Among 136 apparently healthy teachers in under-resourced public primary schools in Gqeberha, South Africa, DXA-derived body composition risks (especially fat mass risk), metabolic syndrome and multimorbidity were prevalent, and adverse risk phenotypes were associated with elevated multimorbidity and poorer metabolic health.
Fat mass risk was nearly universal among the teachers.
A substantial minority of teachers had bone mass risk, and a smaller share had lean mass risk.
Risks frequently co-occurred, with bone-fat risk the most common combined phenotype.
More than half of the teachers met metabolic syndrome criteria.
Adverse body composition risk phenotypes were associated with higher multimorbidity and poorer metabolic health.
This is the first study from South Africa's Eastern Cape to report DXA-derived body composition profiles.
The authors conclude that multi-level strategies are needed to protect teachers' health.
This study looked at the body composition and health of 136 teachers working in under-resourced public primary schools in Gqeberha, South Africa. Using DXA scans, which measure bone, fat and muscle, the researchers found that almost all teachers (about 92%) had a risky level of body fat. About 30% had low bone mass risk and about 16% had low lean (muscle) mass risk. Many had more than one risk at once, and about 6% had all three. More than half of the teachers (53%) met criteria for metabolic syndrome, a cluster of conditions linked to heart disease and diabetes. Teachers with adverse body composition profiles also tended to have more health conditions at once and poorer metabolic health. This is the first study of its kind to report DXA-based results from the Eastern Cape. This research suggests that teachers in under-resourced schools may carry a substantial hidden burden of poor body composition and related illness, even when they appear healthy. The authors suggest workplace screening with low-cost tools, exercise such as weight-bearing and resistance activity, and broader changes such as fairer school resourcing and easier access to screening and treatment. Because the study is cross-sectional and covers a small group, it shows associations rather than causes.
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Upload Your LabsJoubert N, Adams L, Seelig H, Gardiner E, van de Venter R, Degen J, et al.. (2026). Bone health, obesity, and multimorbidity risk among teachers in under-resourced South African public primary schools: results from a cross-sectional DXA study.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1794604