SEMMELWEIS UNIVERSITY DOCTORAL SCHOOL
SECULAR GROWTH CHANGES IN BODY DIMENSIONS AND THE BODY COMPOSITION IN 10-18-YEAR–OLD GIRLS
UVACSEK MARTINA
BUDAPEST 2005
Introduction The health, social and economical status of a certain population or classes can be well-described with the observed changes in growth and development in indirect way. The investigations of secular growth changes started very early in Hungary. As a result of investigations carried out on pubertal children, taller stature, heavier body mass and earlier maturation could be observed and published (2, 14). These changes were connected with the development of public health, hygiene, and qualitative and qualitative changes in nutrition. The relation between the positive secular changes and the social welfare indices (more favourable previous status) – for example the increasing life span, the amount of daily consumption of proteins, yearly income, or GDP, etc. – is proved. Thus significant differences were found in the body composition and body dimensions of the children living in different social and economic conditions. During classifying the socio-economic status of children, the educational level and occupation of parents, the income and the size of the family and the urbanization of the permanent address are also very important viewpoints. In spite of the genetic and environmental conditions, determining body dimension, the belonging to anthropologically different human classes, the verified geographical variability and the changes described by body dimension are very similar. Growth, development and velocity of maturation are formed characteristically for human race. At the same time to analyze development and state of development is absolutely necessary to document, study and evaluate the changes in dimension and the differences in the relative data and indices from time to time and in different populations. There are such body dimensions (e.g. body mass), which react more sensitive to outer environmental effect, than others (e.g. bone width). One of these outer environmental conditions of harmonious development is the regular physical activity for children. According to Malina and Bouchard (13) it is equal with other positive environmental factors (suitable nutrition, general stimulus-richness, quality of health care, etc.). Unfortunately the quantity of physical 2
activity is continuously decreasing even in the highly-developed, wellfare societies, and its reduced amount can be observed already in the childhood. (1, 11) Nowadays sedentary life-style is considered evidence. The relationship of physical hypoactivity with spectacular increasing of body mass and relative body fat of children and adults is proved the same is true for the increase of rate of overweight and obese. Obesity, as a risk factor of cardiovascular, metabolic, locomotor and respiratory diseases, became one of the most important factors to be defended in public health. Actuality of this theme is explained by the fact that obese adolescents become obese adults with great probability, and they already have the high risk of the above mentioned diseases. The secular growth changes can be hardly found or not at all in countries more developed and richer than Hungary. But problems of body composition and the treating of diseases caused by them result in serious financial problems and are heavy loads both on the individuals and society. The importance of prevention and treating of obesity has been already recognized in Western Europe and in the U.S. In spite of that a great percentage of the population is considered to be obese in these regions as well. (5, 1) After the political changes prevalence of obesity was intensified in Hungary in harmony with the social and economic changes, and with the increase of hypoactivity in pre-pubertal and pubertal children (8). The more prevalent appearance of fatness and obesity in the children of poor, well-to-do or middle class families is in similar rate at the turn of the century (20). So the role of prevention, the importance of outer environmental conditions, just like quality and quantity of nutrition and the physical activity – which can be directed by conscious lifestyle – should be stressed. The aim of the study In the present investigation we analysed the physique (morphological physique and constitution) and body composition (relative body fat) of 10-18 years old Budapest girls. To prove the 3
secular growth trend we also estimated the differences in anthropometric data of girls investigated in 1983 and in 2003. Behind the measured and counted anthropometric values the results of the life style questionnaire were also analysed. The questionnaire was connected to the anthropometric investigation in the secondary school girls in 2002-2003. Thus we could get information about their life style, the background of the body dimensions, the degree of activity or hypo-activity and about their nutritional habits. Subjects and methods The subjects were volunteer 10-18 years old healthy girls from Budapest. The tested number of investigated girls in the nine age groups were (n=) 2708. Thus the investigated girls could represent their population in 5%. The investigated girls were selected from primary and secondary schools of different districts (8th, 9th, 13th, 14th, 21st) of Budapest. The secondary school students completed a questionnaire which asked about their free time activity, physical activity, state of health, nutritional habits, and about their information or knowledge about obesity and risk factors. The subjects filled in the form voluntarily. Standard anthropometric field procedures were used (growthtype and somatotype) to establish the physique, body composition and the ratio of relative body fat (7, 6, 17). The following questions were raised: a.) Is there any biological or statistical difference in the body dimensions, growth type, body composition between the samples investigated in 1983 and in 2003. What trends and rate in the secular growth can be observed based on the differences? b.) What is the prevalence of somatothypes, how informative this method is? c.) Has free time activity or passivity, nutritional habits any effects on the body composition of the investigated secondary school girls? Besides all have they any connection with prevalence of obesity or not? 4
The following results were received: a.)
