External skeletal robustness and adiposity in adolescents of low socioeconomic status: A cross‐sectional analysis of body composition

Abstract

Objectives: External skeletal robustness has been decreasing in children, potentially due to a lack of physical activity and the increased prevalence of obesity. However, whether socioeconomic status (SES) influences external skeletal robustness in adolescents has not yet been examined. Methods: A cross-sectional study was performed to examine 370 Chilean adolescents (16.15 ± 1.01 years old) recruited from distinct educational establishments. Body fat percentage (BF%) was evaluated using Ellis' equations for Hispanic children. Obesity was defined as ≥25 BF% in males and ≥ 30 BF% in females. External skeletal robustness was obtained by measuring the humerus biepicondylar width and height (Frame-Index). SES was obtained through the ESOMAR survey. Results: Females exhibited significantly greater BF% and lower Frame-Index values than males (P < .001). Obese adolescents (by BF%) had greater Frame-Index values than non-obese adolescents (P < .001). Females of medium-high SES had significantly lower BF% and Frame-Index values than females of medium and medium-low SES. BF% had a positive correlation with Frame-Index values in all SES groups studied, except in males of medium-high SES. As SES decreased, the correlation increased in both sexes, but overall, the correlation was greater in females than males. Conclusions: The results of this investigation suggest that obesity increases external skeletal robustness in adolescents. Additionally, lower SES corresponded to higher BF% and Frame-Index values. Therefore, modern conditions that influence the prevalence of obesity in adolescence could be affecting bone health in adolescents, primarily in females of medium-low SES. d Comparisons were performed using the One-way ANOVA test with post-hoc comparison Bonferroni test. e Comparisons were performed using the Kruskal-Wallis test with post-hoc comparison Dunn's test. * P < .05. † ESOMAR survey to determine socioeconomic status was used.

Percentiles de referencia del índice de robustez esquelética humeral de niñas y niños (4-14 años). Un estudio antropométrico transversal en tres provincias argentinas

“…En este sentido, diferentes estudios sobre tendencia secular han informado que el incremento del índice de masa corporal, debido particularmente a la falta de actividad física, promovió la disminución de la robustez ósea de niños y adolescentes en poblaciones de Argentina, Bulgaria, Alemania y Rusia (Navazo et al, 2020;Nikolova et al, 2019;Scheffler y Hermanussen, 2014). Por el contrario, para adolescentes de Chile se comunicó que el incremento de la masa adiposa y la mayor carga para el esqueleto, propiciaron el desarrollo de mayor robustez esquelética (Lizana y Hormazabal-Peralta, 2020).…”

“…El IRE ha sido aplicado en adultos, adolescentes y niños para describir diferencias sexuales y cambios asociados al crecimiento de diferentes poblaciones (Mumm et al, 2018). En las últimas décadas también se ha empleado para evaluar el impacto que tienen en el esqueleto los cambios en los estilos de vida y actividad física (Yeste y Carrascosa, 2015), dando indicios de que, durante el crecimiento, la morfología ósea está siendo fuertemente influenciada por los estilos de vida modernos (Hermanussen et al, 2015) y presenta variaciones según las características locales de cada población (Lizana y Hormazabal-Peralta, 2020;Mumm et al, 2018). En tal sentido, se ha informado que la baja actividad física podría ser un factor que incide en la reducción de la robustez esquelética humeral, el aumento del índice de masa corporal (IMC) y la grasa corporal .…”

Anthropometric parameters to estimate body frame size in children and adolescents: A systematic review

“…Diversity of BFS measurements (at least seven), preference for a certain method (European studies use the Frame index while Latin American studies favor the biacromial and bitrochanteric diameter), and availability of information (only four studies provided the values). Additionally, the skeletal structure growth is affected by biological and environmental factors, so heterogeneity and changes over time are expected within and between populations (Lizana & Hormazabal‐Peralta, 2020; Mumm et al, 2018; Navazo et al, 2020; Öztürk et al, 2017; Scheffler, 2011; Scheffler & Hermanussen, 2014). Therefore, the BFS measurement require to be determined for specific populations.…”

“…Anthropometric and body frame size (BFS) parameters are used to interpret body mass and to evaluate nutritional status. The body mass index (BMI) for age is commonly used for determining underweight, overweight, and obesity (Abarca‐Gómez et al, 2017; Cole & Lobstein, 2012; Williams & Strobino, 2008), but this indicator does not consider body components such as fat percentage, muscle, or bone mass (Lizana & Hormazabal‐Peralta, 2020) and it, does not distinguish fat from muscle mass; consequently, it is possible to have normal weight and still have a high percentage of body fat. This phenomenon is called normal weight obesity associated with metabolic syndrome (Oliveros et al, 2014).…”

“…Therefore, the determination of bone complexion adds information to the BMI optimizing the assessment of nutritional status. (Bemjumea et al, 2002; Lizana & Hormazabal‐Peralta, 2020; Mumm et al, 2021; Musálek et al, 2018).…”