Anthropometry and Dietary Assessment of Males and Females Students at Mu'tah University
Y.A. Abdullah Al-Rewashdeh
M. Hanee Al-Dmoor
The aim of this study was to survey the body measurements and dietary intake of university students. One hundred seventy eight students (96 males and 82 females) aged 20.4 to 22.6 years at Faculty of Agriculture/Mu'tah University were participated in the study. The nutrition status of students was assessed by using anthropometry and dietary methods and compared with available references. Males and females had means of weight (kg): 59.6±2.1 and 55.8±2.4 and of height (m): 1.67±0.08 and 1.61±0.07. Males and females had circumferences (cm) of arm: 28.6±1.2 and 25.3±0.8; of waist (W): 86.1±2.6 and 72.8±3.1 and of hip (H): 85.8±1.2 and 90.4±2.8. Males had significantly lower triceps, total skin folds and percent of total body fat than the females. Arm muscle circumference, arm area and arm muscle area were higher, whereas arm fat area was lower in males than in females. Males consumed higher energy (2208±85 kcal day-1) and protein (43.1±4.3 g day-1) than females (2035±93 kcal day-1 and 39.2±3.5 g day-1). The Relative Energy Contribution (REC) of carbohydrates, total fat, saturated fat and monounsaturated fat in diets of males and females was higher, whereas the REC of polyunsaturated fat and protein were lower than the recommended. Males and females received lower vitamins (except E), macro minerals (except sodium) and micro minerals (except iron in males) than the recommended.
Adequate nutrition is the right proportion of food nutrients needed for growth,
energy and maintenance. Improved nutrition status plays an important role in
the well being of individuals and critical for socioeconomic development (Nemati
et al., 2008). Malnutrition is a pathological state resulting from
a deficiency or wrong proportion of essential nutrients. Malnutrition has serious
implications for people and communities thus hindering the socioeconomic and
human development of a nation as one of the most critical health issues because
of its long lasting negative effects (Muller and Krawinkel,
2005; Akinyemi and Ibraheem, 2009; Khattak
and Khan, 2009). Nutrition assessment is the system of determining conditions
of nutritional health of a person, or a group of persons. Nutrition status is
assessed in different ways include anthropometrics, dietary intakes, biochemical
and clinical methods. All these methods can be applied to assess of nutritional
status of individuals or groups.
Nowadays, anthropometric measurements are regarded as important indicators
of an individuals nutritional status. The term anthropometric refers to
comparative measurements of the body. Anthropometric measurements are used in
nutritional assessments. The most commonly used anthropometric measurements
to assess the nutritional status for adults are height, weight, Body Mass Index
(BMI), waist-to-hip ratio, body protein store and percentage of body fat. These
measures are then compared to reference standards to assess the risk for various
diseases (Abu-Samak et al., 2008; Latiffah
and Hanachi, 2008). Malnutrition, either undernutrition or overnutrition
gives rise to detrimental alterations of body composition. Anthropometry is
a convenient and reliable technique whereby changes in the status of nutrition
can be evaluated easily. Many methods have been developed for the dietary assessment
of individuals The 24 h dietary recall method is a widely used approach to collect
dietary information because it is simple, impose little burden to the respondents
and do not require high literacy in respondents (Marjan
et al., 1999).
Based on a combination of nutrition and health indicators and risk factors,
the countries of the East Mediterranean Region of the World Health Organization
were divided into four categories (RCEM, 2007). Jordan
came in the second category, which include moderate levels of overweight/obesity
co-exist with moderate levels of undernutrition in specific population pockets
and age groups alongside widespread micronutrient deficiencies. In Jordan, the
expansion in all dimensions is tremendous and it is more so in the field of
education. It has been observed that the university students are at the risk
of specific nutrients deficiencies and they develop faulty food habits (Khattak
et al., 2002; Khattak and Khan, 2009). These
faulty food habits have been explained to be associated with low nutrients densities
of foods consumption and may result in higher or lower intakes of nutrients.
Therefore, the purpose of this study was attempted to evaluate the nutritional
status of university students.
MATERIALS AND METHODS
Subjects: The study was designed to provide information on anthropometry, body composition and nutrients intakes of students and carried out between February 2007 and June 2008. One hundred seventy eight (96 male, 82 female) students enrolled in human nutrition courses and ranging in age from 20.4 to 22.6 years at Faculty of Agriculture/Mu'tah University were participated in the study. All subjects had normal health status, took no drugs other than mild analgesics, free from known metabolic disorders and had no abnormalalities of urinary pH, protein, or glucose. At the beginning, the students received instructions in practice part of nutritional status assessment course about writing their health and nutritional status data and about keeping three days food records.
