|Year : 2017 | Volume
| Issue : 2 | Page : 137-146
Gender-and age-related differences in anthropometric and body composition parameters in Nigerians, Zaria, Nigeria
Shakirat Yetunde Amoo-Tella1, Barnabas S Danborno1, Shehu Akuyam2, Samuel S Adebisi1
1 Department of Human Anatomy, Faculty of Medicine, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
2 Department of Chemical Pathology, Faculty of Medicine, Ahmadu Bello University, Zaria, Kaduna State, Nigeria
|Date of Web Publication||4-Jun-2018|
Dr. Shakirat Yetunde Amoo-Tella
Department of Human Anatomy, Faculty of Medicine, Ahmadu Bello University, P. M. B 1045, Samaru, Zaria, Kaduna State
Source of Support: None, Conflict of Interest: None
BACKGROUND: Body composition refers to the constituent of the body, namely, lean mass, fat mass, and water. It serves as a great diagnostic value and a sensitive indicator of an individual's health and nutritional status.
AIM: The aim of the study is to determine the age-related difference in anthropometric and body composition parameters in indigenes of Zaria, Kaduna State, Nigeria.
MATERIALS AND METHODS: A total of 1200 participants, 578 males and 622 females, between ages of 7–60 years were selected randomly to participate in the study. The participants were divided into three age groups based on their ages; children (7–12 years), adolescents (13–17 years), and adults (18–60 years). Weight, height, body mass index, waist circumference, hip circumference, abdominal circumference, upper arm circumference, % body fat, triceps and iliac skinfold thicknesses were measured in all participants.
RESULTS: All the anthropometric parameters measured increased significantly across the three age groups and in both males and females across the three age groups. Some of the anthropometric parameters showed significant difference in both sexes in the children, adolescents and adults age group. Percentage body fat also increases across the three age groups and in both sexes in each age group. All the parameters were significantly higher in the females than in the males.
CONCLUSION: Age and gender brings about significant differences in anthropometric and body composition parameters in individuals.
Keywords: Anthropometry, body circumference, body composition, lean and fat mass body mass index, skinfold thickness
|How to cite this article:|
Amoo-Tella SY, Danborno BS, Akuyam S, Adebisi SS. Gender-and age-related differences in anthropometric and body composition parameters in Nigerians, Zaria, Nigeria. J Exp Clin Anat 2017;16:137-46
|How to cite this URL:|
Amoo-Tella SY, Danborno BS, Akuyam S, Adebisi SS. Gender-and age-related differences in anthropometric and body composition parameters in Nigerians, Zaria, Nigeria. J Exp Clin Anat [serial online] 2017 [cited 2018 Sep 26];16:137-46. Available from: http://www.jecajournal.org/text.asp?2017/16/2/137/233680
| Introduction|| |
The term anthropometry refers to measurements that are used to completely describe the human form. Along with the dimensions of the human form (stature, breadth, and length), anthropometry also describes the mass of the human form (weight, center of gravity) and the parameters of human strength and motion (Jacobs 2008). It is the branch of the human sciences dealing with measurements of the size, weight, and proportions of the human body to achieve comfort, fit, and usability (Hanson et al. 2009).
Anthropometrists have reported several universal factors that seem to influence human size and shape: gender, ethnicity, age, and occupation (Pheasant 1998). The recent increase in obesity in the population (Ogden et al. 2006), in particular, will affect the circumferential land breadth measurements of the population. It is well documented that sex, age, race, and occupation, among others are sources of variation in anthropometry (Huchingson 1981).
The measurement of human body composition is important in metabolic, nutritional, and epidemiological research and several methods for body composition assessment are now available (Lukaski 1987; 7 Pichard et al. 2000). Significant changes in body composition occur over a lifetime. Progressive increases in body fat (BF) and decreases in fat-free mass (FFM) during adulthood have been noted (Kyle et al. 2001). Excess adiposity, increased body fatness, percentage of BF (%BF), and depletion of FFM or muscle mass are associated with certain chronic diseases, such as cardiovascular disease (Lee et al. 1999) and respiratory insufficiency (Engen et al. 1999), respectively. In adults, over and undernutrition contribute to increased mortality and morbidity. In the elderly, the age-related loss of muscle mass or sarcopenia is prevalent and strongly associated with impaired mobility, increased morbidity and mortality, and lower quality of life (Baumgartner et al. 1998; Melton et al. 1999; Janssen et al. 2002; Adebisi 2013).
