Научная статья на тему 'Current trends in changes of physical development indicators of children and adolescents'

Current trends in changes of physical development indicators of children and adolescents Текст научной статьи по специальности «Науки о здоровье»

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Bulletin of Medical Science
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PHYSICAL DEVELOPMENT / RISK FACTORS / CHILDREN AND ADOLESCENTS / ACCELERATION / DECELERATION / NUTRITIONAL STATUS / OBESITY / NUTRITION

Аннотация научной статьи по наукам о здоровье, автор научной работы — Saldan I.P., Filippova S.P., Zhukova O.V., Shved O.I., Pashkov A.P.

The data of research literature in Russian and English in electronic search systems eLIBRARY, PubMed, international databases Scopus, Web of Science for the period of 2005-2018 are summarized and analyzed concerning the state of physical development of children and adolescents, its determinants and assessment methods in the current context. The following is presented: the age and sex standards of the physical development of children and adolescents should be regional; dependence of physical development indicators on environmental and socio-economic factors affecting the territory of residence; the need for continuous monitoring of the physical development of children and adolescents with a recheck of regional standards taking into account the ongoing processes of acceleration and deceleration.

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Текст научной работы на тему «Current trends in changes of physical development indicators of children and adolescents»

UDC 613.955/.96 doi.org: 10.31684/2541-8475.2019.1(13).13-19

CURRENT TRENDS IN CHANGES OF PHYSICAL DEVELOPMENT INDICATORS OF CHILDREN AND ADOLESCENTS

Altai State Medical University, Barnaul

I.P. Saldan, S.P. Filippova, O.V. Zhukova, O.I. Shved, A.P. Pashkov, N.Yu. Potseluev, K.V. Schulz, A.S. Nagornyak

The data of research literature in Russian and English in electronic search systems eLIBRARY, PubMed, international databases Scopus, Web of Science for the period of 2005-2018 are summarized and analyzed concerning the state of physical development of children and adolescents, its determinants and assessment methods in the current context. The following is presented: the age and sex standards of the physical development of children and adolescents should be regional; dependence of physical development indicators on environmental and socio-economic factors affecting the territory of residence; the need for continuous monitoring of the physical development of children and adolescents with a recheck of regional standards taking into account the ongoing processes of acceleration and deceleration.

Key words: physical development, risk factors, children and adolescents, acceleration, deceleration, nutritional status, obesity, nutrition.

Physical development (PD) assessment is an integral part of the study of the health status of the child population, as it clearly reflects the impact of environmental factors, lifestyle, and educational process on the body [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]. PD includes a set of indicators: somatometric, somatoscopic, and physiometric, among which the most commonly used for the assessment are the following: body length and weight, chest circumference [11, 12, 13, 14].

In this case, the age and sex standards of PD can be only regional. Evidence in favour of this is the research which showed statistically significant differences in schoolchildren body length and weight in five regions of Russia (the cities of Moscow, St. Petersburg, Rostov-on-Don, Arkhangelsk, Omsk). Besides, data on the change of body sizes of schoolchildren in Moscow and the boost of biological development were obtained, which probably indicates the activity of acceleration [1, 6, 9, 15].

All this led to the interest in studying and generalizing the data of research literature on the state of physical development of children and adolescents, factors determining it, and methods of assessment in the current context.

The research objective is to generalize and analyze the data of research literature on the state of physical development of children and adolescents in the current context.

Materials and methods

The study was conducted on the basis of a review of research literature in Russian and English in electronic search systems eLIBRARY, PubMed, international databases Scopus, Web of Science for the period of 2005-2018. The selection of publications was based on key words that reflected the main trends in physical development of children

and adolescents. Works with low citation rate, with a small number of references were excluded from the sample group. Further, studies were selected that examined the relationship between the physical development indicators of children and adolescents and the factors influencing them, so that the nature of identified problems could then be determined (326 works). The publications were checked against the research objective, and the sample group was reduced to 151 papers. The detailed study of the materials resulted in a further reduction to 73 works, which have been included in this review.

Results and discussion

Methods for assessing physical development of children and adolescents include the method of sigmal deviations, Z-score assessment, method of assessment on regional modified scales of regression of body weight on body length, centile method, as well as combined techniques [11, 14]. To collect somatometric data, there are two methods: individualizing and generalizing. In order to obtain regional age and sex standards, comatometric data collected by generalizing method are used [11].

