Growth and nutritional status of the Bharia--a primitive tribe of Madhya Pradesh

This study is an attempt to understand the physical growth and nutritional status of Bharia, a primitive tribe of Central India. A cross sectional study was conducted on 551 children (283 boys and 268 girls) aged 4 to 18 years. Body weight, height, sitting height, head circumference, upper arm circumference, chest circumference, biceps, triceps, sub scapular and calf skin fold thickness were measured. Body Mass Index was calculated as weight/height2 to calculate chronic energy deficiency. All anthropometric measurements except skin fold measurement exhibit uniform increase with age in both the sexes. Age-specific Body Mass Index (BMI) indicated substantial changes and falls during pre-school age and rise in adolescence. The BMI according to the Indian standard was normal, but when the data was compared with the International standard malnutrition in both sexes was noticed in childhood. Boys remained undernourished after adolescence, while girls reached the normal growth patterns.     

Mother's age effect on the boys' anthropometric properties in the Region of Tuzla (Bosnia and Herzegovina)

Our objective was to establish if mother's age affects the anthropometric properties their 11 and 16 years old sons, and if the boys' BMI is satisfactory. Cross-sections, questionnaires, and statistics were used for data processing BMI (kg/m2) was presented according to the scale Quetelet's index nutritional status. Twelve anthropometric properties were researched. It was established that mother's age affects anthropometric properties in adolescent boys. The younger mothers' boys come to puberty with significantly higher mean values for most anthropometric parameters. In the course of adolescent jump, older mothers' boys have significantly higher anthropometric measures in comparison to their age boys delivered by younger mothers. After the completion of their intensive growth and development anthropometric measures in both category boys are equal or insignificantly higher in younger mothers' sons. Mother's age affects their sons' anthropometric properties of growth and development, particularly in prepuberty and puberty. After puberty that effect is not significant. According to BMI, the boys coming from the researched region make the group of underfed children. That is probably the outcome of bad living conditions, irregular and insufficient diet, stress, etc. in the course of four year aggression on Bosnia and Herzegovina.     

Effect of Ascaris infection on the nutritional status and I.Q. of children

It was estimated that about 1.3 billion persons all over the world were infected with Ascaris Lumbricoides (A.L.), Especially children in tropical and subtropical countries. AIM To investigate the effects of A.L. infection on the nutritional status and the intellectual level in a sample of Egyptian primary school children from rural Giza province. SUBJECTS AND METHODS A sample of 637 children (329 boys and 308 girls) aged 6–12 years, have been subjected to some anthropometric measurements including body weight, body height, arm circumference, head circumference and triceps skinfold thickness. In addition, the I.Q. was determined using “Draw-a-man” test. Blood hemoglobin concentration was also determined using a spectrophotometric method. All the children were then subjected to stools and urine examinations, and peri-anal swab. Only 242 children were included for further study, of whom 45 boys and 38 girls were found infected with A.L. solely, and 81 boys and 78 girls of about the same age free of parasitic infections were taken as control. RESULTS Children infected with A.L. has significantly lower body weight, height, and arm circumference but insignificantly lower skinfold thickness and head circumference as comparedto the control group. Infected children had significantly lower hemoglobin concentration and I.Q. than the controls. CONCLUSIONS Selected anthropometric measurements, biochemical and intellectual tests from a useful complementary battery for reliable and informative investigation of the effects of parasitic infection on child nutrition and health. A.L. was found to have a significant effect on the physical and intellectual status of the rural Egyptian children of age 6–12 years.     

Growth pattern of the Kamars--a primitive tribe of Chhattisgarh,India

A cross sectional study of the physical growth status was made on 655 Kamar children (341 boys and 314 girls), aged 5 to 18 years, in the Raipur district of Chhattisgarh. The study aimed to find out the growth pattern of the Kamar children, which is considered to be a primitive tribe of Chhattisgarh, India and was compared with another Indian tribe and the official data for all India (ICMR). Anthropometric measurements included height, weight, sitting height, biacromial diameter, biilliocrystal diameter, upper arm circumference, calf circumference and measurements of the triceps and subscapular skinfolds. All anthropometric measurements except skinfold thickness exhibit uniform increase with age in both sexes. However, when height and weight of the Kamar boys and girls were compared with the data for other tribes and for all India, the Kamar children (both boys and girls) indicated lower weight and height and the difference showed to be significant, for almost all ages. Kamar boys showed higher anthropometric values than girls in almost all measurements except in biilliocrystal diameter and in measured skinfolds. Poor socio-economic status of this primitive tribe may be one of the reasons for this poor growth pattern. However, in-depth study is necessary in order to arrive at any basic conclusions and to recommend any policy and interventions.     