Anthropometry: The following measurements were recorded to each student:
Body weight was measured without shoes and in light clothing by using common
health balance to the nearest 0.1 kg. Height was measured to the bare footed
standing subjects to the nearest of 0.5 cm by using an ordinary measuring tape.
Body Mass Index (BMI) was calculated as weight (kg)/height (m2) and
categorized according to Ferro-Luzzi et al. (1992).
Body builds (frame size) was determined by the method of Bray
(1978). Arm circumference was measured on the left arm using a no stretchable
tape placed firmly round the mid hanging freely arm. Waist circumference was
measured at half way between umbilicus and xiphoid and reading was taken at
the end of expiration. Hip circumference was measured at the level of the great
trochanters. Skinfolds thickness (triceps, biceps, subscapular, supraeriliac)
were measured on the left side of the body to the nearest 0.5 mm with a calibrated
medical caliper. Percentage of total body fat (TBF %) was calculated by the
equation of Siri (1956) as follows:
where, D is the density which equal to 1.1610-(0.0632X) for males and 1.1581-(0.0720X)
for females, X is the log of sum of skinfold thickness at four mentioned sites
(Durnin and Womersley, 1974). Total body fat (kg) was
obtained by multiplying TBF% by body weight and dividing by 100. Lean Body Mass
(LBM) was calculated by subtracting TBF (kg) from body weight. Arm Muscle Circumference
(AMC), Arm Area (AA), Arm Muscle Area (AMA) and Arm Fat Area (AFA) were measured
according to Frisancho (1981, 1984).
AMA and AFA references were Frisancho (1990).
Energy and dietary intakes: It was obtained from repeated 24 h diet
recall. The students recorded their food intake for three consecutive days,
two weeks days (Monday and Wednesday) and one week end day (Friday). The average
daily intakes of energy, carbohydrates, proteins, total fats, Saturated Fatty
Acids (SFA), Monounsaturated Fatty Acids (MUFA), Polyunsaturated Fatty Acids
(PUFA), cholesterol, fiber, vitamins (A, D, E, C, thiamine, riboflavin, niacin,
pyridoxine, pantothenic, biotin, folate, B12) and minerals (calcium,
potassium, phosphorus, sodium, iron, iodine) were determined (Pellett
and Shadarevian, 1970; Poul and Southgate, 1978).
Energy intake was calculated by multiplying the daily eaten carbohydrates, protein
and fat (g) by 4, 4 and 9, respectively. Nutrients intakes were compared with
Dietary References Intake (DRI, 1998) values (Food
and Nutrition Board, 1997, 2000; Institute
of Medicine, 1998, 2002). Requirements of energy and
protein were calculated on the base of DRI and on the base of: 40 kcal kg-1
b.wt. for males and females and 0.9 g protein kg-1 b.wt. of males
and 0.8 protein kg-1 b.wt. of females (ADA, 1996).
Weights used in the present study were actual weight, ideal weight (Jelliffe,
1966) and weight/ height and weight/age (Frisancho, 1990).
Statistical analysis was performed using Systat 8.0 (SPSS Inc., Chicago, IL,
USA) to compute the means and Standard Deviations (SD). Student t-test was done
in two directions at a significance level of 0.05 and any difference between
two means was considered statistically significant if p value <0.05.
The means of weight, height, BMI of males and females are shown in Table 1. Males had significantly higher means of weight (59.6 kg) and height (1.67 m) than the females (55.8 kg and 1.61 m). Data show that the males had no significant lower BMI (21.4) than the females (21.7). However, both sexes had less weight than the ideal weight. It is -15.8 for males and -14.5 for females.
of weight (kg), height (m) and body mass index (BMI, kg m-2)
of males and females students
Data are Mean±SD. Different superscripts
for the same parameter are significantly different at p<0.05. Ref reference
weight (Jelliffe, 1966)
Mass Index (BMI) (kg m-2) and body frames (Height(cm)/wrist
circumference (cm)) of males and females students
Data are means±SD. Different superscripts
for the same parameter are significantly different at p<0.05. *: Ferro-Luzzi
et al. (1992). **: Height (cm)/wrist circumference (cm), Bray
Data in Table 2 show the categories of BMI and body frame sizes of participants. It showed that the percents of underweight and overweight of males (5.2 and 4.2) are significantly lower than those of females (7.3 and 4.9). Table 2 also shows that the males had significantly higher percent of small and large (5.2 each) body size than the females (3.7 each).