Difference was found in the velocity of growth trend of body height and body mass. The generation differences in body height were proved in every age group. The growth of children, adolescents and post-pubertal children and the effects of environmental conditions of growing came close to the optimum but were not reached. In our opinion the social and economic policy of Hungary in the last 20 years did not help properly the harmonious biological development of children. The most important is to stress the confining factors, just like the hypo-activity of school-children and the consequences of hypo-activity. The respective hypothesis proved to be correct. Significant differences were found in the growth trend of body mass. The girls were generally heavier during the second investigation. The height-related means and standard deviations of body mass indicated that about 30% of the subjects were overweight or obese. The majority of girls were non athletes; usually they took part only in PE lessons. The means and standard deviation of BMI also referred to the nonhealthy body composition. At the second investigation, the start of the peak weight velocity was observed earlier, which might reflect that the hormonal changes (the menarche) might happen earlier. The respective hypothesis proved to be correct. According to Wolanski (21) as a result of decreasing physical activity, the physique and body dimensions have changed, thus it was worth investigating the width of knee and elbow. The differences of age group means after 15 year of age were small. The significantly taller stature did not refer to wider bone diameters in this comparison. In our opinion the outer environmental conditions did not stimulate the width growth of bones as much as earlier. Such a general effect could be the lack of physical activity, after all the linear connection between bone density and regular physical activity is proved (19). 5
The girls investigated in 2003, were more linear by the metric indices than earlier investigated girls in the same age. The more negative values could be the consequences of either the higher stature, or the constant chest dimensions or both. In our opinion the hypo-active life style caused the more linear constitution and the less developed bone widths and chest dimensions. The respective hypothesis proved to be correct. The plastic indices were very similar in the samples, unfortunately the mean bone-muscle development (in spite of the higher stature) was consistently lower at the second investigation than that of those of the girls 20 years ago. The respective hypothesis proved to be correct. b.)
The age group differences of the somatotype in the sample of 2003 did not follow the usual, earlier published trend of non athletic girls (3, 4). The general somatotype direction of 9-18 year-old girls is going from the central to the meso-endomorf direction. In our subjects the meso-endomorf somatotype was characteristic already at the age of 10, consequently their skinfold thicknesses were higher than in published samples. The better than average endomorphy and standard deviations can refer to the fatness of the children, which could be the result of the non healthy life style. The values of the relative body fat were high almost in every age group except for the 18 year-old girls. The greater subcutaneous fat is caused by the difference in energy intake and output. The significant body fat content and the high prevalence of overweight and obese are in the contrast to the generally characteristic leptomorphic body build. The correlation between the relative body fat content and the BMI was evident that the error of the BMI can be better evaluated in case of extremely great or small body fat. The correlation between the two variables was exponential. The positive linear correlation between the relative body fat content and the plastic index was proved in every age group. Thus it can be stated that the subcutaneous body fat could 6
deform the plastic index not only in overweight or obese children. The connection of the greater plastic index and the obesity was already verified earlier (9, 15). Considering these connections the girls investigated in 2003 were ranked among/in the hipoplastic (less developed bone-muscle) group. In this sample the moderate plastics indices were connected with relatively high body fat content. The pattern of the skinfolds localized around the trunk and lower limbs was characteristic for females. The greater subcutaneous fat in trunk with leptomorf body build could be an important risk factor in the cardiovascular diseases. c.)
