ABSTRACT
The relationship between anthropometry, body composition and reproductive
characteristics in women has been a subject of interest currently for biological
anthropologists. The study investigates the relationship between anthropometry,
body composition and menstrual characteristics of women from Kaduna and Rivers
State of Nigeria. Participants were non pregnant women randomly selected from four
(4) tertiary schools: Kaduna (n=387) and Rivers (n=401). Data was analysed using
Sigma Stat version. Data obtained showed that limb circumferences of Kaduna females
are significantly higher than Rivers females (p<0.05) except for the thigh
circumference. While, weight, height, iliac and tricep skinfold of Rivers state women
was significantly higher than Kaduna females (p<0.05). Muscle mass, percentage body
fat, basal metabolic rate and metabolic age of Rivers women was significantly higher
than that of their Kaduna counterparts at a significant level of p< 0.05. This study
showed the incidence of underweight, normal weight, overweight and obesity as (38)
9.8%, (249) 64.3%, (78) 20.2%, and (22) 5.7% respectively for women from Kaduna;
(40) 10%, (253) 63.1%, (80) 20% and (28) 7.0% respectively for women from Rivers.
Results also showed that age had a significant association with BMI (River: χ2=38.585,
p=0.000; Kaduna: χ2=19.323, p=0.023). This study also demonstrates that the frequency
of underweight and normal weight women from Rivers and Kaduna decreases beyond
20 to 23 years, while obesity was maximum within 24-26 years for both states,
overweight was maximum within 23-26 years. Waist circumference (WC) showed the
strongest significant (p < 0.05) partial correlation with BMI and PBF (0.83 and 0.83,
respectively). Hip circumference (HC) was also found to be significantly correlated
with BMI (r = 0.72; p < 0.001) and PBF (r = 0.86; p < 0.001). This study showed that
body weight, BMI, biceps and iliac skinfold correlated positive with all body
composition parameters except for total body water and physique rating which showed
negative correlation. The study showed that the mean age at menarche was higher in
Rivers women than Kaduna women, but no significant difference. The minimum and
maximum menarcheal age for this study was ten (10) and nineteen (19) years
respectively. Results showed that, 311 (80.4%) of Kaduna females and 288 (71.8%) of
Rivers females experienced regular menstrual cycle; 245 (63.3%) of Kaduna females
and 324 (80.8%) of Rivers females experienced a menstrual flow duration of four to six
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days. Study participants experienced at least one PMS (Kaduna: 387; 100%; Rivers:
366; 91.3%) and SDM (Kaduna: 367; 95.1%; Rivers 397; 99%); comparison of PMS
and SDM between subjects from the two states showed significant difference (χ2=
35.348, p=0.000 and χ2= 10.637 and p=0.001, respectively). This study showed the
incidence of minimal, mild, moderate, and severe depression as 257 (66.4 %), 76 (19.6
%), 39 (10.1 %), 15 (3.9 %) respectively for women from Kaduna; 270 (67.3 %), 86
(21.4 %), 35 (8.7 %), 10 (2.5 %) respectively. Generally, Rivers women presented
higher anthropometric variables and body composition but a lower arm, forearm, and
calf circumference than their counterparts from Kaduna state. In Kaduna women,
weight can be used to predict all body composition parameters except bone mass, BMI
can be used to predict all body composition parameters except bone mass and physique
rating, sum of skinfold can also be used to predict body composition parameters except
for bone mass, muscle mass and Basal metabolic rate (BMR). In Rivers women, weight
can be used to predict body composition parameters, BMI can also be used to predict
body composition parameters except for total body water, sum of skinfold can also be
used to predict body composition parameters except for bone mass. In women from
Kaduna, there was significant association between calf, chest and waist circumference
with DS. Percentage body fat also showed association with DS. In Rivers women, there
was no significant association between anthropometric parameters and body
composition parameters with DS.