Obesity and malnutrition are conditions that have been shown to increase morbidity and mortality in adult and children, respectively. It is well documented that body fatness is associated with risk factors for cardiovascular diseases (especially left ventricular hypertrophy) and hypertension (Hammer et al. 1991). Worldwide, the prevalence of overweight and obesity among children and adolescents has shown a remarkable increase not only in developed but also in Sub-Saharan African countries. In view of this, this work is aimed at analyzing anthropometric and body composition parameters in gender and participants of different age groups in Zaria, Nigeria.
| Materials and Methods|| |
The study was conducted in Zaria. Zaria is a major city in Kaduna State in Northern Nigeria, as well as being a Local Government Area. Formerly known as Zazzau, it was one of the original seven Hausa City-States.
The study was carried out among Nigerians residing in Zaria, Kaduna State, Nigeria. The number of participants that participated in this study is 1200. This include children between the ages of 7–12 years (394 participants out of which 189 are males and 205 are females), adolescents between the ages 13–17 years (331 participants out of which 142 are male and 189 are female) and adults between 18 and 60 years (475 participants out of which 247 are males and 228 are females). The participants were selected using simple random sampling. After a detailed explanation on the objectives of the study, informed consent was obtained from all the participants and questionnaires were given to them and the anthropometric and body composition parameters were taken and filled into the questionnaires accordingly. The children group was assisted in filling of the questionnaires. People with obvious acute or chronic diseases, apparent water and electrolytes imbalances (for example, edema), skin diseases, abnormal body geometry (amputation and limb atrophy), pregnant women, and participants that decline to give consent for inclusion were excluded from the study.
The following parameters were measured in all the participants:
Height was measured to the nearest 0.5 cm using vertical scale of a stadiometer (RGZ-160), with the participant in erect position without shoes and head held in the Frankfort plane [Figure 1]. Weight was measured to the nearest 0.1 kg with the weighing scale attached to the stadiometer, with the participant lightly clothed. Body mass index (BMI) was calculated as weight divided by square of height (kg/m 2).
Waist circumference (WC) was measured in centimeters at the narrowest waist (World Health Organization 2008b).
Hip circumference (HC) was measured at the largest posterior extension of the buttocks (World Health Organization 2008b). The abdominal circumference was measured in a horizontal plane around the abdomen at the level of the iliac crest [Figure 2]. The mid-upper arm circumference was measured at the midpoint between the tip of the shoulder and the tip of the elbow, while the left arm was hanging loosely (World Health Organization 2008b) [Figure 3].
|Figure 3: Measurement of mid-upper arm circumference using acute fitness myotape|
Click here to view
All body circumferences were measured to the nearest centimeters with a nonstrectched tape without compressing or pinching the skin.
Triceps iliac skinfold thickness and iliac skinfold thickness (TSFT and ISFT) were measured using skinfold caliper.
The jaw of the caliper was placed perpendicular to the fold of skin in the midpoint between the top of acromial process (top of the shoulder) and the olecranon process of the ulna (Stewart and Esten 1997), while the hand hang loosely by the side, to measure the triceps skinfold. To measure the iliac skinfold, the point above the iliac crest (top of the hip bone) on the most lateral side was noted in the participants (Stewart and Esten 1997). The skinfold on this side was grasped with the thumb and the index finger, anteriorly and downward in line with the natural fold of the skin. The jaws of the caliper were placed perpendicular to the fold and the measurement was taken and recorded.
The body composition parameters were obtained using Tanita BC-532 Total Innerscan Body Composition Monitor, Tanita Corporation, Japan, which uses the principle of bioelectric impedance analysis. The age, gender, and height of the participant were put into the analyzer for each of the participants. Each participant was asked to remove their footwear (if any) and also clean their feet, after which they were instructed to stand with their toes and heels on the footpads of the machine. After a few seconds, the machine automatically generates the %BF in the participants.