Parental education and living environmental influence on physical development, nutritional habits as well as level of physical activity in Polish children and adolescents

The aim of this work was to evaluate the physical development and nutritional status, the nutrition habits as well as level of physical activity of boys and girls in relation to the socio-economic status of their families. The study was conducted on a group of 529 boys and 535 girls aged 7-16 years from Swietokrzyskie Province in Poland. Boys and girls from high SES families had the greatest body height, BMI, upper arm muscle area, as well as upper arm fat tissue area, while the lowest values of these features occurred among those studied coming from families of a low SES. The higher the family SES, the higher habitual frequency of consuming vegetables and fruit as well as fish. The diet of children coming from higher SES families was also linked with a higher total protein content as well as animal protein, all analysed minerals and some vitamins, but there were no significant differences of energetic value in daily food rations as well as fat content. The longer time spent on some sedentary activities was connected with a higher family SES. The girls coming from a high status families also declared a higher level of physical activity, whereas such relationship was not observed among boys. A more rational set of nutritional habits observed among children from a higher SES families can be the basic reason for their higher advancement in development. A shorter time devoted to sedentary activities is assumed to be the main cause of a smaller relative body mass and less obesity among girls and boys from low SES families.     

Trends in body mass index, prevalence of overweight and obesity in preschool Lithuanian children, 1986-2006

The study provides the body mass index (BMI), the prevalence of overweight and obesity in preschool Lithuanian children, 1986-2006. In the 2003-2006 more than 1000 preschool 3-6 year old children from Vilnius (the capital of Lithuania) were investigated according to the standard anthropometric methods. The prevalence of overweight (OW) and obesity (OB) was estimated according to the cut-off points recommended by the International Obesity Task Force (IOTF). Recent data were compared with the data of preschool children from the 1986 Vilnius study and with the data from the other countries. The BMI of preschool children did not change significantly during the last 20 years, except for the statistically significant BMI increment in 6 years old girls. The prevalence of OB among preschool Lithuanian children was low (0.8%-3.7% in boys, and 0-1.9% in girls) and did not change significantly during 1986-2006. The prevalence of OW was higher in preschool girls (10.7%-18.2%) in comparison with preschool boys (6.5%-12.4%). The significant increment of the prevalence of OW was observed among the 6-year-old girls from the 2006 study in comparison with the 1986 study. The possible socio-economic reasons of the defined trend in the BMI and prevalence of OW and OB among preschool Lithuanian children are discussed in the paper.     

Age and sex variation of body mass index and waist circumference among the Santal children of Jharkhand, India

Central body fat (CBF) as measured by waist circumference (WC) etc. has now been considered as risk factor for chronic disease, disability, and death. It has been assumed that one's characteristic level of body fat, as measured by body mass index (BMI), and CBF unfolds during the normal course of growth and development. However, studies of the development of CBF show relatively weak consistency in comparison to body fat. But to the best of our knowledge, no study in this aspect has been undertaken on any Indian population to study the effect of age and sex on body fat and CBF during development. In view of the above consideration, the present work has been undertaken among 179 Santal (a tribal population) children (Boys = 107, Girls = 72) of the Galudih area in East Singbhum, Jharkhand, India. Anthropometric measurements of height, weight, and circumference of waist were taken from each subject using standard procedure. The mean ages of boys and girls were 10.94 years and 9.48 years, respectively. The mean BMI for boys and girls were 14.48 kg/m2 and 13.78 kg/m2 Percent of variance explained by age was much greater for BMI (> 50%) as compared to WC (7-10%) in both sexes. Two way ANOVA showed that BMI had a significant (p < 0.05) effect of age and not of sex, whereas age-sex interaction had a significant impact on WC. The results of the present cross-sectional study indicated that during growth and development unfolding of CBF and BMI is independent of one another. Different set(s) of gene(s), onset of growth hormones during the normal development or their interaction could have been considered for this differentiation.     

