Lawson's Project complete

RELATIONSHIP BETWEEN BODY

MASS INDEX (BMI) AND AGE AT

MENARCHE

1

CHAPTER ONE

INTRODUCTION

Body mass index (BMI) has come to be regarded and

accepted as one of the standard tests for identifying the

level of overweight/obesity of an individual by physical

measurements of height and weight, and rightly so

because of a number of reasons chief amongst which is

its ease of measurement and calculation and its

simplicity.

The BMI of an individual is calculated by dividing the

individual’s body weight by the square of his or her

height. It is measured in kg/m2.

BMI= Weight (kg) ÷ Height (m) 2

Considering the fact that BMI calculations involves the

use of numeric values of weight and height, it cannot be

said to be an actual measure of body fat, but Ancel

(1972) found BMI to be the best proxy for body fat

percentage among ratios of weight and height and also

appropriate for population studies. Garrows and Webster

(1985) also believed that BMI had a correlation with

2

amount of body fats and considered it a “simple and

stable way with which to judge obesity”.

BMI seems to be related to other phenomena, for

example cataracts which it was reported to be more

likely to develop in people with a high BMI as observed

by Glyma et al. (1995) and Hiller et al. (1998), another

example is the decrease in BMI following hospitalization

of senile dementia patients as reported by Watanuki et

al. (1991). But of particular interest is the relationship

between BMI and menarche, and in this case BMI

(referring to adiposity) is said to be a criterion for the

occurrence of menarche as suggested by Johnston et al.

(1975), Trussel (1980) reported that a certain amount of

body fat is necessary for menarche, Garrows and

Webster also reported that body fat (which had a

correlation with BMI) was a correlative indicator of

menarche, Frisch (1987) then indicated that the

attainment of sufficient body mass (typically 17% body

fat) is a criterion for the occurrence of menarche and

finally Deborah et al. (2007) showed that girls with BMI

above the median at age 8 demonstrated earlier

3

menarche than those girls with BMI below the median at

this age. Putting this into perspective, it would be

possible to predict an approximate time for the

occurrence of menarche by using BMI as a tool since

considering that BMI can be used as a means of

measuring adiposity which plays a major role in the

occurrence of menarche.

The age of occurrence of menarche has been on a

constant decline over the past century, in the United

States, UK, France, and Greece, there is a decline in age

at a rate of 0.06-0.07 years every 5 years. Olu Oduntan

(1976) gave the median age for menarche in Nigeria as

13.70±0.03 in urban girls, 14.50±0.09 in rural girls and

13.26±0.06 in girls with university educated parents. In

1976, the menarcheal age of girls with university

educated parents, 13.26±0.06 was comparable with the

median age in the United States back then in 1976. The

latest statistics on the median age at menarche in the

United States is 12.5 years (Anderson et al., 2003), in

Nigeria it is given as 12.22±1.19 years in girls from

middle class homes (Ofuya and Zulest, 2008). This

4

decline in age at menarche has also brought along with

it interests in the effect of early puberty in later years of

the girl’s life, Parents et al. (2005) linked early puberty

(menarche) with increased risk of obesity, diabetes and

cancer. Studies have also shown that girls who are

heavier in childhood experience menarche earlier than

their peers, (Cooper, Kuh, Egger et al. 1996, Petridou,

Syrigou, Toupadaki et al. 1996, Sharma et al., 1988),

and at a given age, girls who are menstruating are

heavier and fatter than their counterparts who are not

(Roberts, Wood and Chinn 1986).

Age at menarche can be influenced by a lot of factors,

but for this study we would be analyzing the relationship

BMI and age at menarche. It is easy to understand that

girls with a higher BMI experience menarche earlier than

their peers, but the knowledge of an approximate BMI

necessary for menarche to occur is important to all

parties with an interest in these studies.

5

1.1 BACKGROUND OF STUDY

Menarche is an important landmark in a woman’s

reproductive career, and the effect of BMI on it is well

documented; a Chinese research carried out showed

that Chinese girls with a low body weight gotten from

the BMI results had a lower bone age, delayed breast

and pubic hair development, a lower rate of menarche,

lower distal one-third radius and ulna bone mineral

content (BMC), bone mineral density and bone width (X

Du et al., 2003). They concluded that a BMI<18 is the

cut-off for delayed general growth including menarche.

Trussel (1980) reported that a certain amount of body

fat is necessary for menarche, Garrows and Webster

also reported that body fat (which had a correlation with

BMI) was a correlative indicator of menarche, Frisch

(1987) then indicated that the attainment of sufficient

body mass (typically 17% body fat) is a criterion for the

occurrence of menarche and finally Deborah et al.

(2007) showed that girls with BMI above the median at

age 8 demonstrated earlier menarche than those girls

6

with BMI below the median at this age. The proximate

cause of menarche is an increase in the frequency of the

gonadotropin releasing hormone (GnRH) pulse

generator in the hypoyhalamus, but the age at

menarche varies widely and is delayed in populations

with poor nutrition (Thomas et al., 2001; Gluckman and

Hanson, 2006). Until recently, it was generally accepted

that the timing of menarche was related to skeletal

growth, which comes about a year after the peak in

height velocity (simmons and Greulich, 1943; Elizondo,

1992).How these apply to the Nigerian society is of

great interest.

1.2 STATEMENT OF PROBLEM

Early physical maturity among females is on a

continuous trend with most countries experiencing a

steady decline in age at menarche. This decline has

continued over the past century and in countries like the

United States, UK, France, Greece and Nigeria, the

decline in age is at a rate of 0.06-0.07 years every 5

years. Olu Oduntan (1976) gave the median age for

menarche in Nigeria as 13.70±0.03 in urban girls,

7

14.50±0.09 in rural girls and 13.26±0.06 in girls with

university educated parents. In 1976, the menarcheal

age of girls with university educated parents,

13.26±0.06 was comparable with the median age in the

United States back then in 1976. The latest statistics on

the median age at menarche in the United States is 12.5

years (Anderson et al., 2003), in Nigeria it is given as

12.22±1.19 years in girls from middle class homes

(Ofuya and Zulest, 2008). This decline in age at

menarche has also brought along with it interests in the

effect of early puberty in later years of the girl’s life,

Parents et al. (2005) linked early puberty (menarche)

with increased risk of obesity, diabetes and cancer.

1.3 PURPOSE OF THE STUDY

The purpose of this study is to explore whether the

timing of menarche is more closely related to the BMI.

Considering the effects of adiposity on age at menarche,

I predict that the likely-hood of menarche will be

positively related to an increased level of BMI, and an

early age at menarche would indicate this.

8

1.4 HYPOTHESIS.

Hypotheses were made to be tested with the chosen

means of experiment inorder to guide the effort and

focus along the line of study. The hypothesis made are

as follows:

Ho: The age at menarche is not dependent on the BMI.

HA: The age at menarche is dependent on the BMI.

1.5 SIGNIFICANCE OF THE STUDY.

The significance of the study would be to explain

early age at menarche, and its accompanying sequelae.

The impact of menarche on adult female life cannot be

undervalued, it’s been associated with increased risk of

obesity, diabetes and cancer. It is difficult to measure

the stages of puberty accurately, and so to indicate the

timing of puberty, epidemiological studies often use age

at menarche. The accurate determination of BMI before

and during menarche could be an indicator for age at

menarche and future effect of early menarche on the

female.9

1.6 SCOPE OF THE STUDY.

The study involves the measurement of the height

and weight of adolescent females to determine the BMI

by the simple weight/height2 ratio. It also involves

measurement of the hip and waist, to determine the

hip/waist ratio, and measurement of blood pressure.