The results show that the circumferences (cm) of arm (28.6) and waist (W) (86.1) of males were significantly higher than those of females (25.3 and 72.8); whereas hip (H) circumference of males was significantly lower than that of females (Table 3). Males had higher W/H ratio (1.0) than that of females (0.8). Males had significantly lower skin folds (38.3 mm) and TBF (16.5%) than the females (47.3 mm and 26.8%). On the contrary, males had significantly higher percent of LBM (83.5%) than the females (73.2%). Table 3 also shows that the AMC, AA and AMA were significantly higher in males than in females, whereas AFA was vice versa. However, both sexes had lower AMA and AFA than the recommended for matched age. This shortfall in AMA was higher in males (-17.6%) than in females (-4.8%). On the contrary, the shortage in AFA was higher in females (-34.9%) than in males (-20.7%).
measurements, body composition and nutritional status indicators of males
and females students
Data are Mean±SD. Different superscripts
for the same parameter are significantly different at p<0.05. *: references
(Frisancho, 1990) TBF: Total body fat. LBM: Lean
body mass. AMC, AA, AMA and AFA are arm muscle circumference, arm area,
arm muscle area (bone-free) and arm fat area, respectively
The energy (Kcal) and protein (g) requirements for males and females are shown
in Table 4. Males received significantly higher energy (2208)
and protein (43.1) than the females (2035 and 39.2). However, both sexes consumed
less energy and protein than recommended. The deficiency in calculated energy
was -19.4% for males and -14.1% for females and in protein was -27.3 and -16.6%
for males and females, respectively.
and protein requirements of males and females based on Dietary Reference
Intake (DRI) * and calculation**
Data are Mean±SD. Different superscripts
for the same parameter are significantly different at p<0.05. *: Institute
of Medicine (2002). **: Calculated on the base of actual body weight
(59.6 kg for males and 55.8 kg for females)
intake and their relative energy contribution (REC %) in diets of males
and females students
Data are means±SD. Different superscripts
for the same parameter are significantly different at p<0.05. A: actual.
*: HWCN (1990) recommendation . SFA, MUFA and PUFA
are saturated, mono unsaturated and poly unsaturated fatty acids
fiber and micronutrients intakes of males and females students
Data are Mean±SD. Different superscripts
for the same parameter are significantly different at p<0.05. Intake
References were for 1: ADA (1996), for 2, 3, 4 and
5: FNB (1997, 2000) and for 6: NRC (1989)
Data in Table 5 show that males had higher intake of carbohydrates,
total fats and protein than the females. The relative energy contribution REC%
of carbohydrates, total fat, Saturated Fatty Acids (SFA) and Monounsaturated
Fatty Acids (MUF) in diets of students were more than the recommended. On the
contrary, the REC% of Polyunsaturated Fatty Acids (PUF) and protein were less
than the recommended.
Males and females received lower cholesterol, fiber, vitamins (except E) and minerals (except sodium in both and iron in males) than the recommended (Table 6). The deficiency of vitamins intake was ranged from -7.7% for B6 to -32.2% for vitamin C in males diet and from -12.7% for riboflavin to -38.0% for pantothenic acid in females diet. Inadequate intake was also observed in dietary macro and micro-minerals. The deficit of macro-minerals intake was ranged from -15.4 and -13.9% for phosphorous to -31.4 and -27.3% for calcium in diets of males and females, respectively. Males and females consumed inadequate dietary iodine (-29.3% of males and -32.0% of females). With regard to iron consumption, data showed that males received more (+78.8%) whereas females received less (-22.1%) than the recommended.
Using weight, height and BMI indices, the males and females of this study were
shorter and thinner than the standard (Table 1). Males had
higher body weight and height than the females. This may be due to that the
males could be continued faster grow than the females (Patricia-Ogechi
et al., 2007). Low dietary intake (Table 5) supported
these results and similar trends were noted by Nwokoro-Smart
et al. (2006) and Patricia-Ogechi et al.
(2007). Results in Table 1 and 2 showed
that 90.6% of males and 87.8% of females had normal weight. These results correspond
to light thinness on the BMI reference data (Ijarotimi et
al., 2003) and did not reflect an obese group of university students.
Current results were in accordance with results obtained by Nwokoro-Smart
et al. (2006). However, BMI results are in disagreements with findings
of Al-Assaf and Al-Numair (2007), that they mentioned
the prevalence of obesity in Saudi adults, that may be due to the differences
in life style and incomes between the participants. W/H ratio is generally dependent
on age and sometimes on BMI. In general, subjects with a high W/H ratio are
fatter compared with subjects with a low W/H ratio and probably have gained
more weight in adult life. High W/H ratio is associated with intra-abdominal
fat which highly lipolytic and drains into the portal vein. Increased concentrations
of free fatty acids may be one of the factors leading to hyperinsulinemia, hypertriglyceridemia
and reduced high density lipoprotein-cholesterol levels (Patricia-Ogechi
et al., 2007). In general, low W/H and body fat measurements indicate
to thinness of present studied subjects.