Statistical Package for the Social Sciences version 20.0 (IBM Corporation, New York, USA) was used for result analysis and data were expressed as mean ± standard deviation and percentages. The effects of age and sex on anthropometry and body composition were examined using Student's t-test and analysis of variance. Statistical significance was set at P < 0.01 for all tests.
| Results|| |
A total of 1200 participants between the ages of 7 and 60 years participated in the study, 622 (58.1%) were female and 578 (48.2%) were male. The mean age of the study group is 18 ± 10.14. There are 189 males and 205 females are in the children age group, 142 males and 189 females were in the adolescent group, and 247 males and 228 females in the adult group.
There was a significant difference in all the anthropometric parameters between the children, adolescents, and adults as shown in [Table 1], with the values of the parameters increasing as the age group increases. The post hoc test shows the significant difference in weight, height, BMI, upper arm circumference, hip circumference, and WC is across the three age groups, while the difference in TSFT and ISFT was only significant between children (7–13 years) and adolescents (13–17 years).
|Table 1: Comparison of anthropometric parameters in different age groups|
Click here to view
In males, all the anthropometric parameters were found to be significant across the three age groups with the highest values of the parameters in the adults [Table 2]. The post hoc test reveals that the significant difference in weight, height, BMI, upper arm circumference, hip circumference, and WC is between all the three age groups, while the difference in TSFT and ISFT was only significant between children (Group I) and adolescents (Group II).
|Table 2: Comparison of anthropometric parameters among females in different age group|
Click here to view
There was a significant difference in all the anthropometric parameters across the three age groups in the females and the values of these parameters increase from children to adult age groups as shown in [Table 3]. The post hoc test shows the significant difference was across the three age groups.
|Table 3: Comparison of anthropometric parameters in males across each age group|
Click here to view
BMI, triceps, and iliac skinfold were significantly higher in females than males as shown in [Figure 4] and [Figure 5] below.
Females had significantly higher hip and abdominal circumferences than males, while the waist and upper arm circumferences were not significant in both sexes although females had higher values of these parameters [Figure 6].
|Figure 6: Mean difference waist, hip, abdominal, and upper arm circumferences according to gender|
Click here to view
Among the children, males had significantly higher values of waist and abdominal circumference than females while females had significantly higher values of hip circumference, TSFT and ISFT than males as shown in [Table 4] below. Other parameters were not significant in both sexes.
All the anthropometric parameters were significant between both sexes in adolescents except mid-upper arm and abdominal circumferences. Males were also significantly taller than females [Table 5].
In the adult group, weight, BMI, triceps, and iliac skinfold were found to be significant between both sexes with the males having higher weight than females [Table 6].
There were significant differences (P = 0.0001) in %BF in the total study population as shown in [Figure 7]. The post hoc test shows that the significant difference is across all the three age groups.
|Figure 7: Comparison of percentage body fat across the three age groups in total population **P = 0.0001|
Click here to view
In the females, there was a significant difference across the age groups with %BF increasing as the age group [Figure 8] increases while in the male population, there were significant differences (P = 0.0001) across the three age groups with higher %BF in children and adult group when compared to the adolescent group [Figure 9]. The post hoc test reveals that the significant difference was only between age Group I (7–12 years) and Group II (13–17 years).
|Figure 8: Comparison of percentage body fat across the three age groups in females population **P = 0.0001|
Click here to view
|Figure 9: Comparison of percentage body fat in the males population across the three age groups **P = 0.0001|
Click here to view
Comparing the %BF, according to gender in children, adolescents, and adults age groups shows significant differences between the two sexes (P = 0.0001). The females had higher %BF than the males in the three age groups as illustrated in [Figure 10].
|Figure 10: Percentage body fat in children, adolescents, and adult males and females. **P = 0.0001 between males and females in all the categories|
Click here to view
| Discussion|| |
In accordance with the WHO expert consultation (World Health Organization 2004), the prevalence of underweight in adolescent group was 42%, 51.7% of them had normal BMI, 5% were overweight and 1.2% were obese [Figure 11]. The figures for overweight and obesity lies within the range of what was earlier obtained in Nigerian adolescence by Ansa et al.(2001) and Ben-Bassey et al. (2007). They reported the range of 3.4%–9.3% for overweight and 0.2%–5.1% for obesity; however, the figures were lower than 5%–25% reported from Europe and US population by Janssen et al.(2005). In the adults, 11.2% were underweight, 58.1% had normal BMI, 19.6% were overweight, and 11.2% were obese [Figure 12]. The prevalence of underweight and obesity was also lower compared to 63% overweight population and 26% obese population in Americans (Fryar et al. 2012). The differences in these figures could be due to genetic constitution, environmental differences, and lifestyle of the different population.