10

CHAPTER TWO.

LITERATURE REVIEW.

Menarche is an important landmark in a woman’s

reproductive career; and, to the degree that the

selection then molds the life-history of a species, one

would expect sexual maturation to be linked to the

acquisition of resources necessary for successful

reproduction. The proximate cause of menarche is an

increase in the frequency of the gonadotropin releasing

hormone (GnRH) pulse generator in the hypothalamus,

fat distribution and BMI but the age at menarche varies

widely and is delayed in populations with poor nutrition

(Thomas et al., 2001; Gluckman and Hanson, 2006).

Until recently it was generally accepted that the timing

of menarche is related to skeletal growth, until studies

showed it was more related to the BMI (Simmons and

Greulich, 1943; Elizondo, 1992).

Another study that menarche depends on a critical

amount of stored fat, since the 16kg of fat typically

stored during childhood and puberty can provide

11

additional energy during pregnancy and lactation was

done (Frisch and Revelle, 1970; Frisch and McArthur,

1974; Frisch et al., 1973; Frisch, 1976,1994). The

hormone leptin, produced by fat cells, provides a

pathway to communicate the size of fat stores to the

GnRH secreting neurons in the hypothalamus via leptin

receptors in KiSS-1 neurons (Smith et al., 2006). Certain

levels of adiposity is required for puberty (menarche)

(Chehab et al., 1996,1997; Clement et al., 1998; Ozato

et al., 1999; Farooqi et al., 2002), and age at menarche

in young women is inversely related to adipose levels

(Matkovic et al., 1997).

Despite the appeal of this hypothesis, studies of

menarche have generally failed to support the critical-

fat theory. Menarche can occur despite low fat levels

with little evidence of a threshold (Johnston et al., 1971;

Billewicz et al.,1976; Trussell, 1978; Garn and LaVelle,

1983); and multivariate analyses have shown that

height and bi-iliac breadth are much more important

than measures of total fat or body weight in predicting

12

the age of menarche (van’t Hof and Roede, 1977;

Ellison, 1982; Stark et al., 1989; Elizondo, 1992).

However, another possibility is that menarche may

be related to fat distribution rather than total fat, and in

particular to the relative amount of lower-body (gluteo-

femoral) versus upper-body fat. Female waist-hip ratio

(WHR) declines during childhood from 1.03 at 4 months

of age to 0.78 at the time of menarche (Fredriks et al.,

2005), and there is a steep increase in hip

circumference just before menarche (Forbes, 1992).

Young German women in higher quartiles for self-

reported hip, thigh, and leg circumferences had higher

odds of menarche in cross-sectional bivariate analyses

(Merzenich et al., 1993).

There is also evidence that gluteofemoral fat

produces more leptin than upper-body fat.

Subcutaneous gluteal fat contains more leptin mRNA

than abdominal fat (Papaspyrou-Rao et al., 1997), and

multivariate analyses indicate that hip circumference is

a significant positive predictor of blood leptin levels

while waist circumference is not (Bennett et al., 1997;

13

Ho et al., 1999; Sudi et al., 2000). For example, in the

study by Bennett et al. (1997), hip circumference

explained 36% of the variance in blood leptin levels,

total fat explained an additional 2%, and waist

circumference was not related. There is also a negative

relationship between the amount of free leptin and both

waist circumference and WHR (Magni et al., 2005). Thus,

gluteofemoral fat deposits could influence the timing of

menarche through their effects on blood leptin level.

X Du et al., 2003 in their work, low body weight

and its association with bone health and pubertal

maturation in Chinese girls, showed that BMI<18 in

females is responsible for delayed general growth,

development, delay in puberty and consequently

menarche.

14

CHAPTER THREE.

MATERIALS AND METHODOLOGY.

3.1 RESEARCH DESIGN

This research work is a basic research; therefore

the research design involves primarily the measurement

of height, weight, hip circumference, waist

circumference, and the filling of a questionnaire.

3.2 STUDY AREA.

This study was conducted in Ekpoma which lies

within Esan West local government area of Edo State. It

lies between latitude 60º 40º N 60º 45º N and 60º 05º E

60º 10º E (Obabori et al, 2006). Ekpoma is the

designated headquater of Esan West local government,

it has a population at last the count (2006) of 125,843

people, 63,785 of which are male and the remaining

62,057 are females (NPC, 2006).

15

3.3 POPULATION OF STUDY AND SAMPLE SIZE.

The study was conducted with subjects residing in

Ekpoma, Esan West local government area of Edo State.

The study involved 102 females between the ages

of 13-20 years, spread over the senior classes (SS1-SS3)

in the various secondary schools listed in the population

of the study. The sample population was limited to only

two secondary schools out of the five known secondary

schools in the area. The selected schools are:

Ambrose Alli University Staff Secondary School,

Ihumundumu.

Zana Memorial College, Ikekogbe.

3.4 SAMPLING AND SAMPLING TECHNIQUE.

The entire population of females used in this

research, were gotten from the secondary schools listed

above. 80 females were gotten from Zana Memorial

College and the remaining 22 were gotten from

16

Ambrose Alli University Staff Secondary School

presenting a total of 102 subjects.

The values represented were taken from only

females, because menarche is particular to the female

gender.

3.5 RESEARCH INSTRUMENT.

The instruments used in this research work were:

Tape rule for measuring height.

Weight scale for measuring weight.

Tape rule for measuring hip & waist circumference

An electronic sphygmomanometer for measuring blood

pressure.

Age at menarche, nutritional status, socio-

economic status was established through questionnaires

and interviews. Details of the questionnaire are shown in

appendix 1.

3.6 ETHICAL PRE-REQUISITES

17

The researcher sought the permission of the

various head of schools before carrying out the

procedures necessary for the research among the

females.

3.7 ANALYSIS OF DATA

Data was tabulated, histograms and graphs were

drawn. Further analysed using the statistical package for

the social sciences version 17 (SPSS 17).The chi squared

test was used to compare variable characteristics.

To test the hypothesis in a bivariate context, we

examined some other data collected during the course

of the research. Measures used for the bivariate analysis

include, BMI, systolic blood pressure, diastolic blood

pressure, mean arterial pressure, waist circumference,

hip circumference, hip-waist ratio, and age at menarche.

The total number of respondents involved in the

study is 102. We divided the BMI values into Low BMI

(<18.5), and Normal BMI (>18.5). We the further divided

the normal BMI into Low-normal BMI (>18.5<21.5) and

High-normal BMI (>21.5<24.9). We pitched each of

18

these classifications against age at menarche and

sought out any relationship therein.

Pearson’s correlations coefficients was used in

correlations, trends were tested using a linear

regression model, in which BMI was entered as the

independent variable (predictors) and age at menarche

was the dependent variable (responsive variable).

Confidence interval (CI) of 95% was chosen in the

analysis.

19

CHAPTER FOUR

RESULTS

This chapter presents the analysis of data and

discussion of results which were based on the data

collected from the sample population on the effect of

BMI on age at menarche in the study population of Esan

West local government area of Edo State.

4.1 SECTION A (BIODATA)

From the data collected using the questionnaire,

4.9% of the subjects were aged 13yrs, with the highest

frequency being age 15 which made up 42% of the

entire population.

Below is a table summarizing the distribution of

subject’s age.