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TABLE OF CONTENTS
Title Page————————————————————————————– i
Declaration———————————————————————————- ii
Certification———————————————————————————- iii
Dedication———————————————————————————- iv
Acknowledgements————————————————————————– v
Table of Contents————————————————————————— viii
List of Figures——————————————————————————– xii
List of Tables——————————————————————————– xiv
List of Appendices————————————————————————– xvii
List of abbreviation ——————————————————————— xviii
Abstract————————————————————————————– xix
CHAPTER ONE
1.0 Introduction————————————————————————— 1
1.1 Background of study——————————————————————- 1
1.2 Statement of the Problem —————————————————– 4
1.3 Aims and Objectives——————————————————————- 5
1.3.1 Aim of study————————————————————————— 5
1.3.2 Objective of study——————————————————————– 5
1.4 Study Hypothesis——————————————————————— 6
1.5 Definition of Terms ———————————————————— 6
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CHAPTER TWO
2.0 Literature Review——————————————————————— 7
2.1 Body height ———————————————————————— 7
2.1.1 Body height, body weight , and
Age at Menarche—————————————————————— 9
2.2 Body Mass Index——————————————————————— 12
2.2.1 BMI and Body fat percentage—————————————————— 14
2.2.2 BMI, Total body fat, Waist hip ratio and
Waist circumference————————————————————– 15
2.2.3 Body Mass Index and Menstrual Cycle——————————————- 16
2.2.4 Body Mass Index, Weight and Depression————————————— 16
2.3 Waist Hip Ratio————————————————————————- 20
2.3.1 Waist Hip Ratio, Waist Circumference, Hip
Circumference and Thigh Circumference———————————– 22
2.3.2 Waist Hip Ratio, Waist Circumference, Hip Circumference,
Thigh Circumference and Depression——————————————– 23
2.4 Gluteofemoral Adiposity and Age of
Menarche ———————————————- 24
2.5 Skinfold —————————————————————————— 26
2.6 Body Composition—————————————————————- 27
2.6.1 Bone mass————————————————————————— 28
2.6.2 Basal metabolic rate—————————————————————– 31
2.6.3 Muscle mass————————————————————————– 32
2.7 Age at Menarche——————————————————————– 34
2.7.1 Age at menarche and BMI —————————————————– 38
2.7.2 Age at menarche and menstrual cycle——————————————– 39
2.8 Menstrual Cycle———————————————————– ——– 40
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2.8.1 Menstrual cycle, Premenstrual syndrome
and menstrual pain—————————————————————– 44
2.9 Dysmenorrhea ———————————————————————— 44
2.9.1 Menstrual pain and menstrual flow————————————————- 45
2.10 Effect of premenstrual syndrome on the daily
activities of females—————————————————————— 46
2.11 Premenstrual syndrome and depression————————————— 48
CHAPTER THREE
3.0 Materials and Methods ————————————————————— 50
3.1 Materials —————————————————————————- 50
3.1.1 Measuring Tape ————————————————————— 51
3.1.2 Body composition monitor—————————————————- 51
3.1.3 Stadiometer ——————————————————————- 51
3.1.4 Skin fold calliper ————————————————————— 51
3.1.5 Becks depression inventory ————————————————— 52
3.2 Methods ————————————————————————- 52
3.2.1 Sampling Technique ———————————————————- 52
3.3 Data collection ——————————————————– 53
3.4 Study location ————— ———————————————- 54
3.4.1 Geographical location of study population———————————— 54
3.4.2 Climatic condition——————————————————————- 54
3.4.3 Vegetation—————————————————————————- 55
3.5 Inclusion Criteria and Exclusion Criteria————————————– 58
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3.5.1. Inclusion criteria——————————————————————- 58
3.5.2. Exclusion criteria——————————————————————- 58
3.6 Ethical Approval —————————————————————- 58
3.7 Statistical Analysis——————————————————————- 59
CHAPTER FOUR
4.0 Results——————————————————————————- 60
4.1 Descriptive Statistics of Study Population————————————- 60
4.2 Comparison between variables Studied ————————————– 62
4.2.1 Comparison of anthropometric variables ————————————— 62
4.2.2 Body composition parameters—————————————————– 62
4.3 Relationships between Studied variables—————————————- 78
4.3.1 Relationship between anthropometric variables and
depression categories during menstruation ———————————— 78
4.3.2 Body composition and depression categories during menstruation ———83
4.4 Correlation between variables Studied—————————————— 86
4.4.1 Correlation between anthropometric variable and body
composition (Kaduna women) ————————————————– 86
4.4.2 Correlation between anthropometric variable and body
composition (Rivers women) —————————————————- 89
4.4.3 Linear regression of height and weight from body
composition parameters———————————————————— 92
4.4.4 Linear regression showing the central adiposity measure that
better predicts percentage body fat (%BF) ———————————- 92
4.4.5 Linear regression showing the central adiposity measure that
better predicts percentage body fat (%BF) ——————————— 92
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4.5 Association with body mass index————————————————- 96
4.5.1 Association between Body Mass Index (BMI) and Age———————– 96
4.5.2 Association between BMI and depression during menstruation————– 96
4.6 Descriptive statistics of reproductive
characteristics————————————————————————- 99
4.7 Comparison between menstrual
characteristics ———————————————————————— 102
4.8 Comparison between premenstrual
syndrome and menstrual symptoms——————————————— 107
4.9 Association between anthropometry and
