A STUDY OF ANTHROPOMETRIC MEASUREMENTS AND PREVALENCE OF OVERWEIGHT AMONGST SCHOOL BOYS IN AN URBAN...

INTERNATIONAL JOURNAL OF MEDICAL AND APPLIED SCIENCES ISSN:2320‐3137

299 www.earthjournals.org Volume 2 Issue 4 2013

Research Article

A STUDY OF ANTHROPOMETRIC MEASUREMENTS AND PREVALENCE OF OVERWEIGHT AMONGST SCHOOL BOYS IN AN URBAN AREA

Minhas S1*, Sekhon H2

1Reader, Department of Community Medicine, Armed Forces Medical College, Pune, India.

2Psychiatrist, Composite Hospital, Central Reserve Police Force, Bantalab, Jammu, J & K, India.

ABSTRACT Today it is a widely accepted fact that children are becoming overweight at younger age day by day, thus increasing the risk of the various other metabolic disorders. Many low- and middle-income countries are now facing a "double burden" of disease, i.e. while they continue to deal with the problems of infectious diseases and under-nutrition, at the same time they are experiencing a rapid upsurge in overweight, particularly in urban settings.To study of anthropometric measurements of school boys in an urban area. To determine the prevalence of overweight amongst them.Settings and Design: The present study was a cross sectional descriptive study.Methods and Material: The present study was a cross sectional descriptive study. The total number of boys studied was 699. Anthropometric measurements taken included: weight, height, Body Mass Index (BMI), Mid Upper Arm Circumference (MUAC), Waist Circumference (WC), Hip Circumference (HC), and the Waist / Hip Ratio (WHR).Statistical analysis used: Chi-square test. The percentage of male children who had completed 5, 6, 7, 8, 9, 10 years of age was found to be 62.9%, 62.4%, 48.8%, 56.8%, 59.8%, and 61.4%, respectively. It was seen that out of a total of 699 male students, 20.5% were found to be having BMI below <5th percentile 48.2% had BMI between ≥5th – <85th percentile, 15.7% had BMI between ≥85th - <95th percentile while 15.6% had BMI ≥95th percentile. The study revealed that the proportion of overweight and at risk of overweight was 15.6% and 15.7% respectively. Key-words: Overweight, obesity, boys, urban, school. INTRODUCTION The definition of overweight and obesity varies, depending on the source of the definition. But the general agreement of the health care professionals is that individuals whose Body Mass Index (BMI) exceeds the age-gender-specific 95th percentile are overweight; while those with BMI between the 85th and 95th percentiles are at risk of overweight [1]. Overweight and obesity are by definition, abnormal or excessive fat accumulation that may impair health [2] or simply as a state of excess adipose tissue [3]. Another definition says that obesity is an excessive accumulation of adipose tissue

containing stored fat in the form of triglycerides [4]. Overweight and obesity are among the most important public health problems even in developing countries [5]. Although, compared to adult population, research in case of childhood overweight is meagre, the accumulating evidence of multiple surveys, indicates that the rising incidence of overweight and obesity among children parallels that among adults [6]. Younger people have largely grown up in a world where a greater variety of food than ever before has become available and at relatively low cost, amongst other reasons,



and so are more prone to become overweight at a younger age [7]. India in the meanwhile has been undergoing a transition from an agrarian to an industrial economy with all the attendant changes of increased incomes, improved food availability and lifestyle changes that encourage decreased physical activity. Assessment of changing prevalence of overweight and obesity in India is difficult in view of lack of comparable data and cut-off guidelines to describe overweight and obesity. However, India today stands comparable to developed countries where overweight and obesity in case of school children is concerned [8, 9]. Therefore, this study was undertaken with the aim and objectives to study the anthropometric measurements of school boys in an urban area and to determine the prevalence of overweight amongst them. SUBJECTS AND METHODS: The present study was a cross sectional descriptive study undertaken to determine the prevalence of overweight amongst school boys in the age group of 5 to 10 years. All the 699 boys in the study population were studied. The instruments used in the present study were a portable digital weighing machine, a portable anthropometric rod and a fibre glass measuring tape. Age was recorded to the nearest completed year (6 months and above being rounded off to the next year and less than six months to the previous year). The anthropometric measurements recorded during the conduct of the study were: a) Weight b) Height c) Body Mass Index (BMI) d) Mid Upper Arm Circumference (MUAC) Weight