20

Figure 1

21

TABLE 1-a; AGE DISTRIBUTION

AgeFrequency Percent Valid Percent Cumulative Percent

Valid 13.00 5 4.9 4.9 4.9

14.00 19 18.6 18.6 23.5

15.00 43 42.2 42.2 65.7

16.00 26 25.5 25.5 91.2

17.00 6 5.9 5.9 97.1

18.00 2 2.0 2.0 99.0

20.00 1 1.0 1.0 100.0

Total 102 100.0 100.0

The subjects used were in senior secondary (SS)

class of their various schools. 39.2% of the subjects

were in SS1 class, with the majority of subjects were in

SS2 as shown in the high frequency of 47.1. The table

below summarizes the educational distribution.

TABLE 1-b; EDUCATIONAL STATUS

Frequency Percent Valid PercentCumulative

Percent

Valid 1.00 40 39.2 39.2 39.2

2.00 48 47.1 47.1 86.3

3.00 14 13.7 13.7 100.0

Total 102 100.0 100.0

22

Figure 2

As expected, majority of the subjects were either of

the Ishan or Bini ethnic extraction, with equal

frequencies of 36.3% of the sample population.

TABLE 1-c; ETHNICITY


Percent

Valid ISHAN 37 36.3 36.3 36.3

BINI 37 36.3 36.3 72.5

HAUSA 3 2.9 2.9 75.5

YORUBA 3 2.9 2.9 78.4

IBO 1 1.0 1.0 79.4

OTHERS 21 20.6 20.6 100.0

Total 102 100.0 100.0

23

Figure 3

Below is a tabular representation of the occupation

of parents.The majority of subjects had fathers who

were businessmen 25.5%, the nearest to that had

fathers who were teachers 12.7%. Majority had mothers

who were traders 47.1%.

24

25

TABLE 1-d; Mothers Occupation


Percent

Valid AAU ST 2 2.0 2.0 2.0

BANKER 2 2.0 2.0 3.9

BUSINE 28 27.5 27.5 31.4

CIVIL 3 2.9 2.9 34.3

DOCTOR 2 2.0 2.0 36.3

FASHIO 1 1.0 1.0 37.3

HAIR S 1 1.0 1.0 38.2

HOUSE 3 2.9 2.9 41.2

LECTUR 2 2.0 2.0 43.1

NURSE 4 3.9 3.9 47.1

TEACHE 5 4.9 4.9 52.0

TRADER 48 47.1 47.1 99.0

WORKER 1 1.0 1.0 100.0

Total 102 100.0 100.0

TABLE 1-e; Fathers Occupation


Percent

Valid AAU ST 4 3.9 3.9 3.9

ACCOUN 2 2.0 2.0 5.9

BANKER 6 5.9 5.9 11.8

BARRIS 2 2.0 2.0 13.7

BUSINE 26 25.5 25.5 39.2

BUSSIN 1 1.0 1.0 40.2

CAR DE 3 2.9 2.9 43.1

CIVIL 5 4.9 4.9 48.0

CONTRA 2 2.0 2.0 50.0

DOCTOR 2 2.0 2.0 52.0

DRVER 2 2.0 2.0 53.9

ENGINE 5 4.9 4.9 58.8

FAMER 2 2.0 2.0 60.8

FARMER 2 2.0 2.0 62.7

FIRE F 1 1.0 1.0 63.7

LAWYER 2 2.0 2.0 65.7

LECTUR 4 3.9 3.9 69.6

PASTOR 2 2.0 2.0 71.6

PHARME 1 1.0 1.0 72.5

POLICE 3 2.9 2.9 75.5

POLITI 1 1.0 1.0 76.5

REVREN 1 1.0 1.0 77.5

RICE M 1 1.0 1.0 78.4

SOLDIE 1 1.0 1.0 79.4

TEACHE 13 12.7 12.7 92.2

TRADER 7 6.9 6.9 99.0

WORKER 1 1.0 1.0 100.0

Total 102 100.0 100.0

Interestingly, 66.7% of subjects reside in flats as

opposed to 3.9% that reside in a duplex, and 8.8% lived

in single rooms.

26

TABLE 1-f; TYPE OF HOUSING


Percent

Valid Single Room 9 8.8 8.8 8.8

Self Contained 15 14.7 14.7 23.5

Flat 68 66.7 66.7 90.2

Duplex 4 3.9 3.9 94.1

Mansion 6 5.9 5.9 100.0

Total 102 100.0 100.0

Figure 4

4.2 SECTION B (LEVEL OF ACTIVITY)

27

Below is the table representing the distribution of

subjects’ means of commuting to and from school, and

it shows that 33.3% and 33.7% of the subjects commute

to school every day on foot and public transport

respectively, while 13.7% go to school with their

parent’s car. Below is the table representing the

distribution.

TABLE 2-a; MEANS OF COMMUTING


Percent

Valid On foot most times 34 33.3 33.3 33.3

Public transport 38 37.3 37.3 70.6

Personal car 14 13.7 13.7 84.3

Dropped off 16 15.7 15.7 100.0

Total 102 100.0 100.0

Figure 5

28

On exercise status, 68.6% of the subjects are

involved in exercise and sporting activities, which leave

us with 31.4% who do not engage themselves in any

form of exercises.

Figure 6

29

TABLE 2-b; EXERCISE STATUS


Percent

Valid YES 70 68.6 68.6 68.6

NO 32 31.4 31.4 99.0

Total 102 100.0 100.0

Of the 68.6% that exercise, just 23.5% exercise on

a daily basis.

TABLE 2-c; EXERCISE FREQUENCY


Percent

Valid DAILY 24 23.5 23.5 23.5

Bi WEEKLY 22 21.6 21.6 45.1

WEEKLY 28 27.5 27.5 72.5

MONTHLY 28 27.5 27.5 100.0

Total 102 100.0 100.0

Figure 7

30

4.3 SECTION C (NUTRITIONAL DATA)

79.4% of the subjects eat three times or more each

day, the table below summarizes the distribution.

TABLE 3-a; DAILY NUTRITIONAL FREQUENCY


Percent

Valid ONCE 2 2.0 2.0 2.0

TWICE 16 15.7 15.7 17.6

THRICE 41 40.2 40.2 57.8

MORE THAN THREE TIMES 40 39.2 39.2 97.1

NOT REGULARLY 3 2.9 2.9 100.0

Total 102 100.0 100.0

31

Figure 8

71.7% of the subjects had carbohydrates and

starch in their staple diet, and a meager 14.7% had

protein in their staple diet. Below is the table

representing the distribution.

TABLE 3-b; STAPLE DIET

Frequency Percent Valid Percent Cumulative Percent

Valid BEANS 9 8.8 8.8 8.8

32

BEANS/R 1 1.0 1.0 10.8

EBA 2 2.0 2.0 12.7

EBA & M 7 6.9 6.9 20.6

EBA & O 1 1.0 1.0 21.6

EGG & Y 3 2.9 2.9 24.5

FRIED P 1 1.0 1.0 25.5

FRIED R 4 3.9 3.9 29.4

INDOME 3 2.9 2.9 32.4

RICE 44 43.1 43.1 75.5

RICE & 2 2.0 2.0 94.1

SANTANA 1 1.0 1.0 95.1

SEMOVIT 1 1.0 1.0 96.1

SNACKS 2 2.0 2.0 98.0

YAM/EGG 2 2.0 2.0 100.0

Total 102 100.0 100.0

72.5% of the subjects claim not to be on any diet or

weight modulator as opposed to 27.5% of subject who

claim to be on a diet and/or weight modulator.