Changes in body size, shape and nutritional status of Middle-Class Bengali boys of Kolkata, India, 1982–2002

Growth changes over time among school-aged boys in Kolkata, India, have been investigated using two surveys: 1982--1983 (n=816) and 1999--2002 (n=1187). The two surveys were implemented according to highly similar protocols which strongly adds to the reliability and accuracy of the results of the study. Age-specific average height, weight and BMI all increased during these two decades (by respectively, 3.2cm, 6.1kg and 2.1kg/m2), while relative sitting height and sitting height-subischial leg length ratio decreased for almost all ages between 7.0 and 16.0 years. Moreover, the prevalence of stunting and thinness declined (stunting from 11.2% to 4.9%, p<0.01, thinness from 50.5% to 22%, p<0.01), while the prevalence of overweight increased (from 4.7% to 17.2%, p<0.01). Through analysis of variance, the relationships between various socio-economic factors and anthropometric traits are analyzed. Factors strongly related with positive changes in anthropometric traits are maternal education and family expenditure.     

Limb lengths of primary school children in a city from western region of Turkey

Anthropometry has been used for the assessment of growth at different ages. Among the anthropometric measurements, weight, height, arm circumference, and lower and upper limb lengths are of the most important criteria showing the development of children in school age. The aim of the present study was to measure the lengths of upper (arm, forearm, hand) and lower (thigh, leg, foot) limbs of children studying in primary schools of Aydin, a city in the western region of Turkey, and to assess the differences according to the gender (female, male) and living areas (urban, rural). In different age groups, many differences were observed when compared for gender and area. Differences were also seen when compared with the other studies done in different part of Turkey. The data was the first one for the region and it might be useful for further regional studies or for national comparisons. More studies designed with bigger sample sizes that cover many cities belonging to the same region of the country are needed. In addition to cross-sectional studies, longitudinal studies may give more useful knowledge for understanding the growth of children.     

Secular trends in some Russian populations

Secular changes of body measurements in children have been the subject of studies in many different countries. In recent years, there has been an increase in BMI associated with a significant trend towards obesity in both Europe and the US. The aim of the present study was to analyze trends in body measurements and BMI in Russia from the 1960's to the beginning of the 21st century. This was done at three locations of the Russian Federation: the city of Moscow, the cities of Saratov and Naberezhnye Chelny in the Volga-river area. In addition, data on secular changes of Abkhazian children were analyzed. A large number of anthropometric measurements were taken on each individual including height, weight, arm, leg and trunk lengths (estimated), body diameters and circumferences, skinfold thickness, head and face dimensions. Stages of secondary sex characteristics also were evaluated; data on menarcheal age were collected by status-quo and retrospective methods. Changes in hand grip strength have been evaluated in some of the samples. While stature was increasing during these years, weight, chest circumference and BMI were characterized by negative changes, which became more obvious in elder girls. Changes in handgrip strength also showed negative trends. There were noticeable changes in head and face measurements, which were expressed in more elongated head and face forms, i.e. the head became longer and narrower with narrower and higher faces. Secular changes in head and facial morphology may be considered part of the general trend.     

Body composition and nutritional status of urban Guatemalan children of high and low socioeconomic class

The effects of socioeconomic differences on the nutritional status of two groups of urban living children are considered via an anthropometric assessment of body composition. The sample consists of 981 Guatemala City children, 7.00 to 13.99 years old, of high and low socioeconomic status (SES). High SES children have larger median values for triceps skinfold, subscapular skinfold, arm circumference, and estimated mid-arm muscle and fat areas than low SES children. Compared with children of a US reference sample, the high SES children generally have larger values for all variables and the low SES children have smaller values. However, the differences between the low SES children and the children of the other two samples are greater for arm fat area than for arm muscle area. The analysis suggests that low SES Guatemalan children suffer to a greater extent from chronic energy, rather than protein, undernutrition. A similar pattern of energy malnutrition has been observed for rural Guatemalan children. These combined data suggest that estimates of fat reserves of the arm provide a useful indication of nutritional status for Third-World children. Results from rural Costa Rican and Honduran studies have been taken to mean that muscle reserves are better than fat reserves as indicators of nutritional status in developing countries. But, those studies did not estimate cross-sectional muscle and fat areas and only considered the extremes of the population distribution for muscle and fat.     