Body weight was measured to the nearest half kilogram using a portable weighing machine, which was standardized periodically during the study. Height Height was recorded with the subject standing against a portable anthropometric rod that was positioned against the wall and was recorded to the nearest 0.1 cm. Body Mass Index The BMI will was calculated as per guidelines given by the WHO as follows: BMI = Weight (in Kgs) / Height2 (in meters) Using the above equation, BMI was calculated until the second decimal value [5]. Mid Upper Arm Circumference (MUAC) The MUAC was measured to the nearest 0.1 cm with a fibre-glass tape, by placing it gently, but firmly, round the left limb to avoid compression of the soft tissues. As recommended by international agreement, the left arm, while hanging freely, was measured to the nearest 0.1 cm at its mid-point [5]. Prior informed consent was taken from the respondents and their parents/ guardians for the study. Anonymity was maintained throughout. The data was collected, compiled and analysed thereafter, using statistical software EpiInfo, keeping in view the aims and objectives of the study. Classification of weight status: The most commonly used parameter is BMI which is calculated as weight in kg divided by the square of the height in meters. CDC classifies weight status according to the percentile range as shown in Table – 1.



Table: 1 CDC Classification of Weight Status According to the Percentile Range

Weight status category Percentile rangeUnderweight <5th percentile Healthy weight 5th percentile upto 85th

percentile At risk of overweight 85th to less than 95th

percentile Overweight Equal to or greater than

95th percentile Results: 61, 123, 124, 126, 122 and 143 boys had completed 5, 6, 7, 8, 9 and 10 years of age respectively. It was seen that out of a total of 699 boys, 20.5% had BMI below <5th percentile, 48.2% had BMI between ≥5th – <85th percentile, 15.7% had BMI between ≥85th - <95th percentile while 15.6% had BMI≥95th percentile. It was seen that for boys who had completed 5, 6, 7, 8, 9 and 10 years of age, the respective mean BMI and standard deviation was, 14.6631 (±1.3046), 14.6593 (±1.5020), 15.2434 (±6.9272), 14.6704 (±1.7228), 15.8783 (±2.5365) and 15.7292 (±2.3590). It was found that mean BMI and standard deviation as shown in Table: 2 were homogeneous with respect to age and sex of the boys (p<0.05). TABLE: 2 Distribution of Mean BMI and Standard Deviation According to Age Age (completed years)

No. Examined

Mean

SD

5 61 14.6631 1.3046 6 123 14.6593 1.5020 7 124 15.2434 6.9272 8 126 14.6704 1.7228 9 122 15.8783 2.5365 10 143 15.7292 2.3590 χ2 = 41.5317 df = 5 p = 0.0000

There was an increasing trend in respective percentiles of weight with respect to age. The weight at the age of 5, 6, 7, 8, 9 and 10 years being 15, 15, 18, 19, 20 and 23 kg at the 5th percentile; the same being 18, 19, 21, 23, 27 and 28 kg at the 50th percentile; and the corresponding weight at the 95th percentile being 24, 26, 29, 31, 42 and 42 kg. There was a gradual increase till the age of 8 years, after which there was a rapid increase observed till 10 years of age. Further, this increase in the weight was more marked at the higher percentiles (Fig: 1). Fig: 1 Distribution of Percentiles of Weight of Boys According to Age

There was an increasing trend in respective percentiles of height with respect to age. The height at the age of 5, 6, 7, 8, 9 and 10 years being 103, 105, 112, 118, 124 and 128 cms at the 5th percentile; the same being 111, 116, 122, 127, 133 and 137 cms at the 50th percentile; and the corresponding height at the 95th percentile being 122, 124, 131, 137, 146 and 146 cms. There was a steady increase in height observed from 5 to 10 years of age (Fig: 2).