TABLE 3-c; DIETING STATUS


Percent

Valid YES 28 27.5 27.5 27.5

NO 74 72.5 72.5 100.0

Total 102 100.0 100.0

33

Figure 9

A greater number of subjects visit a fast food outlet

once in a month, this make up about 42.2% of the

sample population.

TABLE 3-d; Fast Food Outlet Frequency


Percent

Valid DAILY 16 15.7 15.7 15.7

ONCE A WEEK 11 10.8 10.8 26.5

TWICE A WEEK 17 16.7 16.7 43.1

WEEKLY 15 14.7 14.7 57.8

MONTHLY 43 42.2 42.2 100.0

Total 102 100.0 100.0

34

Figure 10

On alcohol consumption, majority of the subjects,

88.2%, claimed not to consume alcohol.

TABLE 3-e; Alcohol Status


Percent

Valid YES 12 11.8 11.8 11.8

NO 90 88.2 88.2 100.0

Total 102 100.0 100.0

35

Figure 11

On family histories of hypertension and

obesity.59.8% of the subjects had no family history of

hypertension, and similar scenario presents itself in the

case of obesity, as 62.7% of the subjects claimed not to

have any family history of obesity. Below are tables and

histograms summarizing the various distributions for

family histories of hypertension and obesity.

36

TABLE 3-f; Family History hx HPT


Percent

Valid YES 15 14.7 14.7 14.7

NO 61 59.8 59.8 74.5

DON’T KNOW 26 25.5 25.5 100.0

Total 102 100.0 100.0

Figure 12

37

TABLE 3-g; Family History of Obesity


Percent

Valid YES 20 19.6 19.6 19.6

NO 64 62.7 62.7 82.4

DON’T KNOW 18 17.6 17.6 100.0

Total 102 100.0 100.0

Figure 13

4.4 SECTION D (Anthropometry/Blood pressure)

When measured, the minimum weight of 40kg was

recorded in 3.9% of the subject population. The highest

38

frequency was 50kg which was recorded in 18.6% of the

subject population.

TABLE 4-a; Weight


Percent

Valid 40.00 4 3.9 3.9 3.9

41.00 1 1.0 1.0 4.9

42.00 3 2.9 2.9 7.8

43.00 5 4.9 4.9 12.7

44.00 4 3.9 3.9 16.7

45.00 3 2.9 2.9 19.6

46.00 6 5.9 5.9 25.5

47.00 4 3.9 3.9 29.4

48.00 4 3.9 3.9 33.3

49.00 6 5.9 5.9 39.2

50.00 19 18.6 18.6 57.8

52.00 4 3.9 3.9 61.8

53.00 4 3.9 3.9 65.7

54.00 2 2.0 2.0 67.6

55.00 9 8.8 8.8 76.5

56.00 3 2.9 2.9 79.4

57.00 1 1.0 1.0 80.4

58.00 7 6.9 6.9 87.3

60.00 6 5.9 5.9 93.1

62.00 2 2.0 2.0 95.1

63.00 3 2.9 2.9 98.0

65.00 2 2.0 2.0 100.0

Total 102 100.0 100.0

39

Figure 14

The tallest height recorded was 1.88m which was

measured in 2% of the subjects; the table below

explains the distributions.

40

TABLE 4-b; Height


Percent

Valid 1.51 1 1.0 1.0 1.0

1.55 2 2.0 2.0 2.9

1.57 1 1.0 1.0 3.9

1.58 7 6.9 6.9 10.8

1.59 7 6.9 6.9 17.6

1.60 13 12.7 12.7 30.4

1.61 2 2.0 2.0 32.4

1.62 5 4.9 4.9 37.3

1.63 11 10.8 10.8 48.0

1.64 13 12.7 12.7 60.8

1.65 8 7.8 7.8 68.6

1.66 6 5.9 5.9 74.5

1.68 1 1.0 1.0 75.5

1.69 5 4.9 4.9 80.4

1.70 6 5.9 5.9 86.3

1.72 4 3.9 3.9 90.2

1.73 3 2.9 2.9 93.1

1.74 4 3.9 3.9 97.1

1.75 1 1.0 1.0 98.0

1.88 2 2.0 2.0 100.0

Total 102 100.0 100.0

41

Figure 15

On BMI, the values varied, with BMI of 16.80 having the

highest frequency of 4.9% of the subjects.

42

43

TABLE 4-c; BMI


Percent

Valid 13.70 1 1.0 1.0 1.0

14.15 2 2.0 2.0 2.9

14.52 2 2.0 2.0 4.9

14.87 1 1.0 1.0 5.9

15.06 1 1.0 1.0 6.9

15.41 1 1.0 1.0 7.8

15.57 2 2.0 2.0 9.8

15.85 2 2.0 2.0 11.8

16.20 1 1.0 1.0 12.7

16.41 1 1.0 1.0 13.7

16.46 2 2.0 2.0 15.7

16.71 1 1.0 1.0 16.7

16.80 5 4.9 4.9 21.6

16.90 2 2.0 2.0 23.5

17.19 2 2.0 2.0 25.5

17.51 2 2.0 2.0 27.5

17.69 1 1.0 1.0 28.4

17.80 1 1.0 1.0 29.4

17.85 1 1.0 1.0 30.4

17.96 1 1.0 1.0 31.4

18.00 1 1.0 1.0 32.4

18.14 2 2.0 2.0 34.3

18.22 2 2.0 2.0 36.3

18.34 3 2.9 2.9 39.2

18.37 3 2.9 2.9 42.2

18.42 1 1.0 1.0 43.1

18.43 4 3.9 3.9 47.1

18.59 3 2.9 2.9 50.0

18.59 1 1.0 1.0 51.0

18.59 2 2.0 2.0 52.9

18.82 1 1.0 1.0 53.9

18.99 2 2.0 2.0 55.9

19.05 1 1.0 1.0 56.9

19.14 2 2.0 2.0 58.8

19.15 2 2.0 2.0 60.8

19.29 1 1.0 1.0 61.8

19.33 4 3.9 3.9 65.7

19.38 1 1.0 1.0 66.7

19.49 1 1.0 1.0 67.6

19.60 1 1.0 1.0 68.6

19.78 1 1.0 1.0 69.6

19.82 2 2.0 2.0 71.6

19.83 1 1.0 1.0 72.5

20.03 1 1.0 1.0 73.5

20.20 1 1.0 1.0 74.5

20.70 2 2.0 2.0 76.5

20.82 1 1.0 1.0 77.5

20.96 1 1.0 1.0 78.4

21.08 2 2.0 2.0 80.4

21.23 1 1.0 1.0 81.4

21.30 2 2.0 2.0 83.3

21.80 1 1.0 1.0 84.3

22.03 1 1.0 1.0 85.3

Figure16

On systolic and diastolic blood pressure, the

subjects also showed varied values, with the value with

the highest frequency for systolic blood pressure being

117mmHg with a frequency of 9.8%, and 71mmHg for

diastolic with a frequency of 8.8%. Below are tabular

and graphical representations.