Growth reference centiles and secular changes in Turkish children and adolescents

The purpose of the study is to develop current reference growth centiles for Turkish children and adolescents. A cross-sectional growth survey was conducted on 1.427 (709 boys and 718 girls) healthy schoolchildren aged 6-17 years in Ankara, the capital city of Turkey. As an indicator of socio-economic status, the occupation of the parents was recorded. Growth references of height, weight, body mass index (BMI), sitting height, iliospinal height, relative iliospinal height and relative sitting height were constructed by the LMS method. Sex differences, association of parental occupation with height and BMI standard deviation scores were assessed by analyses of variance. Results showed significant sexual dimorphism for height, weight, sitting height and iliospinal height (p<0.001). Significant effect of socio-economic background was found on height and BMI. The prevalence of overweight and obesity was found using the International Obesity Task Force (IOTF) reference criteria 22.4% and 5.6% in boys and 21.2% and 3% in girls. Present results demonstrated an increment during the last three decades in height, leg length and weight curves which is more prominent in boys, but not in the sitting height. This positive secular change appears to be a logical outcome of the gradual changes in nutrition, health care and education, and environmental and economic conditions.     

Growth and malnutrition of rural Zimbabwean children (6-17 years of age)

The rural environment is an important factor in delayed growth in developing countries. The aim of this study was to investigate the effects of poor rural living conditions on the growth of a Shona sample in Zimbabwe. In total, 982 subjects aged 6-17 years were analyzed. Mean values of height, weight, skinfolds (triceps, subscapular, suprailiac, biceps, medial calf), cormic index, body mass index (BMI), arm composition (total upper arm area, upper arm muscle area, arm fat area, and arm fat index), fat percentage (%F), centripetal fat ratio (CFR), and the contribution of each skinfold to the adiposity of the trunk and upper limbs are presented. Weight, height, BMI, cormic index, SSCP, TRCP, arm circumference, and arm composition are compared with NHANES percentiles. Boys and girls showed stunting and underweight at ages 11-15 and 8-15, respectively; boys presented particularly severe malnutrition and their means of height and weight were below the 10th percentile. The means of arm circumference, UMA, UFA, and TRCP were below the 15th percentile in both sexes. The contribution of the skinfolds generally showed an overall prevalence of TRCP in both sexes; the contribution of SSCP was prevalent only for the 16- to 17-year-old boys. Males presented a higher CFR than girls after 14 years while females showed an irregular pattern. There was a high incidence of brachycormia and mesocormia in females and males, respectively. Height, weight, and BMI were similar to the values observed in other sub-Saharan countries, although body size was slightly larger than in South Africa and smaller than in Tanzania. The results provide a useful database for future comparisons.     

Differences in physical growth of Aymara and Quechua children living at high altitude in Peru

Physical growth of Amerindian children living in two Aymara and three Quechua peasant communities in the Andean highlands of southern Peru (altitude 3,810–3,840 m) was studied, taking into account differences in the microclimate, agronomic situation, and sociodemographic variables. Anthropometric measurements were taken in 395 children aged under 14 years of age in a sample of 151 families in these communities, who were surveyed for sociodemographic variables as well. Data on the land system were available for 77 families. In comparison with reference populations from the United States (NCHS) and The Netherlands, stature, weight, head circumference, and midupper arm circumference (but not weight for stature) in the sample children were reduced. Growth retardation increased after the age of 1 year. Stature and weight in the present sample were very similar compared with previously published data on growth of rural Aymara children living near Lake Titicaca in Bolivia. Head circumference, midupper arm circumference, and weight for stature were significantly larger in Aymara children compared with Quechua children. Land was significantly more fragmented in Aymara compared with Quechua families, but amount of land owned was not different. Perinatal and infant mortality was elevated in Aymara vs. Quechua communities. Most families in Aymara communities used protected drinking water. One Quechua community had a severe microclimate, grim economic outlook, and weak social cohesion. Children in this community showed significant reductions in weight and midupper arm circumference compared with their peers in the other communities. We conclude that (presumably nutritionally mediated) intervillage and Aymara-Quechua differences in childhood physical growth existed in this rural high-altitude population in Peru and were associated with microclimate and the village economy, sociodemographic factors, and differences in the land system. © 1993 Wiley-Liss, Inc.     