Fig:2 Distribution of Percentiles of Height of Boys According to Age

There was an increasing trend in respective percentile of BMI with respect to age, except for a slight dip around 8 years of age, subsequent to which it started rising on the rebound. The BMI at the age of 5, 6, 7, 8, 9 and 10 years being 13, 13, 12, 13, 12 and 13 kg/ m2 at the 5th percentile; the same being 15, 15, 14, 14, 15 and 15 kg/ m2 at the 50th percentile; and the corresponding BMI at the 95th percentile being 17, 18, 18, 18, 21 and 20 kg/ m2 (Fig: 3). Fig:3 Distribution of Percentiles of BMI of Boys According to Age

Discussion:



The comparison of median height of boys is as shown in Table – 3 and Fig – 4. It was observed that the median height of the boys in the present study was lower than CDC [10] and WHO [11] standards except at the age of 5 years. It was higher at all ages than that observed by KN Agarwal et al [8],

whereas, it was lower than that observed by Marwaha et al [9] and Vijaya Raghavan et al [13], except at age 9. On the whole, it was observed that the median height of the boys in the present study was comparable to the other studies.

TABLE: 3 Comparison of Median Height of Boys

Age

Present Study KN Agarwal

Rath et al

Marwaha et al

Vijaya Raghavan et al

CDC

WHO

5 111 (111.66±5.61)

106 (106±43.66)

111 (111.35±5.04)

114 112 (113.51±5.54)

109 110

6 116 (115.75±5.28)

110 (110.65±33.77)

117 (117.12±5.08)

119 119 (118.90±5.19)

116 116

7 122 (121.75±6.05)

117 (116.91±54.55)

125 (124.4±6.02)

123 123 (123.32±5.71)

122 122

8 127 (127.20±5.69)

123 (123.28±59.24)

130 (130.26±5.93)

128 128 (127.86±5.66)

128 127

9 133 (133.31±6.59)

128 (127.64±56.05)

134 (133.3±5.62)

133 133 (133.63±7.08)

134 133

10 137 (137.65±5.65)

135 (133.55±58.72)

137 (137.04±5.36)

139 138 (138.45±6.82)

139 138

Note: The values in parenthesis correspond to the mean and SD. Fig: 4 Comparison of Median Height of Boys



The comparison of median weight of boys is as shown in Table – 4 and Fig – 5. The median weight of the boys in the present study was higher at all ages than that observed by KN Agarwal et al [13] whereas it was lower at all ages than the median weight observed in WHO and CDC standards, as well as that observed in the study by, Rath et al [15], Marwaha et al [9] and Vijaya Raghavan et al [14]. TABLE: 4 Comparison of Median Weight of Boys

Age

Present Study KN Agarwal

Rath et al

Marwaha et al

Vijaya Raghavan et al

CDC

WHO

5 18 (18.38±2.95)

16 (16.48±17.08)

19 (19.1±2.67)

19 19 (19.33±0.57)

19 19

6 19 (19.70±2.87)

18 (18.16±22.11)

21 (20.42±2.34)

21 22 (22.14±3.30)

21 21

7 21 (22.60±9.41)

20 (20.28±27.80)

23 (24.06±4.92)

23 24 (24.46±4.15)

23 23

8 23 (23.85±4.09)

22 (22.61±28.83)

26 (27.37±4.12)

27 26 (26.42±4.43)

26 25

9 27 (28.48±6.43)

24 (24.89±37.23)

28 (29.01±5.13)

30 29 (30.00±5.61)

29 28

10 28 (29.94±5.70)

26 (27.96±44.27)

30 (31.52±6.17)

33 31 (32.39±5.94)

32 31

Fig: 5 Comparison of Median Weight of Boys

The comparison of MUAC of boys is as shown in Table – 5 and Fig – 6. The mean MUAC of the boys in the present study was higher at all ages except at the age of 5 years, than the mean MUAC of the boys observed in the studies by DK Shrivastava et al [16], Rath et al [15] and Vijaya Raghavan et al [17].