Regarding the body fat and fat free mass, four skin folds were measured. Data
in Table 3 show that males had lower arm skin folds than the
females. Males had higher LBM and lower TBF than females. This may be due to
the fact that males build more muscle mass, larger skeleton and deposit less
fat than females (Heald and Gong, 1999). On the contrary,
the higher TBF in females may be attributed to their tend to lay down more subcutaneous
fat layer than males during the growth spurt at puberty (Patricia-Ogechi
et al., 2007). Current results (Table 1, 2)
showed that the BMI was strongly correlated with TBF and LBM and confirmed findings
of Onimawo et al. (2004) and Patricia-Ogechi
et al. (2007), that the BMI and TBF are better predictors of obesity
than body weight alone, as well as suitable measure of adiposity.
Measurements of muscle and fat areas provide information on total body and
regional muscle and fat mass. Muscle area measurement is a good indication of
LBM and protein reserve. This is important in evaluating the possible protein-energy
malnutrition. Fat area measurement is a reflection of subcutaneous fat and used
to provide information on the amount and rate of change in body energy stores
(Frisancho, 1990). In present study the AMA and AFA were
used as indices for protein and fat stores, respectively. Results in Table
3 show that the males had higher AMA and lower AFA than females. This may
be attributed to male who tend to build more muscle mass and deposit less fat
than females (Osisanya et al., 2002; Patricia-Ogechi
et al., 2007). Studied students had lower AMA and AFA compared with
the references (Frisancho, 1990). Males at higher risk
of protein store and lower risk of fat store than females. From the presented
results in Table 4, it could be noticed that all students
have had lower intake of energy and protein than the recommended. Males consumed
lower energy (75.1%) and protein (72%) than the females (85.9 and 83.3%). These
results are in agreement with findings of Khattak et al.
(2002). The REC% of protein in diets of participants was less than the recommended
(about 8%). This could be attributed to their low protein intake and reflected
in high contribution of fat and carbohydrates in energy intake. These inadequacies
of protein intake and high intake of carbohydrates and fat of all students could
be due to their lifestyle or irregular in their meals (Tamim
et al., 2004).
Concerning the students received low dietary cholesterol and fiber on the base
of ADA (1996) recommendations. The results showed that
the males consumed lower cholesterol and higher fiber than the females. These
differences between both sexes may be due to high intake of eggs and milk which
raised the female's cholesterol intake and to the low intake of bread (bran)
by females which resulted in low fiber intake compared with males. Males received
lower vitamin A, D while both sexes received higher vitamin E compared to the
recommended. This may be due to high male intake of liver and meats. Males consumed
(6.3 mg) vitamin C over that of females, but they met lower (67.6%) than the
females (72.5%) of this vitamin requirements. This could be attributed to the
higher recommended number for males (90 mg) than that of females (75 mg) (Food
and Nutrition Board, 2000). Males received more thiamin, B6,
folate, B12, biotin and pantothenic acid than the females from the
recommended. On the contrary, males consumed lower riboflavin and niacin than
the females from the recommended. It is concluded that males consumed more bread,
liver and meats and lower milk and its products and oil than females. These
reflected in high intake of some vitamins (thiamin, niacin, B6, folic
acid, B12, biotin and pantothenic acid) whereas low intake of riboflavin
and vitamin E compared with those intakes of females (Food
and Nutrition Board, 2000).
Results indicated that males and females consumed inadequate macro and micro minerals than the recommended (except sodium for both sexes and iron for males). Males received lower calcium and phosphorous than the females from the recommended (FNB, 1997). On the contrary, males consumed higher iron and iodine than the females from the requirements. The results showed that the food items and variety were reflected in analysis of student's diet. Female students consumed more milk and dairy products, fruits, chocolate and cola beverages than males which resulted in high intake of calcium, potassium and phosphorous. Meanwhile, males received higher meat, fish (especially canned fish, sardines and tuna) than the females which reflected in their high intake of iron and iodine. Both sexes received higher sodium. However, sodium intake was within the safe level (1100-3000 mg day-1).
If mentioned requirements for vitamins and minerals were fit on the current
study participants, data imply that the students of this study at risk of development
of deficiency diseases. However, the comparison of current results with others
is impossible as a result of lack dietary or biochemical assessment data as
mentioned by Al-Assaf and Al-Numair (2007).
In conclusion, the nutritional status and macro and micro-nutrients intake of university students is poor. The low anthropometric values obtained from this study suggest that there is need for improvement in the nutritional status of these students.
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