In view of the fact that age and sex standards of physical development can be only regional, studies often use the method of assessment on regional modified scales of regression of body weight on body length [1, 6, 10, 13, 14, 15, 16, 17, 18, 19]. So, to assess the changes in PD of schoolchildren in the city of Kiev for the period of 1996-2008, anthropometric studies were carried out, which included measurement of body weight and length, chest circumference, and assessment according to Ukrainian intergroup assessment tables (regression scales on body length) [17]. At the same time, further study on this issue was carried out in the direction of comparative assessment of

functional systems of the organism of pupils. With that, the study of physiometric indicators of PD of schoolchildren in Kiev and Moscow showed their statistically significant differences, such as, for example, the uneven rate of development of the main functional systems: muscular and respiratory [17, 18].

When studying the dynamics over time of somatometric indicators of 8-16 years old schoolchildren in the city of Gomel for the period from 1925 to 2010-2012, in 2010-2012, the examination (body length and weight, chest circumference) of 8-16 years old schoolchildren was carried out. The data obtained by other researchers in 1925 and 1973 were used to assess the dynamics of studied indicators over time. It is found that city schoolchildren at the beginning of the 21 century are characterized by higher rates of development of indicators in comparison with the peers of 1925 and 1973. Sexual dimorphism during acceleration is manifested by increased body length and weight in boys and asthenization in girls. The indicators of chest circumference of boys and girls surveyed at the beginning of the 21 century are significantly higher compared to their peers of 1925. The overall increase in body length within the studied age range is higher in the surveyed boys and girls compared to the data of 1925 and 1973, and in indicators of body weight and chest circumference - in boys and girls examined in 1973 in comparison with their peers of 1925 and 2010-2012. Schoolchildren in Gomel at the beginning of the 21 century demonstrated the presence of acceleration of development of somatometric indicators compared to the peers of 1925 and 1973 [20].

It is important to take into account the processes of acceleration occurring from one decade to the next and to review the standards of physical development in each region in due time. Recently, both domestic and foreign experts agree that the rate of acceleration is slowing everywhere. The highest peak of acceleration in Russia was observed in the mid-70s of the last century, then (in the 80s) there was a clear tendency to stabilize the process of acceleration of growth and development (stagnation), later on, gradual change of it by deceleration occurred in certain regions and major industrial cities [21].

In the city of St. Petersburg, indicators of PD of 7-17 years old schoolboys were studied, the assessment of the level and harmony of PD was conducted in accordance with the standards of the World Health Organization (WHO) ("WHO Growth Reference 2007"). The asymmetry of body length indicators with a significant representation of tall schoolchildren (1.9-10.9%) was established. The surveyed schoolchildren revealed a high level of disharmony variants of PD caused by overweight and obesity (16.4-38.2%) [22].

As for the factors influencing the PD, the analysis of the influence of the educational process organization in modern schools on the physical development of children and adolescents allowed to identify a number of intraschool environment factors, such as an increase in the study load through the intensification of the educational process, lack of motor activity, psycho-emotional tension, side effects of technical training aids use [23].

In studying the quality of life of children of groups of medical and social risk, it was established that the weight in the majority (65.5%) does not correspond to height and age, insufficient weight was in the largest share of children surveyed (58.8%) [24].

When studying the state of health of the child population in reference to the physiological full value condition of nutrition, it was revealed that insufficient calcium intake to 40% in relation to the age norm is accompanied by lower indicators of body length and weight [25, 26].

When studying the impact of actual nutrition on the health of children, the indicators of PD and nutritional status in general are assessed [2, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36]. In their research, Zh.Yu. Gorelova, M.I. Bakanov et al. [37, 38, 39, 40, 41] presented the results of the use of a specialized product in school meals for the correction of nutritional disorders in schoolchildren (weight normalization, nutritional status) during the educational process. The obtained results confirm laboratory (biochemical studies of free amino acids (AA) spectrum excretion in schoolchildren before and after taking the product) and psychophysiological studies (assessment of emotional state according to the method of HAM) [37, 38, 39, 40, 41].

In the studies, N.P. Setko, E.V. Bulycheva et al. [42] used and analyzed the data on nutritional status, functional state of musculoskeletal, respiratory, central nervous systems as the indicators to assess the effectiveness of implementation of the project for improving school nutrition in the city of Orenburg. As a result, it was found that measures to optimize school meals led to improvement of indicators of the nutritional status and functional condition of pupils [42].

PD indicators informatively reflect the conformity of the diet to the needs of the body: the body mass index (BMI) indicator is more dependent on body weight than on height, and its assessment reveals overweight or obesity. In addition, it is recommended to measure the thickness of skin folds of fat above triceps as an indicator of body fat depot, shoulder circumference [6, 26, 29, 32, 35, 43, 44, 45, 46, 47, 48]. For the correct use of BMI in childhood, WHO recommends to use a special method of assessing physical development of children and adolescents (BMI-for-age 5-19 years) [13, 14, 19, 46, 48, 49, 50, 51].