TABLE 4-d; SBP


Percent

Valid 92.00 2 2.0 2.0 2.0

95.00 1 1.0 1.0 2.9

98.00 1 1.0 1.0 3.9

99.00 1 1.0 1.0 4.9

101.00 2 2.0 2.0 6.9

103.00 5 4.9 4.9 11.8

104.00 1 1.0 1.0 12.7

105.00 2 2.0 2.0 14.7

106.00 3 2.9 2.9 17.6

107.00 3 2.9 2.9 20.6

108.00 4 3.9 3.9 24.5

44

109.00 4 3.9 3.9 28.4

110.00 5 4.9 4.9 33.3

111.00 1 1.0 1.0 34.3

112.00 1 1.0 1.0 35.3

113.00 3 2.9 2.9 38.2

114.00 5 4.9 4.9 43.1

115.00 4 3.9 3.9 47.1

116.00 8 7.8 7.8 54.9

117.00 10 9.8 9.8 64.7

118.00 2 2.0 2.0 66.7

119.00 6 5.9 5.9 72.5

120.00 3 2.9 2.9 75.5

121.00 1 1.0 1.0 76.5

122.00 6 5.9 5.9 82.4

123.00 1 1.0 1.0 83.3

125.00 4 3.9 3.9 87.3

126.00 8 7.8 7.8 95.1

127.00 1 1.0 1.0 96.1

128.00 2 2.0 2.0 98.0

132.00 1 1.0 1.0 99.0

172.00 1 1.0 1.0 100.0

Total 102 100.0 100.0

45

Figure 17

46

TABLE 4-e; DBP


Percent

Valid 44.00 1 1.0 1.0 1.0

50.00 2 2.0 2.0 2.9

51.00 1 1.0 1.0 3.9

54.00 1 1.0 1.0 4.9

55.00 4 3.9 3.9 8.8

56.00 5 4.9 4.9 13.7

58.00 2 2.0 2.0 15.7

59.00 2 2.0 2.0 17.6

60.00 5 4.9 4.9 22.5

61.00 1 1.0 1.0 23.5

62.00 3 2.9 2.9 26.5

63.00 4 3.9 3.9 30.4

64.00 3 2.9 2.9 33.3

65.00 5 4.9 4.9 38.2

66.00 2 2.0 2.0 40.2

67.00 2 2.0 2.0 42.2

68.00 3 2.9 2.9 45.1

69.00 2 2.0 2.0 47.1

70.00 1 1.0 1.0 48.0

71.00 9 8.8 8.8 56.9

72.00 3 2.9 2.9 59.8

73.00 4 3.9 3.9 63.7

74.00 6 5.9 5.9 69.6

75.00 6 5.9 5.9 75.5

76.00 1 1.0 1.0 76.5

78.00 4 3.9 3.9 80.4

79.00 6 5.9 5.9 86.3

80.00 3 2.9 2.9 89.2

82.00 2 2.0 2.0 91.2

83.00 3 2.9 2.9 94.1

84.00 2 2.0 2.0 96.1

86.00 3 2.9 2.9 99.0

89.00 1 1.0 1.0 100.0

Total 102 100.0 100.0

47

Figure 18

On pulse pressure, 2% of the subjects had a pulse

pressure of 22; the highest frequency was 8.8% for

values 42 and 48.

48

TABLE 4-f; PP


Percent

Valid 22.00 2 2.0 2.0 2.0

31.00 2 2.0 2.0 3.9

32.00 3 2.9 2.9 6.9

33.00 1 1.0 1.0 7.8

34.00 1 1.0 1.0 8.8

36.00 5 4.9 4.9 13.7

37.00 3 2.9 2.9 16.7

38.00 3 2.9 2.9 19.6

40.00 4 3.9 3.9 23.5

41.00 5 4.9 4.9 28.4

42.00 9 8.8 8.8 37.3

43.00 4 3.9 3.9 41.2

44.00 6 5.9 5.9 47.1

45.00 3 2.9 2.9 50.0

46.00 2 2.0 2.0 52.0

47.00 3 2.9 2.9 54.9

48.00 9 8.8 8.8 63.7

49.00 6 5.9 5.9 69.6

50.00 6 5.9 5.9 75.5

51.00 4 3.9 3.9 79.4

52.00 1 1.0 1.0 80.4

54.00 6 5.9 5.9 86.3

55.00 5 4.9 4.9 91.2

56.00 2 2.0 2.0 93.1

60.00 2 2.0 2.0 95.1

61.00 2 2.0 2.0 97.1

64.00 1 1.0 1.0 98.0

68.00 1 1.0 1.0 99.0

99.00 1 1.0 1.0 100.0

Total 102 100.0 100.0

49

Figure 19

On mean arterial pressure, the values gotten were

so varied, with most values having frequencies of 1%

and 2%.

50

TABLE 4-g; MAP


Percent

Valid 61.00 1 1.0 1.0 1.0

64.00 2 2.0 2.0 2.9

67.00 1 1.0 1.0 3.9

70.00 1 1.0 1.0 4.9

70.33 1 1.0 1.0 5.9

71.00 2 2.0 2.0 7.8

72.33 1 1.0 1.0 8.8

73.00 1 1.0 1.0 9.8

74.00 3 2.9 2.9 12.7

75.00 4 3.9 3.9 16.7

76.33 2 2.0 2.0 18.6

76.67 3 2.9 2.9 21.6

77.00 1 1.0 1.0 22.5

78.33 2 2.0 2.0 24.5

78.67 1 1.0 1.0 25.5

79.67 2 2.0 2.0 27.5

80.33 4 3.9 3.9 31.4

80.67 2 2.0 2.0 33.3

81.00 1 1.0 1.0 34.3

81.33 2 2.0 2.0 36.3

81.67 3 2.9 2.9 39.2

83.00 2 2.0 2.0 41.2

83.33 1 1.0 1.0 42.2

84.00 1 1.0 1.0 43.1

84.33 3 2.9 2.9 46.1

84.67 3 2.9 2.9 49.0

85.00 2 2.0 2.0 51.0

85.33 4 3.9 3.9 54.9

86.00 2 2.0 2.0 56.9

86.33 2 2.0 2.0 58.8

86.67 5 4.9 4.9 63.7

87.00 3 2.9 2.9 66.7

88.67 3 2.9 2.9 69.6

89.67 1 1.0 1.0 70.6

90.00 2 2.0 2.0 72.5

90.67 2 2.0 2.0 74.5

91.33 1 1.0 1.0 75.5

91.67 2 2.0 2.0 77.5

92.00 2 2.0 2.0 79.4

92.33 2 2.0 2.0 81.4

93.00 1 1.0 1.0 82.4

93.33 2 2.0 2.0 84.3

51

94.00 2 2.0 2.0 86.3

94.33 1 1.0 1.0 87.3

95.00 1 1.0 1.0 88.2

95.33 2 2.0 2.0 90.2

96.00 2 2.0 2.0 92.2

96.33 1 1.0 1.0 93.1

96.67 2 2.0 2.0 95.1

97.00 2 2.0 2.0 97.1

97.33 1 1.0 1.0 98.0

101.33 1 1.0 1.0 99.0

106.00 1 1.0 1.0 100.0

Total 102 100.0 100.0

Figure 20

52

On waist and hip circumference, 65cm for waist

circumference had the highest frequency of 12.7% of

the subjects while hip circumference had 88cm as the

value with the highest frequency, 15.7%.

The corresponding hip-waist ratio of the subjects

had 3.9% having hip-waist ratio of 1.10, 1% having 1.11.

Below are graphs and tables depicting the data on

waist circumference, hip circumference and hip-waist

ratio.