A Comparison between BMI,Waist Circumference,and Waist-To-Height Ratio for Identifying Cardio-Metabolic Risk in Children and Adolescents

Background

There is controversial evidence on the associations between anthropometric measures with clustering of cardiovascular disease risk factors in pediatric ages. We aimed to examine the associations between body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with clustered cardiometabolic risk factors and to determine whether these anthropometric variables can be used to discriminate individuals with increased cardiometabolic risk (increased clustered triglycerides, HDL-cholesterol, systolic and diastolic blood pressure, and HOMA-IR).

Methods

The study sample of 4255 (2191 girls and 2064 boys) participants (8–17 years) was derived from pooled cross-sectional data comprising five studies. Outcomes included a continuous cardiometabolic risk factor z-score [corresponding to the sum of z-scores for triglycerides, HDL-cholesterol, systolic and diastolic blood pressure (mean arterial pressure), and HOMA-IR] and children with ≥1.0 SD in this score were defined as being at risk for clustering cardiometabolic risk factors.. Exposure variables were BMI, WC, WHtR. Statistics included mixed-effect regression and ROC analysis.

Results

All anthropometric variables were associated with clustered risk and the magnitudes of associations were similar for BMI, WC, and WHtR. Models including anthropometric variables were similar in discriminating children and adolescents at increased risk with areas under the ROC curve between 0.70 and 0.74. The sensitivity (boys: 80.5–86.4%; girls: 76.6–82.3%) was markedly higher than specificity (boys: 51.85–59.4%; girls: 60.8%).

Conclusions

The magnitude of associations for BMI, WC, and WHtR are similar in relation to clustered cardiometabolic risk factors, and perform better at higher levels of BMI. However, the precision of these anthropometric variables to classify increased risk is low.     

Are the Recent Secular Increases in Waist Circumference among Children and Adolescents Independent of Changes in BMI?

Background

Several studies have shown that the waist circumference of children and adolescents has increased over the last 25 years. However, given the strong correlation between waist circumference and BMI, it is uncertain if the secular trends in waist circumference are independent of those in BMI.

Methods

We analyzed data from 6- to 19-year-olds who participated in the 1988–1994 through 2011–2012 cycles of the National Health and Nutrition Examination Survey to assess whether the trends in waist circumference were independent of changes in BMI, race-ethnicity and age.

Results

Mean, unadjusted levels of waist circumference increased by 3.7 cm (boys) and 6.0 cm (girls) from 1988–94 through 2011–12, while mean BMI levels increased by 1.1 kg/m² (boys) and 1.6 kg/m² (girls). Overall, the proportional changes in mean levels of both waist circumference and BMI were fairly similar among boys (5.3%, waist vs. 5.6%, BMI) and girls (8.7%, waist vs. 7.7%, BMI). As assessed by the area under the curve, adjustment for BMI reduced the secular increases in waist circumference by about 75% (boys) and 50% (girls) beyond that attributable to age and race-ethnicity. There was also a race-ethnicity interaction (p < 0.001). Adjustment for BMI reduced the secular trend in waist circumference among non-Hispanic (NH) black children (boys and girls) to a greater extent (about 90%) than among other children.

Conclusions

Our results indicate that among children in the U.S., about 75% (boys) and 50% (girls) of the secular increases in waist circumference since 1988–94 can be accounted for by changes in BMI. The reasons for the larger independent effects among girls and among NH blacks are uncertain.     