menstrual characteristics —————————————————— 112
4.9.1 Age and menstrual characteristics ——————————————— 112
4.9.2 Association between Anthropometric parameters and
regularity of menstruation——————————————————— 115
4.9.3 Association between body composition parameters
and regularity of menstruation ————————————————— 115
4.9.4 Association between Anthropometry and duration of flow ——————- 120
4.9.5 Association between anthropometry and dysmenorrhoea ———————- 120
4.10 Association between Anthropometric variables
and Parental education———————————————————- 125
CHAPTER FIVE
5.0 Discussions——————————————————————————- 130
5.1 Description statistics of study population—————————————- 130
5.2 Relationships between anthropometric variables, body composition
and depression categories during menstruation —————————– 135
5.3 Correlation between Anthropometric variable and body
composition ———————– ———————————————— 137
5.4 Description of Reproductive characteristics ———————————– 141
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CHAPTER ONE
INTRODUCTION
1.1 Background of the study
Anthropometry is the measurement of humans for the purposes of identification and
understanding human physical variation. Anthropometry is a simple reliable method for
quantifying body size and proportions by measuring body length, width, circumference
and skinfold thickness (Wang et al., 2000). Pheasant, (1996) suggested that the
variations of body dimensions of different groups can be observed in terms of overall
body size and bodily proportions. The mean anthropometric dimensions, for example
stature and sitting height, are the most typical distinctions among ethnic groups.
Another significant ethnic difference lies in the ratios of body dimensions, i.e. bodily
proportions (Liu et al., 2004). The bodily proportion is a scaling relation calculated with
a ratio of one body dimension to a specific reference dimension. The most common
reference dimension is mean stature (Roebuck et al., 1975). Changes in life styles,
nutrition and ethnic composition of populations has also been shown to cause changes
in distribution of body dimensions (Adebisi, 2008).
Body height has also been used as a societal level indicator of the standard of living.
Living conditions during the growing year‘s especially in early child hood influence
body height through their impact on net nutrition (Silventoinen, 2003; Steckel, 2009).
Genetic factors are most important when explaining these geographic differences in
height (Holden and Mace, 1999). Variation in the heritability estimates of body height
was larger between the study populations in women compared to men.
2
Researchers have shown that anthropometric characteristics are closely related to
reproductive characteristics and body composition (Lassek and Gaulin, 2006).
Anthropometric characteristics predict higher productive success in women (Danborno
and Oyibo, 2008), high waist hip ratio has been associated with decreased fertility and
menstrual irregularities (Zaadstra et al., 1993; Wass et al., 1997). Female
anthropometry reveals that, adiposity has a strong influence on female reproductive
characteristics marked by age of menarche (Lassek and Gaulin, 2006). The age at
menarche is investigated for several reasons because it is one of the major indices of a
female‘s fertility (Kazem et al., 2005). The age at menarche is widely varied in different
populations and is delayed especially in populations with poor nutrition (Thomas et al.,
2001; Gluckman and Hanson, 2006).
A woman‘s first menstruation is termed menarche and it is an important maturity
indicator used to assess the developmental status of a pubertal female (Cameron and
Nadgdee, 1996; Blondell et al., 1999). It has been established that, menarche is
influenced by factors such as socioeconomic class, sports and genetic factors (Diegton
et al., 1993). The age at menarche seems to be decreasing in industrialized countries
(Chodick et al., 2005). Before 1900, the average age at menarche in the United States
was greater than 14 years (Drife and Magowan, 2004). This has been attributed to
improvements in socioeconomic conditions, nutrition and general health (Drife and
Magowan, 2004; Chodick et al, 2005). However, the average age at menarche has not
changed during the last 20 to 30 years in the United Kingdom and is now 12.9 years
(Whincup et al., 2001). Early menarche (before 12 years) is a risk factor for breast
cancer (Hirshaut, 2000) and is associated with a risk of obesity in postmenopausal
women with breast cancer (Wasserman et al., 2004).
3
Higher gluteofemoral adiposity has been associated with lower menarche age (Fredriks
et al., 2005; Lassek et al., 2006). Female anthropometry reveals that, adiposity has
shown a strong influence on female reproductive characteristics marked by age at
menarche (Lassek and Gaulin, 2006). This was the basis for the hypothesis proposed by
Frisch and McAuthor, (1974) that a female need to store a critical amount of fat to reach
menarche, even though the theory generally failed (Lassek and Gaulin, 2006). It is now
thought that the distribution of fats towards the gluteofemoral region tend to be more
plausible (Fredriks, 2005; Lassek and Gaulin, 2006). Achieving a critical weight was
necessary for timing of menses and that increases in childhood body weight over time
may explain the secular decline in menarche (Frisch and Revelle, 1997).
