Menarcheal Age, Nutritional Status and of Adolescent Girls of Salboni Block of West Medinipur, West Bengal, India

 

Kan Kana De¹,  Kaushik Sankar Bose²

¹Research Scholar,  Vidyasagar University, Medinipur, West Bengal

²Professor, Department of Anthropology, Vidyasagar University, Medinipur, West Bengal

 

 

ABSTRACT:

Age at menarche is a significant indicator of growth and sexual maturation in girls. During adolescence, anthropometry provides a tool for monitoring and evaluating the hormone-mediated changes in growth and reproductive maturation, Menarche is defined as the first menstrual period. It is considered to be the most obvious sign of puberty in girls. It has been regarded in many cultures as a transitional step to womanhood.

 

This is a cross sectional study which is done on 1009 school girls were who belong  to Salboni block of district Paschim Medinipur of WestBengal, India.To study effect of nutrition on age at Menarche,  different anthropometric measurements are applied. The study had  been done on 10-19 Adolescents school girls(1009). For this study different types of anthropometric measurements were taken like Weight, Height. Height is measured through Anthropometric rod, by weighing machine. Triceps and biceps Skinfold are taken by skinfold Caliper skin folds are measured. Structured questionnaires were followed to know details socio-economic status. Height was measured to the nearest 0.1 cm and weight to the nearest 0.5 kg. Each subject was weighed with minimum clothing and no footwear. Among studied sample 896 girls had experienced menarche , Their mean age at menarche is 11.88 years(1.23).To compare anthropometric variable premenarchel and postmenarcheal girls that  mean anthropometric measurement of premenarcheal girls more higher than post menarcheal girls in studied girls  minimum age at menarche is  9 years and maximum age at menarche is 17 ye Body mass Index increased progressively from 13 years to 19 years of age where overall increase was (1.89 kg/m²) from 10 to 19 years which is statistically  significant  with age (F=17.3,P<0.001), Percent body fat is statistically significant with Age(F=38.7,P<0.001).ars. Nutritional status are better  in Postmenarcheal girls than Premenarcheal girls, The study represents typical differential rates of positive change in different body composition measures after the attainment of menarche.

 

 

INTRODUCTION:

During Adolescence, growth and nutritional status are heavily influenced by the sexual maturation process, and thus cannot be accurately assessed without knowledge of the degree of sexual maturation (Sizonenko and Himes 1993). up to 37% of total bone mass .(Key and Key, 1994). Nutrition influences growth and development throughout infancy, childhood and adolescence; It is, however, during the period of adolescence that nutrient needs are the greatest (Lifshitz, Tarim and Smith, 1993).

 

Menarcheal age is the most widely used indicator of sexual maturation and can be used as an indicator of female health growth and development, and the capacity to reproduce. Onset of maturation and age at menarche, are influenced by several factors, e.g. genetics, ethnicity, height, weight, body mass index (BMI), and socioeconomic circumstances. Several studies from various developed countries worldwide have shown a systematic decrease in median age at menarche in the past 160 years.( Rees M (1993, Redriks AM, van Buuren S, Burgmeijer RJ, Meulmeester JF, Beuker RJ (2000), Demerath EW, Towne B, Chumlea WC, Sun SS, Czerwinski SA, et al. (2004)  Parent AS, Teilmann G, Juul A, Skakkebaek NE, Toppari J & Bourguignon, 2003).

 

Anthropometrics can be sensitive indicators of health, growth and development in infants and children. In particular anthropometry has been used during adolescence in many contexts related to nutritional status (WHO1985, 2002 Bose and Mukhopadhay2004). Malnutrition which refers to an impairment of health from a deficiency or imbalance of nutrients is of public health significance among adolescents all over the world.

In USA the mean age at menarche decreased from 14> years prior to  1900 (Wyshak and Frisch 1982) to <12.5 years present (Chumlea et al 2003).due to the improvement in the health care over the past century,Age at menarche in Europe, North America and other developed countries has shown a general downward trend(Tanner 1966,1973).

 

A study on family composition and menarcheal age was conducted by Matchock and Susan (2006).Data were collected on menarcheal age and family composition from a college population. The mean menarcheal age for total sample was 12.79.Absence of biological father, The presence of half and step brothers and living in an urban environment were associated with earlier menarche. Body weight and race were also associated with menarche.

