Growth and Secular Trend in School-Children from Cento, Ferrara, Italy
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Coll. Antropol. 30 (2006) 1: 65–74 Original scientific paper Growth and Secular Trend in School-Children from Cento, Ferrara, Italy Stefania Toselli, Angela Raffaella Ventrella, Grazia Franzaroli and Patricia Brasili Department of Evolutionary Experimental Biology, Unit of Anthropology, University of Bologna, Bologna, Italy ABSTRACT Growth parameters were surveyed in a sample of 296 Italian children, 6–9 years old, from Cento (Ferrara, Emilia- -Romagna). The comparison with children from the same town measured in 1974–75 show changes in some parameters, suggesting an ongoing secular trend. To better understand the observed weight increase and the sex difference, we also evaluated body composition and motricity. The analysis of the present sample is a preliminary part of a longitudinal study dealing with modifications of body composition and motor capacity induced by growth. In our sample the children are growing according to the Italian reference standard. The females present weight, height and Body Mass Index (BMI) values comparable to the 50th centile, while the males present higher values of weight, skinfold thicknesses and BMI. Sex differences in the motor performance were noted. A methodological comparison of obesity assessments based on BMI and percentage of body fat (%F) shows similar conclusions but somewhat different results. Key words: secular trend, children, body composition, nutritional status Introduction Numerous studies have been carried out in Italy to cations13–15. The cause of childhood obesity has not been evaluate variations of the principal anthropometric char- completely clarified, although a complex interaction of acteristics in relation to growth1. Height data for 6–12 genetic, environmental and behavioral factors seems to year-old Italian children suggest that the intensity of the be responsible16. secular height increase is tending to diminish in Italy, while weight shows a greater increase1. The greater in- The hallmark of obesity is excess body fat. Increased crease of weight than height agrees with literature re- fatness in an individual or an increased frequency of ports of a high incidence of nutritional disorders such as overweight in a population can occur only as a result of a overweight and obesity1–7. sustained positive balance, i.e. when energy intake ex- ceeds energy expenditure17. Several factors are suspected Obesity is a major public health problem throughout in this trend, including increased food intake, reduced most of the world, but in some areas both obesity and physical activity in childhood, and a pattern of food in- undernutrition coexist. Although overweight and obesity take in which high-calorie fast food plays an important in Italian children have received attention, there is a role. need for information about the other extreme, under- weight. The notion that obesity is caused by excess energy in- Many studies have confirmed the strong association take is not generally supported in the scientific literature. between obesity and the high risk of chronic health prob- However, recent research suggests that the composition lems such as coronary artery disease risk factors8, non- of the diet, including high fat and low carbohydrate in- -insulin diabetes9,10 and psychological problems11. The takes, may play a role in overweight16, even though this prevalence of obesity in children is increasing; in fact, conclusion is debatable18. A number of studies suggest a the average child in the 1980s was fatter than the aver- significant relationship between physical activity and age child of 20 years earlier12. One of the worrying as- obesity19–24, but other studies refute such a relation- pects of childhood obesity is the increased risk of obesity ship25,26. Indeed, the issue is clouded by the wide variety in adulthood, with its well established health compli- of methods used to assess children’s activity levels. Received for publication August 5, 2004 65 S. Toselli et al.: Growth and Secular Trend in Children, Coll. Antropol. 