|Figure 11: BMI categories in adolescent population (percentage). 1.00 – Underweight (BMI <18.5 kg/m2), 2.00 – Normal (BMI between 18.5 kg/m2 and 24.5 kg/m2), 3.00 – Overweight (BMI between 24.5 kg/m2 and 29.5 kg/m2), 4.00 and 5.00 – Mild and moderate obesity (BMI >30 kg/m2). BMI – Body mass index|
Click here to view
|Figure 12: MBMI categories in adult population (percentage). 1.00 – Underweight (BMI <18.5 kg/m2), 2.00 – Normal (BMI between 18.5 kg/m2 and 24.5 kg/m2), 3.00 – Overweight (BMI between 24.5 kg/m2 and 29.5 kg/m2), 4.00 – Mild and moderate obesity (BMI >30 kg/m2). BMI – Body mass index|
Click here to view
In this study, the difference in the anthropometric parameters that is weight, height, BMI, upper arm circumference, hip circumference, WC, ISFT and TSFT, were found to be significant across the three age groups (children, adolescents, and adults) and in gender across the three age groups. The findings were in conformity with studies carried out among adolescents in Kano and among children and adolescents in Southern Nigeria (Atiku and Yunusa 2009; Eneobong et al. 2012). The researchers both reported higher prevalence of overweight among adolescents than children and higher prevalence of thinness among children than adolescents; however, a study conducted in the US (Ogden et al. 2008) to analyze high BMI for age among children and adolescents within 3 years reported no significant changes in the prevalence of BMI for age 3 years.
Sex differences in the children age group show significant difference in waist, hip, and abdominal circumferences, and iliac and triceps skinfold thickness, with males having higher significant WC than females. This in agreement with the study of Zafirova and Todorovska (2009), which reported higher skinfold thickness in females than males. Although, they also reported higher values of anthropometric parameters in males than females in school children of ages 6-7 years in another study carried out by them (Zafirova and Todorovska, 2009). The slight difference in these reports could be as a result of the little variation in the age group of the children in the different researches.
The result of this study on the sex differences in adolescents shows that the males had a significantly higher height than females, while BMI, skinfold thicknesses, waist and hip circumferences were significantly higher in the females than males. This is in conformity with the report among adolescents in Abeokuta in Nigeria (Senbanjo and Oshikoya 2012), in which higher significant differences in BMI and WC were reported in females than males while another report shows no significant difference in the BMI of the adolescents of Enugu state (Odo et al. 2015). In the adult age group of this study, BMI, TSFT and ISFT were higher in females than males, while weight was higher in the males than in females. The results obtained in this study agree with the study by Ogunlade and Adalumo, 2015 that reported higher body weight in males than females among young adults of Nigeria, also with a study that reported higher skinfold thicknesses, waist, hip, and upper arm circumferences among Igbo females than males (Ekezie and Danborno 2008). The result of this study also agrees with what was reported in Italian population (Perrissinotto et al. 2002), in which higher BMI was reported in females than males.
The differences observed in these anthropometric parameters in each of the age group could be due to the fact that growth brings about increase in these parameters in people irrespective of sex and this further emphasizes the use of these parameters as a measure of growth and development in individuals. Furthermore, it can be related to nutritional status, socioeconomic levels, and degree of urbanization or industrialization. Body circumferences have been measured in children for many years, notably the head and mid-upper arm, but the emphasis on their link with BF distribution has arisen only recently (Weststrate et al. 1989). In adults, the most commonly used circumferences for BF distribution have been the waist, hip, and thigh, and the same sites are now being measured in children. These circumferences are used mainly to calculate indices such as the waist–hip or waist–thigh ratio, representing BF distribution (Rolland-Cachera 1993).
