• Martha E van Stuijvenberg, Jana Nel, Serina E Schoeman, Carl J Lombard, Lisanne M du Plessis, and Muhammad A Dhansay.
• Nutritional Intervention Research Unit, South African Medical Research Council, Cape Town, South Africa; Currently Non-communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa. Electronic address: Lize.van.stuijvenberg@mrc.ac.za.
• Nutrition. 2015 Jun 1;31(6):841-6.

ObjectivesThis cross-sectional study examined the nutritional factors associated with the high levels of stunting in 2- to 5-y-old children in an impoverished South African setting where liver is frequently eaten and vitamin A deficiency known to be absent.MethodsChildren's dietary intake was assessed by a single 24-h recall. Heights and weights were measured and information was obtained on breast-feeding history, the child's habitual milk intake, as well as substance use by the mother during pregnancy (n = 150).ResultsThe overall prevalence of stunting was 36.9% (CI 29.2, 44.6) and increased with age, being 49% in the 4- to 5-y-old age category. Birth weight correlated significantly with height-for-age z-scores (HAZ; r = 0.250, P = 0.003), and was lower in children whose mothers smoked and used alcohol during pregnancy than in children whose mothers abstained (P < 0.0001). Median intake of energy, carbohydrate and protein was adequate. Median intake for all micronutrients was at least 90% of the estimated average requirement, except for calcium, vitamin D and vitamin E, which was 21%, 15%, and 32%, respectively. Intake of fat, calcium, phosphorous, vitamin D, riboflavin, and vitamin B12 (nutrients that typically occur in milk) was significantly lower in stunted than in non-stunted children (P < 0.05). When excluding children with low birth weight, intake of calcium, vitamin D, and riboflavin were still significantly lower (P < 0.05). HAZ was higher in children who habitually drank milk compared to those who did not (P = 0.003).ConclusionsInadequate calcium and vitamin D intake, presumably because of low intake of milk after weaning, may have contributed to stunting in this population.Copyright © 2015 Elsevier Inc. All rights reserved.

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