 

The average weight, height and BMI were found to be 54 kg and 161 cm, BMI respectively. (Several studies have proven that girls with higher body mass index reach their menarche earlier .However, in a Publication of the USDA Centre for Nutrition Policy and Promotion

March 2000, this study revealed that, variations in BMI within the normal range of 18.5-24 are not consistent with the age attained at menarche. It seems that childhood obesity may influence the menarche age, however whether food intake or age attained at menarche.

 

MATERIALS AND METHOD:

Subject:

The study area of Salboni Block which is 25 km away from  Medinipur town. Subjects are 10-19 years adolescent girl The study were done on  1009 girls. .

For this study different types of anthropometric measurements were taken like Weight, Height, Chest Circumference, Waist Circumference Hip Circumference etc. Height is measured through Anthropometric rod, by weighing machine. Weight is taken by skinfold Caliper skin folds are measured. Structured questionnaires were followed to know details of socio-economic status. Height was measured to the nearest 0.1 cm and weight to the nearest 0.5 kg. Each subject was weighed with minimum clothing and no footwear.

 

Statistical analysis:

Data were entered in Microsoft excel 2007 and was analysed using SPSS 19.0. Descriptive statistics and chi square test were used wherever required, to test statistical significance. Statistical significance was set at p <0.05.

 

Objectives of study:

i)                 To study mean age at Menarche of studied population.

ii)               To study effect nutritional status on age at menarche.

 

Result:

This present study shows as age wise variation   in  different anthropometric variablefrom10-19 years age which is  adolescence period i.e. growing stage and entering into puberty, That girls experience  menarche in this Period, This study indicate that high Body Mass index girls experience early menarche. Body fat from skinfolds gives a more direct estimate of body fat mass (Heitmann 1990) especially more so on Children and adolescents (Deurenburge et al 1990) and may be used in field studies (Heitmann 1990).

 

Among   study 85.2 % are menarcheal girls and this study shows that girls experience highest menarche at age of 12 years, 16.3 % girls suffer from  CED I,This study shows 4.1 % girls belongs to CEDIII.

 

The overall means, standard deviations of Height and weight of the adolescent girls were 150.01 cm (4.81) and 44.06kg (5.70) respectively. Among all circumferential measurements mean Hip Circumference is highest 84.85 cm (6.57) and Among skin folds Triceps skinfold is 8.98 mm (2.03) According to table 4.2 mean height increases (7.54) cm progressively from 10 years to 19 years, 8.76 kg weight increases from 10 to 19 years.

 

Overall data estimation:

 

 

In this cross-sectional study it is shown girls with earlier onset of menarche had higher body mass and body fat mass than the other girls prior to menarche, or whether these differences were constituted partially or completely after menarche. Table 1 Shows general characteristics and menarcheal information of studied sample i.e. mean age at menarche 11.88(±1.23), Table2 represents at age 308 girls experience Menarche in between (12-12.9) years. In this study, 5.87 % of Percent Body Fat is increasing from 10 years to 19 years. As Body mass Index increased progressively from 13 years to 19 years of age, but overall increase was (1.89 kg/m²) from 10 to 19 years in age wise change in Mean BMI (kg/m²) represent In Table 3.Age wise comparison of Premenarcheal and Postmenarcheal Anthropometric characters is shown which present that Postmenarcheal girls significantly higher anthropometric, Correlation of mean age at menarche with Fat Mass,Fat Free Mass, Percent body fat represent in table 5 which represent those (Fat mass, fat free mass, Percent Body fat) have positive but weak relation with Mean age at menarche and statistically significant.