Nutritional anthropometric indicators provide a reflection of the nutritional status of the community and hence complement the information obtained by other approaches (Shetty 2001), most importantly, it allows for monitoring and evaluation of hormone-mediated changes in growth and maturation, especially in the adolescent group, and this will provide an opportunity to classify and compare BMI range (that is as underweight, normal, and overweight) in children, adolescents, and adults. Although a standard already exists in adults, such classification is scarce in children and adolescents. Body composition assessment is a useful procedure for the study of nutritional status and water distribution both in pediatric and adult participants (Pietrobelli et al. 2003). On the other hand, BF dispersion is the most accurate method in defining obesity. Obesity is one of the main problems in this century, leading to severe morbidity and mortality. Several studies have shown that 60%–80% of the obese children under the age of 3 years become obese adults if untreated or not treated sufficiently (Moran 1999). Body fatness is associated risk factors for cardiovascular diseases (especially left ventricular hypertrophy) and hypertension (Hammer et al. 1991).
In the present study, there was a significant increase in %BF across the three age groups. The significant difference also reflects in sex across the three age groups and in sex in each of the age group with females having higher percentage of BF. Males also had a significantly higher muscle mass than females in each of the groups. These findings agreed with the report of a study (Kirchengast 2010) conducted to investigate the sex differences in body composition (fat percentage and muscle mass), which shows that in both children, adolescent, and adults, females exhibited a significantly higher amount of BF and lower amount of muscle mass than males (P < 0.001). Furthermore, higher %BF was also noted in females than males in studies by Eneobong et al. (2012) and Owa and Adejuyigbe (2012). Other studies (Faulkner et al. 1993; Nelson et al. 1997; and Mast et al. 1998) also reported significant gender differences in BF and lean body mass. In another study (Ayca et al., 2012) in 86 people comprising of children and adolescents between ages of 7-15 years, statistical significant differences in body composition including fat percentage, fat mass and FFM was found only in boys in the children and adolescent groups but not in girls. A statistical significant differences in body composition including fat percentage, fat mass, and FFM was found only in boys in the children and adolescent groups but not in girls. These results disagree with the findings of the present study.
Among many species, in particular among humans, males and females differ not only in size and shape but also show marked differences in body composition (Kyle et al. 2001). It is well established that adult females surpass males in absolute and relative amount of subcutaneous fat tissue, while males exhibit a quantitative higher amount of fat free body mass including bone and soft tissue lean body mass that is muscle mass throughout adult life (Kyle et al. 2001; Forbes 1987; Malina et al. 1999; Shen et al. 2009).
Sex differences in body composition can be explained by sex-typical secretion of sex hormones (Rosenbaum and Leibel 1999; Gatford et al. 1998) and gender-typical differences in lipid metabolism (Mittendorfer 2005; Magkos and Mittendorfer 2009). The higher amount of muscle mass in males may be interpreted in the same sense as the sexual dimorphism in stature height, as a result of sexual selection. Sex differences in body composition, first of all in BF, seem to reflect gender typical energetic demands of reproductive physiology (Kirchengast 2010). BF, in particular subcutaneous fat of the lower body region, represents an important energy store, which enables the female body to bear the energetic costs of pregnancy and lactation (Frisch 1985; Ellison 1990; Kirchengast and Huber 2001). Since a negative energy balance, low-fat storages, and low weight status have adverse effects on female reproductive success, sex differences in the amount of BF may be interpreted as a result of natural selection (Kirchengast 2010).
| Conclusion|| |
Age and gender are important factors that bring about notable changes in anthropometric and body composition parameters. Females, having found to have higher %BF, should watch out for other factors that may increase this factor as they grow older. Physical activity should also be well emphasized in the female gender as they grow older to avoid complications associated with obesity.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
We thank all those who volunteered to participate in this research.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Adebisi S.S. (2013). Consequence of maternal and child under nutrition in human malnutrition. In: Bose K, editor. Twin Burdens of under Nutrition and over Nutrition. Ch. 8. Nova Publisher, Hauppauge, New York, 143-154.
Ansa V.O., Odigwe C.O., Anah M.I. (2001). Profile of body mass index and obesity in Nigerian children and adolescents. Niger J Med 10 (2):78-80.
Atiku M., Yunusa I. (2009). Body mass index variations among adolescents from Kano metropolis, Nigeria. Bayero J Pure Appl Sci 2 (2):102-4.
