Bernard Preston on 13th August, 2020.

Stunting is defined as poor physical and mental development of children as a result of chronic under-nutrition.

Some children are naturally short, and not physically stunted, but worldwide this is reckoned to be no more than 3% of all kids. But in South Africa it has reached epidemic proportions with 27 percent of all children under the age of five falling below the guidelines[1].

Add to that stuntedness of cognitive development, and we have a catastrophe.

  1. Bernard Preston
  2. What are legumes
  3. Stunting of children

Maternal undernutrition

Maternal undernutrition means inevitably a poor start for children who will already be on the path to stuntedness even before they are born.

Adequate balanced protein for the development of a strong and normally tall body, and a complete fatty acid complement for the rapidly expanding brain are non-negotiable.

Add to that the multitude of micronutrients for a strong mother and child, and one grasps the need for sound nutrition. Just the deficiency of folate means the high likelihood of a neural tube defect as in cleft lip or spina bifida.

Foods with high folate levels include a glass of freshly squeezed orange juice, without the pulp strained out, and a cup of spinach. Stunting of children because of deficiency of vitamin B9 should be extremely rare but it is not.

Breast feeding

There is an abundance of research that proves beyond any shadow of a doubt that breast-feeding is the best for the infant. How did we ever believe otherwise?

Whether it is the high-quality fats and protein, or the immunity to disease that is passed on, nothing can compare with the breast.

However, unscrupulous infant-formula companies have targeted less well educated mothers, and convinced them that their very expensive products are far superior.

For the wealthy, it is less of a problem, but for the poor who can no longer afford the formula, but cannot return to breast-feeding, it is an unmitigated disaster; stunting of children is inevitable.

Mother's milk is high in one of the omega-3 fats called DHA; an astonishing 25 percent of the grey matter of the normal brain is made up of this nutrient. A deficiency would certainly mean stunting of our children.

Fatty fish, avocados, free range eggs and dairy from pasture fed cows and freshly-ground flaxseed are the best sources, none of which are routinely available to the poor; but mother's milk provides it all.

The first two to three years are generally recognised as the most important; once the child reaches five, the damage done is permanent and cannot be reversed. The cognitive development will be impaired too and they will never reach their true potential.

Stunting of children

Stunting of children is not only a third-world problem but is prevalent in the west too, if one includes mental backwardness from poor nutrition.

The data shows that 27 percent of children under 5 are considered short for their age or stunted, and of them 10% are severely effected.

- SADHS 2016.


Stunting in children.

Kwashiorkor is one of the more obvious severe but less common signs of stunting of children.

It is caused by a severe protein deficiency. The low albumin in the blood causes a drop in the oncotic pressure in the capillaries causing the leakage of fluid into extracellular spaces causing ascites; swelling of the abdomen.

Of far greater concern is the less visible poor nutrition of more than a quarter of South Africa's children that starves them of a future.

It also starves the country of strong and productive workers who are physically and mentally up to the challenges of a modern economy.

According to Wikipedia, South Africa loses about R15 billion in GDP to vitamin and mineral deficiencies arising from malnutrition, to which I would add micronutrient shortages; omega-3 would be one of the more obvious examples. They go on to state that it would cost less than 1/20th of that to alleviate the problem[3].

A balanced diet containing all the essential amino acids is absolutely necessary to prevent the stuntedness of Kwashiorkor; simply an egg and a glass of milk a day would go a long way to provide sufficient protein; the are both rich in albumin.

Free range cage free eggs are probably more available to rural children, where the hens can roam freely.

School feeding schemes

School feeding schemes in South Africa are based on polony, a relatively cheap processed meat byproduct known to cause tumours, and highly refined mealiemeal, deficient in the protein, fat and vitamins found in whole corn. Neither should be allowed within the gates; they destine children to poor health and stuntedness.

Simply contracting with local farmers to supply a head of corn, a glass of milk and an egg a day, together with greens like spinach or cabbage should be the aim of school feeding schemes.

How to grow spinach should be the aim of every rural school.

Many of those who are more financially able enjoy a cola or fruit juice  and sandwiches made using white bread for lunch; it is little better.

Lysine in chickpeas may be the solution. The World Health Organization recommends consuming 30 milligrams of this amino acid per day for each kilogram of body weight. A 1/2-cup serving of chickpeas contains 486 milligrams[5], enough for a 15kg child.

Using dried chickpeas, at R23/kg which provides 15 cups, the cost would be less than R1 per child.

Prevention of stunting

Fast food boys enjoying a meal very high in refined carbohydrate and cholesterol.

With the human brain consisting of more than 60 percent fat, it is no coincidence that mother's milk is very rich in these nutritious acids; in other animals the preponderance rather is protein so the tiny calf for example can grow physically quickly.

But human children need fat and protein; if either are absent there will be mental or physical stunting.

And then children of course need all the vitamins, minerals and phytochemicals that adults require for their well-being.

They too need whole grains and at least seven different coloured foods every day.

There is continuing controversy in research circles about how much carbohydrate children need; all are agreed however that refined starches like white bread, sugary cakes and cookies and colas should be kept to a minimum.

There is no doubt that, with the average American consuming half a cup of sugar per day, there is stunting of children in the West too; the effect on the brain and behaviour is more apparent than shortness of stature.

Pellagra is highly prevalent in South Africa, a deficiency of vitamin B3, or niacin. Meat, chicken, avocados and legumes are rich sources.

In short, stunting of children should be rare in countries like South Africa, yet over a quarter of our children are permanently disabled because of poor feeding schemes.

This green mealie risotto made with brown rice is particularly nutritious with all of the vitamins and fibre found in whole grains.

1. Statistics South Africa. South Africa Demographic and Health Survey 2016: Key Indicator Report.

2. Why child malnutrition is still a problem in South Africa 22 years into democracy

3. Malnutrition in South Africa.

4. A mealie a day.

5. Chickpeas and lysine


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