 

 

 

Table-1. (General Characteristics and Menarcheal information of studied sample)

 

Table 2 Age wise Frequency Age at Menarche

Age range	Frequency	Percentage	Cumulative Percentage
9-9.9	12	1.3	1.3
10-10.9	129	14.4	15.7
11-11.9	220	24.6	40.3
12-12.9	308	34.4	74.7
13-13.9	153	17.1	91.7
14-14.9	51	5.7	97.4
15-15.9	16	1.8	99.2
16-16.9	5	.6	99.8
17-17.9	2	.2	100.0
Total	896	100.0

 

 

Table 3: Anova table show age wise increase Anthropometric variables of Adolescent

 

 

 

 

 

 

 

Table: 4 Age wise Comparison of Postmenarcheal and Premenarcheal of anthropometric variable

 

Table 5: Correlations between Mean age at Menarche (years), Fat Mass(kg), Fat free Mass(kg), Percent body fat

		Mean Age at Menarche (years)	Fat Mass(kg)	Fat Free Mass (kg)	Percent body fat
Mean Age at Menarche(years)	Pearson Correlation	1	.239**	.048	.231**
	Sig. (2-tailed)		.000	.150	.000
	N	896	896	896	896
Fat Mass(kg)	Pearson Correlation	.239**	1	.537**	.807**
	Sig. (2-tailed)	.000		.000	.000
	N	896	1009	1009	1009
Fat Free Mass(kg)	Pearson Correlation	.048	.537**	1	-.051
	Sig. (2-tailed)	.150	.000		.105
	N	896	1009	1009	1009
Percent body fat	Pearson Correlation	.231**	.807**	-.051	1
	Sig. (2-tailed)	.000	.000	.105
	N	896	1009	1009	1009
**. Correlation is significant at the 0.01 level (2-tailed).

 

 

 

Figure1:

 

 

Figure :2

 

 

 

Figure :3

 

 

 

DISCUSSION:

At present it is observed that age wise mean value of anthropometric measures are increasing which shows growth spurt in Adolescence period. After age 13 year BMI (kg/m²) steadily increases with Mean age at Menarche which is influenced by Body Mass index.

As Body mass Index increased progressively from 13 years to 19 years of age, but overall increase was (1.89 kg/m²) from 10 to 19 years in age wise change in Mean BMI (kg/m²), Figure (1-3) represents comparisons between Adolescent girls of Assam and rural adolescent girls of Salboni WestBengal which show at age of 13-19 years mean weight Height coincide each other.

CONCLUSION:

·          The mean menarcheal age (determined by retrospectives method) of the studied sample was 11.88(1.23)This study shows sexual maturation in early Adolescence period in Eastern India girls and present study sample experience their early menarche compare to rest Indian. In global perspective the age at menarche in this study is less than most African and Asian studies but closer to most European and North American countries.

·          Percent body fat is increasing with age, it has weak but positive correlation with mean age at Menarche, FM has   strong positive correlation with percent body fat, and BMI has strong positive correlation between Fat Mass and Fat Free Mass.

 

ACKNOWLEDGEMENT:

At first I thankfully acknowledge to authorities of the Department of Anthropology, Vidyasagar University for providing me indispensable amentities,i convey my deep sense gratitude and earnest thanks to my Supervisor Prof Kaushik Sankar Bose for his pleasant guidance and careful assistance I thankfully acknowledge to clients of Anwesha Clinic for open handed support and cooperation during field Survey. I also express my loving thankfulness to all Adolescent girls who participated in research survey,

 

REFERENCES :

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3.     Brabin L, Brabin BJ 1992. The cost of successful adolescent growth and development in girls in relation to in relation to iron and vitamin A status. Am J ClinNutr 55:955-958.

4.     De Onis M, Habicht JP 1996. Anthropometric reference data for international use: recommendations from WHO Expert Committee. Am J ClinNutr. 64:650-658.

5.     Giuseppina D 2000. Nutrition in Adolescence. Pediatrics in Review 21(1):32-33.

6.     Haboubi J, Rizwana B 2009. A Comparision of the Nutritional status of adolescents from the selected schools of south India and UAE: A Cross-sectional study. Indian J Com Med. 34(2):108-111.

7.     Kalhan M, Vashisht B, Kumar V, Sharma S 2010. Nutritional status of adolescent girls of rural Haryana. Internet J Epidemiol 8(1).

8.     Kanade AM, Joshi SB, Rao S 1999. Undernutrition and adolescent growth among rural Indian boys. Indian Pediatrics, 36:145-156.

 

 

 

 

Received on 26.06.2016       Modified on 22.07.2016

Accepted on 08.08.2016      © A&V Publication all right reserved