TABLE: 5 Comparison of Means of MUAC of Boys

Age Present Study DK Shrivastava et al Rath et al Vijaya Raghavan et al

5 16.33 ± 1.58 15.5 ± 1.0 16.66 ± 1.30 16.42 ± 1.70 6 18.28 ± 5.09 15.8 ± 1.3 16.70 ± 1.32 16.68 ± 1.55 7 19.87 ± 1.93 16.3 ± 1.3 17.57 ± 2.16 17.36 ± 1.85 8 20.14 ± 1.45 17.1 ± 1.6 18.21 ± 1.94 17.72 ± 2.03 9 20.48 ± 1.36 17.5 ± 1.4 18.92 ± 2.30 18.55 ± 2.29 10 21.99 ± 2.68 18.1 ± 1.6 19.41 ± 2.57 18.98 ± 2.41

Fig: 6 Comparison of Means of MUAC of Boys

The comparison of 3rd percentile of height of boys is as shown in Table – 6 and Fig – 7. On comparing the 3rd percentile of height with respect to age of boys, it was observed that it was less than that in the WHO standards [11] at all ages. It was also less than the height observed by Marwaha et al [9] in their study, except at the age of 9 years, and less than that in the CDC standards [10] except at the age of 5 years. TABLE: 6 Comparison of 3rd Percentile of Height of Boys Age Present Study WHO CDC Marwaha et al 5 101(111.66±5.61) 102 100 104 6 104(115.75±5.28) 107 106 108 7 112(121.75±6.05) 112 112 112 8 115(127.20±5.69) 117 117 117 9 122(133.31±6.59) 121 122 121 10 126(137.65±5.65) 126 127 126 Note: The values of SD are not available in respect of the other studies.



Fig: 7 Comparison of 3rd Percentile of Height of Boys

The comparison of 5th percentile of height of boys is as shown in Table – 7 and Fig – 8. On comparing the 5th percentile of height with respect to age of boys, it was observed that the 5th percentile of height of the boys in the present study was higher at all ages than that observed by KN Agarwal et al [13]. It was less than that in the WHO standards [12] except at the age of 9 years. It was also less than that in the CDC standards [10] except at the age of 5 years. TABLE: 7 Comparison of 5th Percentile of Height of Boys Age Present Study Agarwal et al WHO CDC Rath et al 5 103(111.66±5.61) 97 103 102 103(111.35±5.04) 6 105(115.75±5.28) 103 108 107 109(117.12±5.08)7 112(121.75±6.05) 108 113 113 115(124.4±6.02) 8 118(127.20±5.69) 113 118 119 119(130.26±5.93)9 124(133.31±6.59) 119 123 124 124(133.3±5.62) 10 128(137.65±5.65) 123 127 128 129(137.04±5.36) Note: The values in parenthesis correspond to the mean and SD. The values of SD are not available in respect of the other studies. Fig: 8 Comparison of 5th Percentile of Height of Boys



The comparison of 95th percentile of height of boys is as shown in Table – 8 and Fig – 9. On comparing the 95th percentile of height with respect to age of boys, it was observed that the 95th percentile of height of the boys in the present study was higher at all ages than that observed by KN Agarwal et al [13]. It was more than that in the WHO standards [12] except at the age of 6, 8, 10 years. It was less than that in the CDC standards [10] and that observed by Rath et al [15] in their study, except at the age of 5 and 9 years. TABLE: 8 Comparison of 95th Percentile of Height of Boys Age Present Study Agarwal et al WHO CDC Rath et al 5 122(111.66±5.61) 116 118 117 121(111.35±5.04) 6 124(115.75±5.28) 116 124 124 126(117.12±5.08) 7 131(121.75±6.05) 127 130 131 136(124.4±6.02) 8 137(127.20±5.69) 135 137 138 140(130.26±5.93) 9 146(133.31±6.59) 138 143 144 144(133.3±5.62) 10 146(137.65±5.65) 143 148 150 147(137.04±5.36) Note: The values in parenthesis correspond to the mean and SD. The values of SD are not available in respect of the other studies. Fig: 9 Comparison of 95th Percentile of Height of Boys