TABLE 4-g; WAIST CIRCUMFERENCE

Frequency Percent Valid Percent Cumulative Percent

Valid 60.00 1 1.0 1.0 1.0

61.00 2 2.0 2.0 2.9

63.00 1 1.0 1.0 3.9

64.00 9 8.8 8.8 12.7

65.00 13 12.7 12.7 25.5

66.00 5 4.9 4.9 30.4

67.00 3 2.9 2.9 33.3

68.00 4 3.9 3.9 37.3

69.00 9 8.8 8.8 46.1

70.00 3 2.9 2.9 49.0

71.00 10 9.8 9.8 58.8

72.00 5 4.9 4.9 63.7

73.00 7 6.9 6.9 70.6

74.00 9 8.8 8.8 79.4

75.00 1 1.0 1.0 80.4

76.00 5 4.9 4.9 85.3

77.00 1 1.0 1.0 86.3

78.00 4 3.9 3.9 90.2

79.00 4 3.9 3.9 94.1

81.00 2 2.0 2.0 96.1

82.00 1 1.0 1.0 97.1

87.00 2 2.0 2.0 99.0

96.00 1 1.0 1.0 100.0

Total 102 100.0 100.0

53

Figure 21

Figure 22

54

55

TABLE 4-h; HIP CIRCUMFERENCE


Percent

Valid 79.00 4 3.9 3.9 3.9

80.00 5 4.9 4.9 8.8

81.00 1 1.0 1.0 9.8

82.00 2 2.0 2.0 11.8

83.00 7 6.9 6.9 18.6

84.00 5 4.9 4.9 23.5

85.00 11 10.8 10.8 34.3

86.00 7 6.9 6.9 41.2

87.00 4 3.9 3.9 45.1

88.00 16 15.7 15.7 60.8

89.00 8 7.8 7.8 68.6

90.00 3 2.9 2.9 71.6

91.00 4 3.9 3.9 75.5

92.00 2 2.0 2.0 77.5

93.00 11 10.8 10.8 88.2

94.00 1 1.0 1.0 89.2

95.00 3 2.9 2.9 92.2

96.00 2 2.0 2.0 94.1

97.00 1 1.0 1.0 95.1

98.00 1 1.0 1.0 96.1

101.00 1 1.0 1.0 97.1

107.00 3 2.9 2.9 100.0

Total 102 100.0 100.0

56

TABLE 4-i; H/W RATIO


Percent

Valid 1.10 4 3.9 3.9 3.9

1.11 1 1.0 1.0 4.9

1.12 3 2.9 2.9 7.8

1.14 3 2.9 2.9 10.8

1.14 1 1.0 1.0 11.8

1.15 1 1.0 1.0 12.7

1.16 1 1.0 1.0 13.7

1.17 1 1.0 1.0 14.7

1.18 4 3.9 3.9 18.6

1.19 3 2.9 2.9 21.6

1.20 3 2.9 2.9 24.5

1.21 3 2.9 2.9 27.5

1.22 7 6.9 6.9 34.3

1.23 10 9.8 9.8 44.1

1.24 4 3.9 3.9 48.0

1.25 7 6.9 6.9 54.9

1.26 5 4.9 4.9 59.8

1.27 3 2.9 2.9 62.7

1.28 1 1.0 1.0 63.7

1.29 3 2.9 2.9 66.7

1.30 2 2.0 2.0 68.6

1.31 6 5.9 5.9 74.5

1.32 2 2.0 2.0 76.5

1.33 9 8.8 8.8 85.3

1.34 3 2.9 2.9 88.2

1.35 4 3.9 3.9 92.2

1.36 2 2.0 2.0 94.1

1.38 2 2.0 2.0 96.1

1.38 1 1.0 1.0 97.1

1.43 2 2.0 2.0 99.0

1.67 1 1.0 1.0 100.0

Total 102 100.0 100.0

Figure 23

4.5 SECTION E (GENERAL)

On sexual activity, 84.3% of the subject claimed

not to be sexually active, leaving 15.7% who are

sexually active.

57

TABLE 5-a; SEXUAL ACTIVITY


Percent

Valid YES 16 15.7 15.7 15.7

NO 86 84.3 84.3 100.0

Total 102 100.0 100.0

Figure 24

On age at menarche, 2.9% had 11yrs as their age at

menarche; a further 28.4% had their age at menarche at

12yrs. The table below shows the distribution.

58

TABLE 5-b; AGE AT MENARCHE


Percent

Valid 11.00 3 2.9 2.9 2.9

12.00 29 28.4 28.4 31.4

13.00 34 33.3 33.3 64.7

14.00 23 22.5 22.5 87.3

15.00 11 10.8 10.8 98.0

16.00 1 1.0 1.0 99.0

18.00 1 1.0 1.0 100.0

Total 102 100.0 100.0

Figure 25

59

4.6 PRESENTATION AND ANALYSIS OF DATA

TABLE 4.6-1

Statistics

Age BMI SBP DBPAGE AT

MENARCHE MAPWAIST-

C HIP-CH/W

RATIOValid 102 102 102 102 102 102 102 102 102

Missing 0 0 0 0 0 0 0 0 0

Mean 15.1961 18.9254 115.0490 69.0980 13.1765 84.4150 70.7941 88.1961 1.2562

Std. Error of Mean

.11150 .24517 1.00459 .95436 .11608 .85711 .60242 .56202 .00861

Median 15.0000 18.5906 116.0000 71.0000 13.0000 85.0000 71.0000 88.0000 1.2500

Mode 15.00 16.80 117.00 71.00 13.00 86.67 65.00 88.00 1.23

Std. Deviation

1.12610 2.47607 10.14584 9.63853 1.17239 8.65643 6.08413 5.67614 .08700

Variance 1.268 6.131 102.938 92.901 1.374 74.934 37.017 32.219 .008

Range 7.00 11.22 80.00 45.00 7.00 45.00 36.00 28.00 .57

Minimum 13.00 13.70 92.00 44.00 11.00 61.00 60.00 79.00 1.10

Maximum 20.00 24.92 172.00 89.00 18.00 106.00 96.00 107.00 1.67

Percentiles 25 15.0000 17.1875 108.7500 62.0000 12.0000 78.5833 65.0000 85.0000 1.2075

50 15.0000 18.5906 116.0000 71.0000 13.0000 85.0000 71.0000 88.0000 1.2500

75 16.0000 20.7008 120.2500 75.2500 14.0000 91.4167 74.0000 91.2500 1.3200

The table above shows the details of data such as

the mean, median, mode, percentiles of the total data

collected.

The range of age of subjects used in this study was

between the ages of 13 and 20. The median age was 15

which made up 42.2% of the total subjects (n=102). The

mean age was 15.20±1.13 which was 86.3% of the total

subjects. 4.9% of the total respondents fell above the

mean age, while 8.9% fell below it.60

The mean age at menarche is 13.18±1.17, the

maximum age at menarche of the female subjects is 18

yrs, and the minimum age is 11 yrs.

The mean BMI of the female subjects is

18.93±2.48, the maximum BMI is 24.92 and the

minimum BMI is 13.70.

Upon analysis, the values of BMI were divided into

normal BMI and low BMI.