Menstruation may be associated with various symptoms occurring before or during
menstrual flow. A significant number of females complained of dysmenorrhea, and this
was more common among older girls with longer bleeding periods (Franco et al., 2012).
Female experiencing premenstrual syndrome (PMS) have depression symptoms and
PMS has been linked to depressive disorders (Hallman, 1986). Sleep disturbances also
form important component of PMS. Common sleep related complaints in patients with
PMS include: insomnia, hypersonmia, fatigue, nightmares, lethargy and inability to
concentrate.
A relationship has also been shown between early menarche and increasing severity of
painful menstruation, and pregnancies at a younger age (Repke, 1989; Balbi et al.,
2000). Ryan et al., (1999) reported that the mean age of menarche was 12.7 years in the
United States; Whincup et al. (2001) also reported that the average menarche age of a
4
1982–86 birth cohort in England and Scotland was 12.9 years. In another study the
mean age of menarche among 338 sporting women was 13.8 years (Malina et al., 1994).
1.2 Statement of the problem
Anthropometric study among the different geographical locations in Nigeria
particularly Rivers and Kaduna is inadequate, hence, statistical data showing variations
or similarities that exist between anthropometric variables, body composition
parameters and reproductive characteristics of women from Kaduna and Rivers States to
the best of our knowledge is not in existence.
Menstrual disorders like delayed menarche, premenstrual syndrome, irregular menstrual
cycles and dysmenorrhoea create a great anxiety among women and their families.
These disorders are a major source of gynaecological problems among women. Hence,
the need to study the variation in menstrual pattern and its disorders among women
from Kaduna and Rivers States.
Information on the menstrual pattern of Kaduna and Rivers States women will aid in
clinical evaluation of gynaecological problems. The results of the present study will
demonstrate if differences actually exist between the measured anthropometric
parameters of women from Kaduna and Rivers States. This knowledge will enable
anthropologists, biomedical scientists and clinicians to access the influence of
environment and genetics on the anthropometry, body composition and reproductive
characteristics of women from Rivers and Kaduna states of Nigeria.
5
The results of this study will also show the relationships between anthropometric
parameters and menstrual characteristics of Rivers State and Kaduna State, which could
be relevant in appreciating the reproductive status of the study population. This study
would provide a reference data for the anthropometric, menstrual characteristics and
prevalence of premenstrual syndrome of different geographical location especially
Kaduna and Rivers States of Nigeria.
1.3 Aim and objectives of the study
1.3.1 Aim of the Study
The aim of the study is to investigate the relationship between anthropometric
parameters, body composition and menstrual characteristics of women from Kaduna
and Rivers States of Nigeria
1.3.2 Objective of the Study
The objectives of the study are to:
i. investigate the anthropometric indices, body composition parameters
and menstrual characteristics of women from Kaduna and Rivers States
women.
ii. investigate the relationship between anthropometric and menstrual
characteristics of women from Kaduna and Rivers States women.
iii. compare the prevalence of depression between women from Kaduna and
Rivers States during their menstruation.
iv. investigate the effect of menstrual pain on the daily activities of women
from Kaduna and Rivers States.
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1.4 Study hypothesis (alternate)
There will be differences in the anthropometric indices, body composition parameters
and reproductive characteristics of women from Kaduna and Rivers States due to
genetics and environmental factors.
1.5 Definition of Terms
i. Basal metabolic rate: Amount of energy expended while at rest in a neutrally
temperate environment. Also known as the amount of calories required to
keep the body functioning at rest.
ii. Body fat percentage: Body fat percentage is the amount of body fat as a
proportion of body weight.
iii. Body Mass Index: An index that expresses adult weight in relation to height,
it is calculated as weight in kilograms divided by height in meter square.
iv. Bone Mass: This feature indicates the amount of bone (bone mineral level,
calcium or other minerals) in the body.
v. Metabolic age: Indicates the age at which the body is currently working. It‘s
a reflection of physical health form of a calculation based on basal metabolic
rate.
vi. Muscle mass: Weight of muscle in the body. This includes the skeletal and
smooth muscles, the water in the muscles.
vii. Physique rating: This is the ratio of body fat to muscle mass. It changes
with the level of physical activity.
viii. Total Body Water Percentage: Body Water Percentage is the total amount
of fluid in the body expressed as a percentage of the total weight.
ix. Visceral Fat: Visceral fat is the fat that is in the internal abdominal cavity,
surrounding the vital organs in the trunk (abdominal) area.
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