The comparison of 97th percentile of height of boys is as shown in Table – 9 and Fig – 10. On comparing the 97th percentile of height of boys in the present study, it was observed that at all ages it was less than that observed by Marwaha et al [9] in their study. It was also less than WHO standards [12], except at the age of 5, 7, and 9 years. It was however, greater than CDC standards [18], except at the age of 8 and 10 years. TABLE: 9 Comparison of 97th Percentile of Height of Boys Age Present Study WHO CDC Marwaha et al 5 123(111.66±5.61) 119 118 125 6 125(115.75±5.28) 125 124 130 7 133(121.75±6.05) 132 132 135 8 138(127.20±5.69) 138 138 141 9 146(133.31±6.59) 144 142 147 10 148(137.65±5.65) 150 148 153 Note: The values in parenthesis correspond to the mean and SD. The values of SD are not available in respect of the other studies.



Fig: 10 Comparison of 97th Percentile of Height of Boys

The comparison of 3rd percentile of weight of boys is as shown in Table – 10 and Fig – 11. On comparing the 3rd percentile of weight with respect to age of boys, it was observed that the 3rd percentile of weight of boys in the present study was less than WHO [12] and CDC standards [10] at all ages. However, it was less than that observed by Marwaha et al [9] at all ages except at the age of 5 years. TABLE: 10 Comparison of 3rd Percentile of Weight of Boys Age Present Study WHO CDC Marwaha et al 5 14(18.38±2.95) 15 15 14 6 15(19.70±2.87) 16 16 16 7 17(22.60±9.41) 18 18 17 8 18(23.85±4.09) 20 20 19 9 20(28.48±6.43) 22 22 21 10 21(29.94±5.70) 24 24 23 Note: The values in parenthesis correspond to the mean and SD. The values of SD are not available in respect of the other studies. Fig: 11 Comparison of 3rd Percentile of Weight of Boys



The comparison of 5th percentile of weight of boys is as shown in Table – 11 and Fig – 12. On comparing the 5th percentile of weight of boys, it was observed that the weight of boys in the present study was more than that observed by Agarwal et al [13] at all ages. However, it was less than that in the CDC [10] and WHO standards [12] as well as that observed by Rath et al [15] at all ages. TABLE: 11 Comparison of 5th Percentile of Weight of Boys Age Present Study Agarwal et al WHO CDC Rath et al 5 15(18.38±2.95) 13 15 15 16(19.1±2.67) 6 15(19.70±2.87) 14 17 17 17(20.42±2.34)7 18(22.60±9.41) 15 18 19 19(24.06±4.92)8 19(23.85±4.09) 18 20 21 21(27.37±4.12)9 20(28.48±6.43) 20 22 23 23(29.01±5.13)10 23(29.94±5.70) 22 24 25 24(31.52±6.17) Note: The values in parenthesis correspond to the mean and SD. The values of SD are not available in respect of the other studies. Fig: 12 Comparison of 5th Percentile of Weight of Boys

The comparison of 95th percentile of weight of boys is as shown in Table – 12 and Fig – 13. On comparing the 95th percentile of weight of boys, it was observed that the weight of boys in the present study was more than that observed by Agarwal et al [13] at all ages. However, it was less than that in the CDC [10] and WHO standards [12] at all ages except at the age of 5 years. It was also less than that observed by Rath et al [15] except at the age of 6 and 9 years.



TABLE: 12 Comparison of 95th Percentile of Weight of Boys Age Present Study Agarwal et al WHO CDC Rath et al 5 24(18.38±2.95) 21 23 24 24(19.1±2.67) 6 26(19.70±2.87) 26 26 27 24(20.42±2.34) 7 29(22.60±9.41) 26 29 31 35(24.06±4.92) 8 31(23.85±4.09) 29 33 35 33(27.37±4.12) 9 42(28.48±6.43) 32 37 40 39(29.01±5.13) 10 42(29.94±5.70) 36 42 46 46(31.52±6.17) Note: The values in parenthesis correspond to the mean and SD. The values of SD are not available in respect of the other studies. Fig: 13 Comparison of 95th Percentile of Weight of Boys