TABLE 4.6-2

Statistics

AGE BMI SBP DBP MAPWAIST-

C HIP-CH/W

RATIO

AGE AT MENARCH

EN Valid 54 54 54 54 54 54 54 54 54

Missing 0 0 0 0 0 0 0 0 0

Mean 15.3333 20.6947 116.1111 70.4815 85.6914 72.0000 91.0741 1.2702 13.3148

Std. Error of Mean .12950 .24383 1.03727 1.28740 1.05095 .90692 .75922 .01058 .17299

Median 15.0000 20.1154 117.0000 71.0000 84.6667 71.0000 90.0000 1.2600 13.0000

Mode 15.00 19.33a 117.00 71.00 76.67a 71.00 93.00 1.33 13.00

Std. Deviation .95166 1.79176 7.62238 9.46043 7.72289 6.66447 5.57911 .07771 1.27122

Range 5.00 6.33 33.00 38.00 34.33 33.00 24.00 .33 7.00

Minimum 13.00 18.59 99.00 51.00 67.00 63.00 83.00 1.10 11.00

Maximum 18.00 24.92 132.00 89.00 101.33 96.00 107.00 1.43 18.00

Percentiles 25 15.0000 19.1467 110.0000 63.0000 80.5833 66.0000 87.7500 1.2200 12.0000

50 15.0000 20.1154 117.0000 71.0000 84.6667 71.0000 90.0000 1.2600 13.0000

75 16.0000 22.1003 122.0000 78.2500 93.0833 76.0000 93.0000 1.3300 14.0000


the mean, median, mode, percentiles of the data

collected based on a normal BMI range from 18.5-25.0.

61

54 subjects fell within the normal BMI range.

The range of age of subjects that fell within normal

BMI was between the ages of 13-18. The median age

was 15 which made up 42.6% of the subjects with

normal BMI (n=54). The mean age was 15.33±1 which

was 88.9% of the subjects with normal BMI. 7.5% of the

subjects with normal BMI were above the mean age,

while 3.7% fell below it.

The mean age at menarche was found to be

13.32±1.27, the maximum age at menarche of the

female subjects was 18 yrs, and the minimum age was

11 yrs.

The mean BMI of the female subjects with normal

BMI was 20.70±1.80, the maximum BMI was 24.92 and

the minimum BMI was 18.59.

62

TABLE 4.6-3

Statistics


C HIP-CH/W

RATIO

AGE AT MENARCH

EN Valid 48 48 48 48 48 48 48 48 48

Missing 0 0 0 0 0 0 0 0 0

Mean 15.0417 16.9365 113.8542 67.5417 82.9790 69.4375 84.9583 1.2402 13.0208

Std. Error of Mean .18584 .19954 1.78498 1.39971 1.36774 .73472 .53838 .01367 .15032

Median 15.0000 17.0450 114.0000 70.5000 85.3300 69.0000 85.0000 1.2300 13.0000

Mode 15.00 16.80 116.00 56.00a 74.00a 65.00 88.00 1.23a 12.00a

Std. Deviation 1.28756 1.38243 12.36672 9.69746 9.47599 5.09028 3.73003 .09472 1.04147

Range 7.00 4.73 80.00 42.00 45.00 21.00 14.00 .57 4.00

Minimum 13.00 13.70 92.00 44.00 61.00 60.00 79.00 1.10 11.00

Maximum 20.00 18.43 172.00 86.00 106.00 81.00 93.00 1.67 15.00

Percentiles 25 14.0000 15.9375 107.2500 59.2500 75.0000 65.0000 82.2500 1.1825 12.0000

50 15.0000 17.0450 114.0000 70.5000 85.3300 69.0000 85.0000 1.2300 13.0000

75 15.7500 18.2200 119.0000 74.7500 89.6675 73.0000 88.0000 1.3050 14.0000



collected based on a low BMI range <18.5.

48 subjects fell within the low BMI range.

The range of age of subjects that fell within low BMI

was between the ages of 13-20. The median age was 15

which made up 41.7% of the subjects with low BMI

(n=48). The mean age was 15.04±1.29 which was

83.4% of the subjects with low BMI. 10.5% of the

63

subjects with low BMI were above the mean age, while

6.3% fell below it.




11 yrs.

The mean BMI of the female subjects with low BMI

was 16.94±1.38, the maximum BMI was 18.43 and the

minimum BMI was 13.70.

For a more thorough analysis, the values of the

normal BMI were further divided into low-normal BMI

and high-normal BMI.

TABLE 4.6-4

Statistics


C HIP-CH/W

RATIO

AGE AT MENARCH

EN Valid 17 17 17 17 17 17 17 17 17

Missing 0 0 0 0 0 0 0 0 0

Mean 14.8824 22.9305 119.1765 74.6471 89.4902 75.9412 94.7647 1.2535 12.8235

Std. Error of Mean .22496 .25671 1.87325 2.37781 1.92191 2.02279 1.63268 .02020 .39515

Median 15.0000 22.5827 122.0000 79.0000 94.0000 74.0000 93.0000 1.2400 12.0000

Mode 15.00 22.10 120.00a 83.00 75.00a 71.00a 93.00 1.23 12.00

Std. Deviation .92752 1.05844 7.72363 9.80396 7.92422 8.34019 6.73173 .08329 1.62924

Range 3.00 3.12 25.00 29.00 22.33 31.00 19.00 .32 7.00

Minimum 13.00 21.80 103.00 55.00 75.00 65.00 88.00 1.11 11.00

Maximum 16.00 24.92 128.00 84.00 97.33 96.00 107.00 1.43 18.00

Percentiles 25 14.5000 22.1003 115.0000 68.5000 82.8333 70.0000 89.0000 1.2100 12.0000

64

50 15.0000 22.5827 122.0000 79.0000 94.0000 74.0000 93.0000 1.2400 12.0000

75 15.5000 24.2188 125.0000 83.0000 96.0000 80.0000 99.0000 1.2900 13.0000



collected based on a high normal BMI range from

>21.5<25.0.

17 subjects fell within the high normal BMI range.

The range of age of subjects that fell within normal

BMI was between the ages of 13-16. The median age

was 15 which made up 52.9% of the subjects with high

normal BMI (n=17). The mean age was 14.88±0.93

which was 88.3% of the subjects with high normal BMI.




11 yrs.

The mean BMI of the female subjects with high

normal BMI was 22.93±1.06, the maximum BMI was

24.92 and the minimum BMI was 21.80.

65

TABLE 4.6-5

Statistics

age BMI SBP DBP MAPWAIST-

C HIP-CH/W

RATIOAGE AT

MENARCHEN Valid 37 37 37 37 37 37 37 37 37

Missing 0 0 0 0 0 0 0 0 0

Mean 15.5405 19.6675 114.7027 68.5676 83.9459 70.1892 89.3784 1.2778 13.5405

Std. Error of Mean .14803 .14551 1.19173 1.44340 1.16194 .80150 .66368 .01232 .16709

Median 16.0000 19.3337 116.0000 68.0000 83.3333 71.0000 88.0000 1.3000 13.0000

Mode 16.00 19.33 117.00 71.00 76.67a 64.00 85.00 1.33 13.00

Std. Deviation .90045 .88510 7.24900 8.77984 7.06780 4.87532 4.03699 .07495 1.01638

Range 4.00 2.71 33.00 38.00 34.33 16.00 15.00 .28 4.00

Minimum 14.00 18.59 99.00 51.00 67.00 63.00 83.00 1.10 12.00

Maximum 18.00 21.30 132.00 89.00 101.33 79.00 98.00 1.38 16.00

Percentiles

25 15.0000 19.0158 109.0000 62.5000 80.3333 65.0000 85.5000 1.2200 13.0000

50 16.0000 19.3337 116.0000 68.0000 83.3333 71.0000 88.0000 1.3000 13.0000

75 16.0000 20.4514 117.0000 74.5000 88.3333 73.5000 93.0000 1.3400 14.0000



collected based on a low normal BMI range of <21.5.

