As we recognize School Health Week, it’s important to reflect on the stark realities facing children globally—and especially here in South Africa—regarding their health and nutrition. Two major issues stand out: childhood obesity and malnutrition. While these problems may seem like opposite ends of a spectrum, they share a root cause—poor diet quality. This week serves as a critical reminder that the health and future of millions of children are in jeopardy and that schools can either be part of the solution or an aggravating factor in this crisis.
Global and National Picture of Childhood Obesity
Childhood obesity is a global epidemic. According to the World Health Organization (WHO), over 340 million children and adolescents aged 5 to 19 were classified as overweight or obese in 2016, a figure that has only grown in recent years. While this is often thought of as a problem in developed countries, the rising rates of childhood obesity in developing nations like South Africa are alarming. South Africa has one of the highest rates of child obesity in the world, with 13.2% of children aged 6-14 classified as overweight or obese, according to the South African Demographic and Health Survey (SADHS).
This growing trend is deeply concerning because childhood obesity has long-term consequences that extend beyond adolescence. Obese children are more likely to suffer from chronic health issues such as Type 2 diabetes, heart disease, and hypertension as adults. Beyond physical health, these children often experience psychosocial challenges such as bullying, low self-esteem, and depression, further hindering their development.
A Different Kind of Hunger: The South African Malnutrition Crisis
While obesity threatens one segment of the population, malnutrition—specifically undernutrition—is devastating another. In South Africa, many children come to school hungry or malnourished, a condition marked by inadequate intake of calories and nutrients. Statistics South Africa revealed that approximately 30% of children under five are classified as stunted due to chronic malnutrition, while over 6 million South Africans regularly go hungry, many of them school-aged children.
Schools, particularly in lower-income communities, are often the first and only line of defense against hunger. The National School Nutrition Programme (NSNP) in South Africa provides meals to over 9 million children in public schools, a crucial intervention given the economic hardships faced by many families. However, the nutritional quality of these meals is concerning. While they provide the necessary calories to sustain students throughout the day, they often lack the vital nutrients children need to grow and thrive.
The Problem with School Meals: Not All Calories Are Equal
The issue isn’t just whether children are eating, but what they are eating. Many school feeding programs provide meals that are high in carbohydrates and sugars but low in essential nutrients like proteins, healthy fats, vitamins, and minerals. For many students, especially those coming from impoverished homes, this is their only meal of the day. But when that meal is primarily made up of low-cost, high-carbohydrate foods, it exacerbates issues like obesity and malnutrition.
In South Africa, this problem is even more pronounced because of the double burden of disease—where malnutrition and obesity coexist in the same populations. Children who don’t get the nutrients they need at critical growth stages often develop lifelong health issues, and those who are consuming high-calorie but nutrient-poor diets are prone to obesity and its related complications.
Schools at the Frontline of Change
South African schools are in a difficult position. They are expected to provide nutritious meals on tight budgets while also ensuring that children are equipped to learn and thrive. However, with rising food costs and increasing demands, many schools struggle to meet even the basic nutritional needs of their students. In addition, the education system has yet to fully integrate nutritional literacy into the curriculum, leaving both children and parents uninformed about what constitutes a healthy diet.
Schools need to take on a more active role in addressing childhood nutrition. Whether it’s by revamping meal programs to include more nutrient-dense foods or integrating education about healthy eating into the curriculum, schools can play a critical role in combating both childhood obesity and malnutrition. Research and evidence-based studies that focus on the link between nutrition and children’s health outcomes are invaluable in guiding these efforts, ensuring schools have the knowledge and support needed to make informed decisions. Initiatives like school gardens, which can provide fresh vegetables, or partnerships with local farmers to source healthier food options, are some ways schools can improve the situation. Schools working alongside other organizations and research groups can further improve the quality of food provided and implement sustainable, long-term changes for the benefit of students’ health.
A Call for Action
As we observe School Health Week, we must confront the uncomfortable truth: children are suffering—some from too much food and others from too little, and yet many from a lack of the right kind of food. The future of our children depends on a collective effort to address these issues at the root.
Parents, educators, policymakers, and communities need to come together to prioritize child nutrition—not just to fill stomachs, but to nourish young minds and bodies. We must also demand more from our government programs, ensuring that the meals provided at schools meet the nutritional needs of the students they serve.
As a society, we have an obligation to do better for our children. We cannot afford to wait until it’s too late. The next generation depends on the actions we take today.