Decrease of external skeletal robustness (Frame Index) between two cohorts of school children living in Puerto Madryn, Argentina at the beginning of the 21st century

Abstract

Background: It has been shown that modern life style with reduced physical activity can lead to lower bone accumulation. Also a decline trend in external skeletal robustness in children and young adolescents, measured by the Frame Index (FI), seems to have a parallel trend with the increase in overweight and obesity. Based on these findings we estimate that likely, the FI should be changed after a decade in the Argentinean population as well as in others population of the world. Thereby, the aim of the present study was to describe, using the FI, the pattern of external skeletal robustness in school children aged 6-14 years from two cohorts of Argentina (Puerto Madryn, Chubut) and to compare them with the European reference (Czech Republic, Germany, Poland and Russia). Methods: Elbow breadth and height of Puerto Madryn school children were collected in two cross-sectional studies conducted between 2001-2006 (cohort 1 = C1) and 2014-2016 (cohort 2 = C2). Percentiles (P) values, for males and females, from C1 and C2 were calculated combining the LMSmethod and its extension. A t-test has been used to compare, by age and sex, the FI values between the Argentinean cohorts and the European reference (ER). Then, in order to know the percentage of the variation of the percentiles values between cohorts, as well as with ER, percent differences between means (PDM%) were employed. Results: FI from Argentinean cohorts differed significantly from ER. Even more, C2 was not only smaller than ER, but also than C1. In males, C1-C2 showed significant differences at 6-8, 11 and 12 years and in females at all ages. Then, respect to ER each Argentinean cohort showed significant differences in males of C1 at 6, 12-14 years and in females at 6 and 11-14 years; and of C2, in both sexes, from 6 to 14 years. The PDM% values for elbow breadth of male were negative in ER-C1 in all percentiles analyzed; in ER-C2 positive (P3 and P50) and negative (P97) and C1-C2 recorded positive values. In females, elbow breadth showed negative values for ER-C1 (P50 and P97), and positive for the remaining values. Finally, height registered, in both sexes, negative values in ER-C1 (except P97 in females), ER-C2 and C1-C2. Conclusions: After ten years of the first study carried on in Puerto Madryn, school children show a negative trend in the external skeletal robustness. Additionally, the children of both Argentinean cohorts have lower values compared to the European reference, and mainly the actual cohort. This situation would be explained, in part, by the progressive increase over time of overweight and obesity as consequence, among others, of the change in the quantity and/or quality of the food that children have access to and with the physical activity they do at school and outside.

Estimation of percentage of body fat in field studies – a method based on relative elbow breadth (Frame Index) and BMI

“…For example, the 10 th centile of German boys of skeletal robusticity, measured by Frame Index (Frisancho 1990) in 2010, is below the 3 rd centile of a similar cohort measured in 2000 (Rietsch et al 2013a;Scheffler 2010). Similar results were found in Argentina (Navazo et al 2020). In the short period of ten years a tremendous decline in skeletal robustness, independently of ethnicity, age and sex occurred worldwide mainly due to a lack of physical activity (Rietsch et al 2013a).…”

“…Over the last 20 years, a decreasing trend in external skeletal robusticity was observed worldwide e.g., Germany, Russia, and Argentina (Hermanussen et al 2015;Navazo et al 2020;Rietsch et al 2013b;Scheffler and Hermanussen 2014). The phenomenon is independent of sex and age and occurs not only in persons with average values but also in all centiles (Mumm et al 2018;Navazo et al 2020;Rietsch et al 2013b). For example, the 10 th centile of German boys of skeletal robusticity, measured by Frame Index (Frisancho 1990) in 2010, is below the 3 rd centile of a similar cohort measured in 2000 (Rietsch et al 2013a;Scheffler 2010).…”

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

“…Tal como ya se ha mencionado pueden ser aplicados en el monitoreo de la obesidad oculta o también, para evaluar el impacto que tiene en el esqueleto los cambios en los estilos de vida en el rango etario analizado. 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).…”

“…Dado que la información acerca del IRE para poblaciones contemporáneas de nuestro país es escasa (Navazo et al, 2020) y que el incremento de la malnutrición por exceso a nivel nacional ha aumentado notablemente en los últimos años (Encuesta Nacional de Nutrición y Salud, 2007; Ministerio de Salud y Desarrollo Social, 2019) resulta de interés disponer de valores de referencia regional para su evaluación. Por lo tanto, el objetivo del presente trabajo es estimar y describir valores percentilares de referencia del índice de robustez esquelética de niñas y niños de 4 a 14 años, residentes en tres provincias argentinas.…”

Growth during times of fear and emotional stress

“…The relation of the high level of fat accumulation and overweight/obesity with Peer Relationship Scores and its subdomains should be carefully monitored in adolescents. Bárbara Navazo analyzed if the expression of sexual dimorphism in preadolescent and adolescent school children, residents in different neighbourhoods of Puerto Madryn, northeast Patagonian region (Argentina) (Navazo et al, 2020(Navazo et al, , 2019, may be modified by socio-environmental conditions. Weight, height, elbow breadth, and bicipital, tricipital, suprailiac and subscapular skinfolds were measured in 2,731 school children, aged 6 to 14, grouped into two categories: preadolescents and adolescents.…”