Ayça T.E., Turhan O., Kamile M., Hatice S., Banu S., Ahmet Ö. (2012). Comparison of body composition parameters in children and adolescents, using skinfold and bioelectrical impedance methods. Turk J Pediatr6 (3):133-8.
Baumgartner R.N., Koehler K.M., Gallagher R.D. (1998). Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147:755.
Ben-Bassey U.P., Oduwole A.O., Ogundipe O.O. (2007). Prevalence of overweight and obesity in Eti- Osa LGA Lagos, Nigeria. Obest Rev 8 (6):475-9.
Ekezie J., Danborno B. (2008). Spousal similarities and differences in physical and cultural traits among Igbo Ethnic group in Nigeria. Internet J Biol Anthropol 1 (2):1-7.
Ellison P.T. (1990). Human ovarian function and reproductive ecology: New hypotheses. Am Anthropol2:933-52.
Eneobong H., Ibeanu V., Onuoha N. (2012). Prevalence of overweight, obesity and thinness among urban school-aged children and adolescents in Southern Nigeria. Cadiovasc Thorac Open 33 (4):242-50.
Engen M.P., Schols A.M., Lamers R.J., Wouters E.F. (1999). Different patterns of chronic tissue wasting among patients with chronic obstructive pulmonary disease. Clin Nutr 18:275-80.
Faulkner R.A., Bailey D.A., Drinkwater D.T., Wilkinson A.A., Houston C.S., McKay H.A. (1993). Regional and total bone mineral content, bone mineral density and total body tissue composition in children 8-16 years of age. Calcif Tiss Int 53:7-11.
Forbes G. (1987). Human Body Composition. Growth, Ageing, Nutrition and Activity. Springer-Verlag, New York.
Frisch R.E. (1985). Fatness, menarche and fertility. Perspect Biol Med 28:611-33.
Fryar C.D., Gu Q., Ogden C.L. (2012). Anthropometric reference data for children and adults: United States, 2007-2010. National center for health statistics. Vital Health Stat 11 (250):1-40.
Gatford K.L., Egan A.R., Clarke I.J., Owens P.C. (1998). Sexual dimorphism of the somatotrophic axis. J Endocrinol157:373-89.
Hammer L.D., Kraemer H.C., Wilson D.M., Ritter P.L., Dornbusch S.M. (1991). Standardized percentile curves of body-mass index for children and adolescents. Am J Dis Child 145:259-63.
Hanson L., Sperling L., Gard G., Ipsen S., Vergara C.O. (2009). Swedish anthropometrics for product and workplace design. Appl Erg 40:797-806.
Huchingson R.D. (1981). New Horizon for Human Factors in Design. McGraw Hill Book Co, New York, 76-85.
Jacobs K., editor. (2008). Ergonomics for Therapists. Mosby Elsevier, United States.
Janssen I., Heymsfield S.B., Ross R. (2002). Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 50:889-96.
Janssen I., Katzmarzyk P.T., Boyce W.F., Vereeckan C., Mulvihill C., Roberts C., et al
. (2005). The health behavior in school-aged children obesity working group. Obest Rev 6:123-32.
Kirchengast S. (2010). Gender differences in body composition from childhood to old age: An evolutionary point of view. J Life Sci 2 (1):1-10.
Kirchengast S., Huber J. (2001). Fat distribution in young amenorrheic females. Hum Nat 12:123-40.
Kyle U.G., Genton L., Hans D., Karsegard V.L., Michel J.P., Slosman D.O. (2001). Total body mass, fat mass, fat-free mass and skeletal muscle in older people: Cross sectional differences in 60-year- old persons. J Am Geriatr Soc49:1633-40.
Lee C.D., Blair S.N., Jackson A.S. (1999). Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr 69:373-80.
Lukaski H.C. (1987). Methods for the assessment of human body composition: Traditional and new. Am J Clin Nutr 46:537-56.
Magkos F., Mittendorfer B. (2009). Gender differences in lipid metabolism and the effect of obesity. Obst Gynecol Clin North Am 36:245-65.
Malina R.M., Koziel S., Bielicki T. (1999). Variation in subcutaneous fat distribution associated with age, sex and maturation. Am J Hum Biol 11:189-200.