Time spent on studying has significantly increased, while the time spent on active way of lifestyle has considerable decreased with the time spent on studying. Watching television is the most important activity in general (10), but here it has not been proved. It is true in general, that the time spent on physical recreation has increased, but the relative importance of this activity is small even it this case. As a contrary to the results published earlier (11), more than 50 % of the questioned girls were active out of school as well. The statement in relation to general hypo-activity, formulated in the hypotheses, cannot be maintained on the bases of the questionnaires. The results of consumption of the National Institute for Supply and Nutrition showed similarities with the data of the National Institute for nutrition and for the 1992-1994 periods. (16) Cereals have been pushed to the background, but chocolate and cakes have come to the forefront, while the consumption of vegetables and fruits were adequate. The supply of fast-food restaurants was unambiguously rejected. This result was doubted. The results hinting to the spreading of a healthy diet corresponded to those in the hypotheses. The prevalence of overweight in secondary school girls of Budapest was 25 %; the rate of obese was 3-5 %. It has been stated that they are well-informed about the possible disease as 7
a result of their fatness. They were generally satisfied with their bodies, the majority wanted to lose weight. From among the social factors influencing body composition the right of primogeniture has been proved. Publications of Uvacsek Martina Mészáros J., Szabó T., Lee Chee P., Tatár A., Uvacsek, M. (2001): Testösszetétel és motorikus teljesítmény 12 és 14 éves fiúknál. Magyar Sporttudományi Szemle, 3-4. 34-36. Uvacsek, M., Mészáros, J., Mohácsi, J. (2002): Secular growth trend in Hungarian girls. Studia Kinanthropologica, 3: 107-112. Uvacsek M. (2003): A kövérség és az életmód összefüggése. Magyar Sporttudományi Szemle, 1. 22-25. Uvacsek M., Szmodis, M. (2003): A táplálkozás és a kövérség kapcsolata középiskolás leányoknál. Sportorvosi Szemle, 44. 23. 79-84. Farkas Anna, Zsidegh Miklós, Tatár András, Prókai András, Mészáros Zsófia, Uvacsek Martina, Vajda Ildikó. (2003): Physique and body composition parameters of preadolescents. Revista Portuguesa de Ciencias do Desporto. 3: 36-40. Zsidegh Miklós, Mészáros János, Mohácsi János, Uvacsek Martina, Tatár András, Mészáros Zsófia, Prókai András, Vajda Ildikó. (2003): Growth type and motor performance in obese children. Revista Portuguesa de Ciencias do Desporto. 3: 139-141. Mohácsi János, Uvacsek Martina (2004): A vízi túrázók sportegészségügyi ismeretei, In: Bánhidi Miklós (Szerk.): A vízi és vizek menti turizmus alapjai. Budapesti Gazdasági Fõiskola Kereskedelmi, Vendéglátóipari és Idegenforgalmi Fõiskolai Kar, Budapest 116-120. Abstracts Gábor A., Uvacsek M. (1999): A terhelés alatti hõszabályozás változása a menstruációs ciklus függvényében. A Magyar Testnevelési Egyetem 1998-1999. Tanévi T. D. K. Program és Tartalmi Kivonatok, 25. 8
Uvacsek M., Gábor, A. (2000): A terhelés alatti hõszabályozás vizsgálata a menstruációs ciklus függvényében. Semmelweis Egyetem Testnevelési és Sporttudományi Kar 1999-2000. Tanévi T. D. K. Program és Tartalmi Kivonatok, 22. Uvacsek, M., Gábor, A. (2000): Postexercise Thermoregulation in the Function of Menstrual Cycle. The 14-th International Congress on Sport Sciences for Students-2000, Semmelweis University Faculty of Physical Education and Sport Sciences (TF) Budapest, 37. Uvacsek, M., Mészáros, J., Mohácsi, J. (2002): Secular trend in Hungarian girls aged between 11 and 14 years. XXVII FIMS World Congress of Sports Medicine- Abstracts, Budapest, 98. Frenkl, R., Mészáros, J., Uvacsek, M., Tatár, A. (2002): The comparison of peakexercise cardiorespiratory parameters in obese and non-obese females. 4 th. International Congress of Pathophysiology. Abstracts, Budapest, 260. Uvacsek, M., Mészáros, J., Mohácsi, J. (2002): Secular growth changes in Hungarian girls. Collegium Antropologicum, 13th. Congress of the European Anthropological Assiciation Abstracts, Zagreb, 218-219. M. Uvacsek (2003): Obesity and Lifestyle. XXVI. OTDK Konferencia Testnevelés és Sporttudományi szekció elõadás kivonatok. Gyõr, 78. Frenkl, R., Mészáros, J., Uvacsek M., Zsidegh, M. (2003): The comparison of peak exercise cardiorespiratory parameters in obese and non-obese females. 3rd European Congress of EFSMA, Abstract, Hasselt, 114. Prókai A., Völgyi E., Tatár A., Zsidegh M., Uvacsek M., Mészáros J. (2003): Relatív testzsírtartalom és motorikus teljesítmény. Magyar Sporttud., Szemle, 3. 32. Uvacsek M. (2003): A kövérség és az életmód összefüggései középiskolás leányoknál. Magyar Sporttudományi Szemle, 3. 40. Farkas Anna, Szõts Gábor, Uvacsek Martina (2004): A testalkati mutatók és a csontsûrûség aktivitásfüggõ jellemzõi egyetemista nõkön. Sportorvosi Szemle, 45. 1. 37. 9
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