The comparison of 97th percentile of weight of boys is as shown in Table – 13 and Fig – 14. On comparing the 97th percentile of weight of boys, it was observed that the 97th percentile of weight of boys in the present study was less than that observed by Marwaha et al [9] at all ages. However, it was more than the WHO standards [12] at all ages except at the age of 6 and 10 years. It was less than the CDC standards [10] at all ages except at the age of 5 and 9 years. TABLE: 13 Comparison of 97th Percentile of Weight of Boys Age Present Study WHO CDC Marwaha et al 5 25(18.38±2.95) 24 25 31 6 26(19.70±2.87) 27 28 34 7 31(22.60±9.41) 30 33 38 8 35(23.85±4.09) 34 37 43 9 44(28.48±6.43) 39 43 49 10 43(29.94±5.70) 44 49 54 Note: The values in parenthesis correspond to the mean and SD. The values of SD are not available in respect of the other studies.



Fig: 14 Comparison of 97th Percentile of Weight of Boys

The comparison of 3rd percentile of BMI of boys is as shown in Table – 14 and Fig – 15. On comparing the 3rd percentile of weight with respect to age of boys, it was observed that the 3rd percentile of weight of boys in the present study is less at all ages than the CDC [10] and WHO standards [12]. It was also less than that observed by Marwaha et al [9] in their study except at 5 and 6 years of age. TABLE: 14 Comparison of 3rd Percentile of BMI of Boys Age Present Study WHO CDC Marwaha et al 5 12(14.66±1.30) 13 14 12 6 12(14.66±1.50) 13 14 12 7 12(15.24±6.93) 13 14 13 8 12(14.67±1.72) 13 14 13 9 12(15.87±2.54) 14 14 13 10 12(15.73±2.36) 14 14 13 Fig: 15 Comparison of 3rd Percentile of BMI of Boys

The comparison of 5th percentile of BMI of boys is as shown in Table – 15 and Fig – 16. On comparing the 5th percentile of BMI of boys, it was observed that the 5th percentile of BMI of boys in the present study was more or less equal to the WHO [12] and CDC [10] standards till the age of 6 years, subsequent to which it decreased at the age of 7 years and 9 years.



TABLE: 15 Comparison of 5th Percentile of BMI of Boys

Age Present Study WHO CDC 5 13(14.66±1.30) 13 14 6 13(14.66±1.50) 13 13 7 12(15.24±6.93) 14 13 8 13(14.67±1.72) 14 14 9 12(15.87±2.54) 14 14 10 13(15.73±2.36) 14 14

Fig: 16 Comparison of 5th Percentile of BMI of Boys

The comparison of 85th percentile of BMI of boys is as shown in Table – 16 and Fig – 17. On comparing the 85th percentile of BMI of boys, it was observed that the 85th percentile of BMI of boys in the present study was less than that in the WHO [12] and CDC [10] standards till the age of 8 years, subsequent to which it increased. TABLE: 16 Comparison of 85th Percentile of BMI of Boys





The comparison of 95th percentile of BMI of boys is as shown in Table – 17 and Fig – 18. On comparing the 95th percentile of BMI of boys, it was observed that the 95th percentile of BMI of boys in the present study was less than that in the WHO [12] and CDC [10] standards, except at the age of 6 and 9 years. TABLE: 17 Comparison of 95th Percentile of BMI of Boys



The comparison of 97th percentile of BMI of boys is as shown in Table – 18 and Fig – 19. On comparing the 97th percentile of BMI of boys, it was observed that the 97th percentile of BMI of boys in the present study was less than the CDC [10] standards and that observed by Marwaha et al [9] at all ages. It was also less than the WHO [12] standards at all ages, except at the age of 9 years.



TABLE: 18 Comparison of 97th Percentile of BMI of Boys Age Present Study WHO CDC Marwaha et al 5 18(14.66±1.30) 18 18 21 6 18(14.66±1.50) 18 19 22 7 20(15.24±6.93) 19 20 23 8 20(14.67±1.72) 19 21 24 9 21(15.87±2.54) 20 22 25 10 22(15.73±2.36) 21 24 26 Fig: 19 Comparison of 97th Percentile of BMI of Boys

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A STUDY OF ANTHROPOMETRIC MEASUREMENTS AND PREVALENCE OF OVERWEIGHT AMONGST SCHOOL BOYS IN AN URBAN...

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