Prevalence and severity of malnutrition and age at menarche; cross-sectional studies in adolescent schoolgirls in western Kenya

Abstract

Objective: Nutritional status is an important marker of overall health and linear growth retardation has serious long-term physiological and economic consequences. Approximately 35 and 29% of preschool children in sub-Saharan Africa are stunted and underweight, respectively. There is relatively little information available about the nutritional status in adolescents, the age group with the highest growth velocity after infancy. We conducted a series of cross-sectional surveys to determine the prevalence and main risk groups for malnutrition and to describe the associations between age, sexual maturation and nutritional status in adolescent schoolgirls in western Kenya. Design: Three cross-sectional surveys; one in Mumias, using random sampling in all schools, and two surveys in Asembo, using a multi-stage random sample design. Setting: Public primary schools in two different rural malaria endemic areas in western Kenya with high levels of malnutrition in preschool children. Subjects: In all, 928 randomly selected adolescent schoolgirls aged 12-18 y. Results: Overall prevalence of stunting and thinness was 12.1 and 15.6%, respectively. Of the total, 2% were severely stunted. Menarche and start of puberty were delayed by approximately 1.5-2 y compared to a US reference population. The prevalence of stunting and thinness decreased with age and mean height for age z-scores converged towards the median of the US reference curve. Girls who had not yet started menstruating were more likely to be stunted than the girls of the same age who were post-menarche. Conclusions: Stunting and thinness are common in young adolescent schoolgirls in these poor rural settings in western Kenya, but the prevalence decreases with age, providing observational support that children catch up on incomplete growth attained earlier in life due to a maturational delay of 1.5-2 y allowing prolonged growth.

Nutritional Status of Adolescent Girls from Rural Communities of Tigray, Northern Ethiopia

“…While these achievements are encouraging, sustainable results are not expected if the nutritional status of adolescent girls is neglected. Regardless of the scientific reports of high rates of adolescent undernutrition from the developing world (6,(19)(20)(21)(22)(23)(24), adolescents have been considered low risk groups for health and nutrition. This has further been complicated by the absence of local reference data and difficulty of interpreting anthropometric data in this age group.…”

Associação entre déficit de crescimento e retardo maturacional de crianças e adolescentes infectados

“…O déficit de crescimento físico associou-se ao atraso da puberdade (0R=4,01; IC95%1, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]8). Esta associação pode ser explicada pelo impacto negativo que a desnutrição exerce sobre a produção de hormônios associados ao crescimento e sobre a produção dos hormônios sexuais.…”

“…É relatado, na literatura científica, que a puberdade -marcada pelo estirão de crescimento, aumento rápido das secreções de diversos hormônios e aparecimento dos caracteres sexuais secundários -em crianças cujo crescimento físico linear encontra-se comprometido, pode não ocorrer no tempo fisiológico esperado 5 . Admite-se que o atraso na instalação da puberdade esteja associado ao acúmulo insuficiente de reserva adiposa em fases anteriores da vida e à deficiência de micronutrientes -especialmente zinco, cobre e ferro -envolvidos no crescimento e desenvolvimento na infância bem como à carga de morbidade em especial decorrente da presença das parasitoses 5 . Baseado na hipótese de que o adiamento do aparecimento das primeiras características sexuais secundárias possa ser influenciado pelo estado antropométrico, desenvolveu-se o presente estudo.…”

“…Diferenças estas que se perpetuaram ao longo dos estágios maturacionais subseqüentes (Tabela 3). Esses dados corroboram o que é relatado na literatura em que se tem evidenciado, de modo geral, que a maturação sexual se inicia um ano mais cedo, no sexo feminino, quando comparada ao masculino 5 .…”

The monthly rhythm of incidence and age at menarche: thirty five years of research: The circa-vacation-study expectancy rhythm of incidence and age at menarche

“…We confi rm our proposition that this is not a seasonal circa-annual rhythm, but a circa-[vacation (fi esta)]-[study (non-fi esta)] expectancies rhythm that is a systematic periodicity repeated year after year, caused by socio-cultural events with deep signifi cance for girls. The decay of the age at menarche from 5.5 to 8.4 months between December and February, in the four samples (and in the sample from USA, but without published values) is an extraordinary biotic process; this decay shows that the cultural-expectancy of important events for girls is a factor comparable to deep under nutrition (Leenstra et al, 2005), highly competitive physical training (Vadocz et al, 2002) or near 50 years in the secular trend of menarche age (Nakamura et al, 1986;Vecek et al, 2012;Woronkowicz et al 2012).…”