30 (2006) 1: 65–74 Despite widespread concern about obesity, the devel- composition and mobility induced by growth in a sample opment of standard definitions of obesity for screening of Italian school-children. and intervention remains problematic. Valid and practi- The purposes of this study were: 1) a preliminary as- cal methods based on health-related criteria for obesity sessment of the growth of school-age children of Cento screening in children and adolescents are not available. (Ferrara – Emilia-Romagna, Italy); 2) evaluation of a Therefore, because simple, accurate methods for the di- possible secular trend in the children of Cento; 3) deter- rect assessment of body fat are lacking, anthropometric mination of the prevalence of underweight, overweight indexes such as the body mass index are often used as and obese subjects; 4) evaluation of motricity and strength surrogates for body composition. However, interpreta- in relation to sex; and 5) comparison of the assessment of tion of the results is difficult, because Body Mass Index obesity on the basis of different methodologies. (BMI) reflects relative leg length, body frame size and fat-free mass in addition to fatness. Consequently, two persons with the same amount of body fat can have quite Materials and Methods different BMI values. These problems are underscored by the discordant estimates of prevalence when obesity is In 2001–2002, we surveyed a sample of 296 Italian estimated via BMI and other anthropometric measures children (147 males, 149 females, 6–9 years) from Cento 27 such as skinfold thicknesses . (Tables 1 and 2) to evaluate body composition and mot- The present study is a preliminary part of a larger ricity during growth. Each age class incorporate children longitudinal study dealing with modifications of body from x.5 to (x+1).49 years of age, where x equals a given TABLE 1 DESCRIPTIVE STATISTICS OF THE ANTHROPOMETRIC VARIABLES IN FEMALE SAMPLE 6 yrs. (N=15) 7 yrs. (N=58) 8 yrs. (N=55) 9 yrs. (N=21) XSDXSDXSDXSD Height (cm) 119.45 4.62 122.61 5.18 127.66 5.94 132.72 6.69 Weight (kg) 24.00 4.54 25.52 5.01 28.37 5.81 29.45 6.72 Body mass index (BMI, kg/m2) 16.77 2.67 16.84 2.39 17.29 2.65 16.63 3.15 Sitting height (cm) 64.41 2.64 65.98 2.64 67.67 3.12 70.01 4.01 Chest circumference normal (cm) 59.47 4.65 60.67 5.04 62.73 5.42 64.24 6.21 Chest circumference maximum (cm) 62.89 4.74 64.41 4.91 66.58 5.40 68.33 5.76 Chest circumference minimum (cm) 58.03 4.58 58.97 4.89 61.09 5.33 62.60 6.06 Relaxed arm circumference (cm) 18.67 2.13 18.96 2.37 19.77 2.37 19.82 2.98 Contracted arm circumference (cm) 19.75 2.32 19.99 2.29 20.83 2.55 20.99 2.87 Wrist circumference (cm) 12.60 1.15 12.90 1.60 13.41 1.70 14.44 5.26 Thigh circumference (cm) 34.57 3.33 35.85 3.70 37.31 3.99 37.33 4.20 Calf circumference (cm) 25.53 2.27 26.18 2.63 27.31 2.57 27.71 2.89 Humerus breadths (mm) 4.99 0.83 4.96 0.49 5.20 0.63 5.22 0.36 Femur breadth (mm) 7.26 0.79 7.46 0.59 7.71 0.63 7.93 0.51 aspalphaBiceps skinfold (mm) 6.93 2.80 6.41 3.34 6.83 3.40 7.64 4.24 Triceps skinfold (mm) 10.10 3.31 10.13 3.45 11.19 4.21 10.43 4.85 Subscapular skinfold (mm) 8.07 3.83 7.30 3.41 7.96 3.85 8.19 4.62 Supraspinal skinfold (mm) 7.00 4.00 7.51 4.00 8.45 4.70 8.83 5.85 Suprailiac skinfold (mm) 10.47 5.18 9.97 4.87 11.51 5.21 11.93 6.38 Thigh skinfold (mm) 18.73 3.39 18.38 4.95 20.13 5.14 19.67 5.73 Medial calf skinfold (mm) 12.77 3.53 12.54 3.66 14.06 4.14 14.57 5.01 Lateral calf skinfold (mm) 12.97 2.69 12.05 3.29 13.51 3.77 13.07 2.99 Fat free mass (FFM, kg) 19.80 2.84 21.20 3.12 23.10 3.57 24.10 3.99 Fat mass (FM, kg) 4.20 2.11 4.40 2.18 5.20 2.62 5.30 3.32 Percentage fat (%F) 16.80 5.22 16.20 5.25 17.50 5.88 16.80 6.98 Sit-and-reach (cm) 41.23 6.02 42.09 5.42 40.97 5.50 41.84 4.45 Hand grip strength (kg) 8.70 2.40 9.60 2.16 11.40 2.98 13.70 3.02 N – number of children by age 66 S. Toselli et al.: Growth and Secular Trend in Children, Coll. Antropol. 30 (2006) 1: 65–74 years of age at the time of the measurement. This is in In addition, the BMI was calculated and body compo- agreement with the indications of Tanner28, Malina et sition parameters (Fat Free Mass, Fat Mass, Percentage al.29 and other studies on growth. Fat) were computed with the skinfold equations of Sla- The anthropometric characters examined were: height, ughter31. sitting height (Raven magnimeter), weight (scale), eight Questionnaire was used to asses the frequency and circumferences (normal chest, maximum chest, mini- the number of hours of extra-curricular physical activity. mum chest, arm relaxed and contracted, wrist, thigh and Questionnaire was filled out by the parents of the young- calf)(inelastic tape), humerus and femur breadths (small ster.