According to L.Yu. Volkova, O.N. Komarova, I.Ya. Kon' [27], it is established that for mass screening diagnostics of overweight and obesity in the conditions of organized groups, it is expedient to use anthropometric and somatometric methods.

The works on the study of peculiarities of the nutritional status of children in different environmental conditions is of interest. Studies conducted by S.K. Bermagambetova, T.K. Karimova et al. showed that the nutritional status of children has its peculiarities by indicators of physical development, hemoglobin level, serum iron, and ferritin in different ecological regions [52].

At present, the problem of obesity in children is a significant part of the literature on child and adolescent health. In this context, the prevalence of obesity among the child population is of concern to both domestic and foreign experts. According to numerous research, the number of overweight children in Europe increases rapidly and has reached high indicators [2, 27, 44, 50, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67]. In literature, there are indications that almost 60% of adults began obesity in childhood and adolescence [43, 66, 67, 68].

A number of works are devoted to the study of this problem in foreign literature. In Brazil, overweight among children is one of the major public policy issues. However, among children who lived and studied in rural areas, there is a lower prevalence of obesity, and none of the rural children were underweight. The authors note that this may be due to low social and economic conditions and more intense physical activity in their daily lives [69]. According to the national literature, obesity is common in 5.5% of children living in rural areas and in 8.5% of urban children in the Russian Federation [44, 55].

In Turkey, according to a study, the prevalence of obesity among school-aged children was 10.3% and overweight was 22.4%. Among adolescents, the number of obese boys is statistically higher than girls. Among schoolchildren who did not have breakfast, the percentage of obesity was higher than in a group that ate regularly 3 times a day. The prevalence of obesity in adolescents who watch TV for more than 3 hours a day was higher than in the rest [56]. Similar data are presented by domestic authors: the absolute majority of overweight and obese children spend more than 3 hours a day on TV and computer [66].

Doctors of various specialties as the causes of such multi-factor disease as obesity include the role of malnutrition and lifestyle [44, 60, 66, 70, 71, 72, 73]. It is noted that parents of children with overweight are not sufficiently literate in matters of a healthy lifestyle and overestimate physical activity of children, underestimating the caloric content of consumed food [44, 56, 66].

Obesity problems in childhood have led to research on clothing hygiene for obese children

and adolescents. According to studies carried out by I.A. Makhrova, I.N. Ivashchenko, the choice of proportionate clothing corresponding to the basic hygienic principles for these children is limited. The study of the design features of clothing, the analysis of the properties of materials, as well as the lifestyle of such children are relevant [53].

Conclusion

Analysis of literature sources shows, first, the dependence of indicators of physical development of children and adolescents on ecological, social, and economic factors affecting on the territory of residence; second, the need for constant monitoring of PD of the younger generation with a recheck of regional standards every decade taking into account the time trend and the ongoing divergent acceleration and deceleration processes [19].

Thus, due to the fact that in Altai Krai tables (regression scales on body length) on the research data of Professor L.N. Klimenov of 1989 are used to assess physical development of the child population aged from 1 month to 14 years, it seems reasonable to carry out appropriate studies of anthropometric indicators of children and adolescents on the territory of Altai Krai in present.

Conflict of interest. The authors declare that there is no conflict of interest.

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Contacts

Corresponding author: Saldan Igor Petrovich, Doctor of Medical Sciences, Rector, Head of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul.

656038, Barnaul, Lenina Prospekt, 40. Tel.: (3852) 566800. E-mail: rector@agmu.ru

Author information

Filippova Sofia Petrovna, Candidate of Medical Sciences, Associate Professor of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: sofya.filippova@mail.ru

Zhukova Olga Viktorovna, Candidate of Medical Sciences, Associate Professor of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: oov-@mail.com

Zhved Olga Ivanovna, Lecturer of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: siboshv@gmail.com

Pashkov Artem Petrovich, Candidate of Medical Sciences, Associate Professor of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: pashkart@mail.ru

Potseluev Nikolai Yurievich, Candidate of Medical Sciences, Associate Professor of the Department of Hygiene, Fundamentals of Ecology and Health and Safety, Altai State Medical University, Barnaul. 656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566835. E-mail: pocelueff@gmail.com

Shults Ksenia Viktorovna, Lecturer of the

Department of Hygiene, Fundamentals of Ecology

and Health and Safety, Altai State Medical

University, Barnaul.

656038, Barnaul, per. Nekrasova, 65.

Tel.: (3852) 566835.

E-mail: ksu994@mail.ru

Nagornyak Aleksei Sergeevich, Lecturer of

the Department of Hygiene, Fundamentals of

Ecology and Health and Safety, Altai State Medical

University, Barnaul.

656038, Barnaul, per. Nekrasova, 65.

Tel.: (3852) 566835.

E-mail: tezaurismosis@gmail.com

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