Mast M., Kortzinger I., Konig E., Muller M.J. (1998). Gender differences in fat mass of 5-7 years old children. Int J Obes 22:878-88.
Melton L.J., Khosla S., Crowson C.S. (1999). Epidemiology of sarcopenia. J Am Geriatr Soc 48:625-30.
Mittendorfer B. (2005). Sexual dimorphism in human lipid metabolism. J Nutr 135:681-6.
Moran R. (1999). Evaluation and treatment of childhood obesity. Am Fam Phys 59 (4):861-8.
Nelson D., Simpson P., Johnson C., Barondess D., Kleerekoper M. (1997). The accumulation of whole body skeletal mass in third and fourth grade children: Effects of age, gender, ethnicity and body composition. Bone 20 (1):73-8.
Odo I.F., Lawrence U.S., Uchendu N. (2015). The relationship among body composition and BMI in a population adolescents in Enugu state, Nigeria. Int J Curr Microbiol Appl Sci4 (1):884-97.
Ogden C.L., Carroll M.D., Curtin L.R., McDowell M.A, Tabak C.J., Flegal K.M. (2006). Prevalence of overweight and obesity in the United State. JAMA 295:1549-55.
Ogden C.L., Carroll M.D., Flegal K.M. (2008). High body mass index for age among US children and adolescents between 2003 and 2006.JAMA 299 (20):2401-5.
Ogunlade O., Adalumo O.A. (2015). Mean values, normal limits and sex differences of anthropometry of young adults in a University community in Nigeria. Am J Clin Exp Med 3 (1):44-7.
Owa J.A., Adejuyigbe O. (2012). Fat mass, fat mass%, BMI and mid upper arm circumference in a healthy population of Nigerian children. J Trop Pediatr 43 (1):13-9.
Perrissinotto E., Pissent C., Sergi G., Grigoletto F., Enzi G. (2002). Anthropometric measurements in the elderly, age and gender differences. Br J Nutr 87 (2):177-86.
Pheasant S. (1998). Body Space:Anthropometry, Ergonomics, and Design,
ed. Taylor andFrancis, Philadelphia.
Pichard C., Kyle U.G., Bracco D., Slosman D.O., Morabia A., Schutz Y. (2000). Reference values of fat free and fat masses by bioelectrical impedance analysis in 3393 healthy subjects. Nutrition 16:245-54.
Pietrobelli A., Andreoli A., Carvelli V., Canbirelli M.G., Peroni D.G., De Lonrenzo A. (2003). Predicting fat free mass in children using bioimpedance analysis. Acta Diabetol 1:212-5.
Rolland-Cachera M.F. (1993). Body composition during adolescence: Methods, limitations and determinants. Horm Res Suppl 39:25-40.
Rosenbaum M., Leibel R.L. (1999). Role of gonadal steroids in the sexual dimorphisms in body composition and circulating concentrations of Leptin. Clin Endocrinol Metab 84:1784-9.
Senbanjo I.O., Oshikoya K.A. (2012). Obesity and blood pressure levels of adolescents in Abeokuta, Nigeria. Cardiovasc J Afr 23 (5):260-4.
Shen W., Punyanita M., Silva A.M., Chen J., Gallagher D., Sardinha L.B., et al
. (2009). Sexual dimorphism of adipose tissue distribution across life span, cross sectional whole body magnetic resonance imaging study. Nutr Metab 6:17-26.
Shetty P. (2001). Measures of Nutritional Status from Anthropometric Survey. Vialle delle Terme di Caracalla, FAO, United Nations.
Stewart A.D., Esten R.G. (1997). Skinfold thickness measurement. Br J Nutr 78:1031-44.
Weststrate J.A., Deurenberg P., Van Tintern H. (1989). Indices of body fat distribution and adiposity in Dutch children from birth to 18 years of age. Int J Obest 13:465-77.
World Health Organization. (2004). Expert consultation. Appropriate body mass index for Asian populations and its implications for policy and intervention strategies. Lancet 363 (9603):157-63.
World Health Organization. (2008b). STEPwise Approach to Surveillance (STEPS). World Health Organization, Geneva, Switzerland.
Zafirova B., Todorovska L. (2009). Anthropometric parameters of growth and nutritional status in children aged 6 to 7 years. Adv Med Sci 54 (2):289-95.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]