Waist-to-height ratio is an accurate and easier index for evaluating obesity in children and adolescents

Objectives: The present study aims to evaluate the accuracy of the index of waist‐to‐height ratio (WHTR), and proposed the optimal thresholds of WHTR in the definition of childhood overweight and obesity in a bi‐ethnic Chinese school‐aged population. Research Methods and Procedures: Overweight and obese were identified by BMI for age and gender in a random sample including 2055 Han and 2132 Uygur ethnic school‐aged children (8 to 18 years old). WHTR was calculated by waist circumference divided by height on the basis of standard anthropometric measurements. Receiver operating characteristic (ROC) curve analyses were performed to assess the accuracy of WHTR as a diagnostic test for childhood overweight and obesity, compared with waist circumference. The optimal thresholds of WHTR for defining overweight and obesity were recommended respectively by gender. The correlation between WHTR and age was analyzed and compared with BMI. Results: A‐values (area under curve) of WHTR for diagnosing overweight and obesity were both over 0.90 in both genders and better than those of waist circumference. A threshold of 0.445 was identified for overweight in both genders, with the sensitivity and specificity >0.80. The thresholds for defining obesity was 0.485 in boys and 0.475 in girls, both having the sensitivity and specificity >0.90. WHTR showed less association with age than BMI. Conclusions: WHTR is a simple, easy, accurate, and non‐age‐dependent index with high applicability to screening overweight and obesity in children and adolescents. The use of WHTR in the general childhood population has been justified by this study.     

Nutritional status of adults in rural Mali.

An anthropometric assessment was conducted of 441 adults from six rural villages in southern Mali. As is typical for human populations, females are shorter and lighter than males. Both females (N = 320) and males (N = 121) are shorter and lighter than their U.S. counterparts. Mean weight in the sample is 53.4 +/- 8.5 kilos for females and 58.8 +/- 6.5 kilos for males. Mean height is 160.4 +/- 5.7 cm for females and 171.3 +/- 6.6 cm for males. The data for height in males are very similar to those reported from other surveys in Mali, and show no evidence for a positive secular trend in height. Mean body mass index (BMI) is 20.8 for females and 20.0 for males. These are lower than U.S. averages, but well above suggested cutoff points for malnutrition in adults. Average arm circumference is 26.5 cm for females and 26.4 cm for males. Females have relatively large arm circumferences due, in part, to the heavy manual labor they perform. Average head circumference is 53.0 cm for females and 54.8 cm for males. For both sexes, these values are more than 1 standard deviation (SD) below the U.S. means. Adult values for anthropometric measurements reflect childhood stresses of malnutrition and disease, and a lifetime of accommodation to a high-carbohydrate, low-protein diet, and hard physical labor. Females are significantly closer to the U.S. standards than males for weight, height, BMI, and arm circumference; these findings support the idea that females are buffered from environmental stresses relative to males. In addition, females exhibit significantly more variability than males for weight, arm circumference, and head circumference, but not for height, suggesting that variability in adult height does not reflect the presence or absence of female buffering or the level of environmental adversity.     

Serum albumin concentration,arm circumference,and oedema and subsequent risk of dying in children in central Africa.

OBJECTIVE--To measure the prognostic value of clinical, anthropometric, and biological indicators of protein energy malnutrition in hospitalised children. DESIGN--Hospital based follow up study from admission to discharge or death of a cohort of children. SETTING-Paediatric hospital in Zaire. SUBJECTS--1129 children consecutively admitted between August 1986 and October 1988. MAIN OUTCOME MEASURES--Height, weight, arm circumference, skinfold thicknesses, serum albumin concentration, and mortality. RESULTS--Mortality was higher in wasted children and in those with a mid-upper arm circumference < 125 mm, a serum albumin concentration < 16 g/l, and oedema. After multivariate analysis, serum albumin concentration was the best predictor of subsequent risk of dying. Mid-upper arm circumference and oedema, however, still contributed considerably to evaluation of mortality. CONCLUSIONS--In this specific environment of central Africa an isolated clinical sign such as oedema is not enough to detect children with a high risk of dying among those admitted to paediatric wards with severe protein energy malnutrition. Measurement of additional indicators such as arm circumference and serum albumin concentration seems to be of crucial importance.