37 subjects fell within the low normal BMI range.

The range of age of subjects that fell within low

normal BMI was between the ages of 14-18. The median

age was 16 which made up 40.5% of the subjects with 66

low normal BMI (n=37). The mean age was 15.54±1

which was 89.1% of the subjects with low normal BMI.




12 yrs.

The mean BMI of the female subjects with low

normal BMI was 19.67±0.89, the maximum BMI was

21.30 and the minimum BMI was 18.59.

4.7 CHI SQUARE TEST COMPARING BODY MASS

INDEX AND AGE AT MENARCHE

Upon completion of analysis of the data, a negative

correlation between BMI and age at menarche was

found. The same was realized in all the categories and

sub-classification of BMI. This correlation was however

found not to be statistically insignificant (p>0.05) in all

but one, the normal BMI, with a high level of statistical

significance (p<0.01) found. Tables and graphs below

show the relationship between the two variables.

67

4.7.1 FOR TOTAL DATA

4.7.1.1 Correlations

TABLE 4.7.1.1-a; Descriptive Statistics

Mean Std. Deviation N

age 15.1961 1.12610 102BMI 18.9254 2.47607 102AGE AT MENARCHE 13.1765 1.17239 102

TABLE 4.7.1.1-b; Correlations

age BMIAGE AT

MENARCHE

age Pearson Correlation 1 -.023 .251*

Sig. (2-tailed) .817 .011

N 102 102 102BMI Pearson Correlation -.023 1 -.057

Sig. (2-tailed) .817 .566

N 102 102 102AGE AT MENARCHE Pearson Correlation .251* -.057 1

Sig. (2-tailed) .011 .566

N 102 102 102

*. Correlation is significant at the 0.05 level (2-tailed).

4.7.1.2 Regression

TABLE 4.7.1.2-a; Variables Entered/Removedb

ModelVariables Entered

Variables Removed Method

1 BMIa . Enter

a. All requested variables entered.b. Dependent Variable: AGE AT MENARCHE

68

TABLE 4.7.1.2-b; Model Summary

Model R R SquareAdjusted R

SquareStd. Error of the

Estimate

1 .057a .003 -.007 1.17628

a. Predictors: (Constant), BMI

TABLE 4.7.1.2-c; ANOVAb

Model Sum of Squares df Mean Square F Sig.

1 Regression .459 1 .459 .332 .566a

Residual 138.365 100 1.384

Total 138.824 101

a. Predictors: (Constant), BMIb. Dependent Variable: AGE AT MENARCHE

TABLE 4.7.1.2-d; Coefficientsa

Model

Unstandardized CoefficientsStandardized Coefficients

t Sig.

95.0% Confidence Interval for B

B Std. Error Beta Lower Bound Upper Bound

1(Constant) 13.692 .902 15.177 .000 11.902 15.482

BMI -.027 .047 -.057 -.576 .566 -.121 .067

a. Dependent Variable: AGE AT MENARCHE

69

Figure 26

Figure 27

4.7.2 FOR NORMAL BMI

70




age 15.3333 .95166 54BMI 20.6947 1.79176 54AGE AT MENARCHE 13.3148 1.27122 54


age BMIAGE AT

MENARCHE

age Pearson Correlation 1 -.188 .224

Sig. (2-tailed) .174 .104

N 54 54 54BMI Pearson Correlation -.188 1 -.352**

Sig. (2-tailed) .174 .009

N 54 54 54AGE AT MENARCHE Pearson Correlation .224 -.352** 1

Sig. (2-tailed) .104 .009

N 54 54 54

**. Correlation is significant at the 0.01 level (2-tailed).

4.7.2.2 Regression




1 BMIa . Enter





Estimate

1 .352a .124 .107 1.20115


71



1 Regression 10.625 1 10.625 7.364 .009a

Residual 75.023 52 1.443

Total 85.648 53



Model


t Sig.



1(Constant) 18.486 1.913 9.665 .000 14.648

BMI -.250 .092 -.352 -2.714 .009 -.435


72

Figure 28

Figure 29

73

4.7.3 FOR LOW BMI




age 15.0417 1.28756 48BMI 16.9365 1.38243 48AGE AT MENARCHE 13.0208 1.04147 48


age BMIAGE AT

MENARCHE

age Pearson Correlation 1 -.209 .269

Sig. (2-tailed) .154 .064

N 48 48 48BMI Pearson Correlation -.209 1 -.037

Sig. (2-tailed) .154 .804

N 48 48 48AGE AT MENARCHE Pearson Correlation .269 -.037 1

Sig. (2-tailed) .064 .804

N 48 48 48

4.7.3.2 Regression




1 BMIa . Enter





Estimate

1 .037a .001 -.020 1.05202


74



1 Regression .069 1 .069 .062 .804a

Residual 50.910 46 1.107

Total 50.979 47



Model


t Sig.



1(Constant) 13.490 1.886 7.152 .000 9.693 17.286

BMI -.028 .111 -.037 -.249 .804 -.251 .196


Figure 30

75

Figure 31

4.7.4 FOR HIGH NORMAL




age 14.8824 .92752 17BMI 22.9305 1.05844 17AGE AT MENARCHE 12.8235 1.62924 17


age BMIAGE AT

MENARCHE

age Pearson Correlation 1 .030 .068

Sig. (2-tailed) .908 .795

N 17 17 17BMI Pearson Correlation .030 1 -.175

Sig. (2-tailed) .908 .503


Sig. (2-tailed) .795 .503

N 17 17 17

76

4.7.4.2 Regression




1 BMIa . Enter





Estimate

1 .175a .030 -.034 1.65681




1 Regression 1.295 1 1.295 .472 .503a

Residual 41.175 15 2.745

Total 42.471 16



Model


t Sig.B Std. Error Beta

1 (Constant) 18.987 8.983 2.114 .052

BMI -.269 .391 -.175 -.687 .503


77

Figure 32

Figure 33

78

4.7.5 FOR LOW NORMAL




age 15.5405 .90045 37BMI 19.6675 .88510 37AGE AT MENARCHE 13.5405 1.01638 37


age BMIAGE AT

MENARCHE

age Pearson Correlation 1 .264 .218

Sig. (2-tailed) .115 .194

N 37 37 37BMI Pearson Correlation .264 1 -.323

Sig. (2-tailed) .115 .051


Sig. (2-tailed) .194 .051

N 37 37 37

4.7.5.2 Regression




1 BMIa . Enter





Estimate

1 .323a .104 .078 .97568


79



1 Regression 3.871 1 3.871 4.066 .051a

Residual 33.319 35 .952

Total 37.189 36



Model


t Sig.



1(Constant) 20.827 3.617 5.758 .000 13.484 28.169

BMI -.370 .184 -.323 -2.016 .051 -.743 .003


Figure 34

80

Figure 35

81

CHAPTER FIVE

DISCUSSION, SUMMARY, CONCLUSION AND

RECOMMENDATION.

5.1 DISCUSSION AND SUMMARY

The findings from this research show that total

Body mass index has a negative correlation with age at

menarche, but it is not enough to be used as a standard

in this study population; hence it is not statistically

significant. But interestingly the findings from this

research show that normal Body mass index has a

negative correlation with age at menarche P<0.01, and

it was enough to be used as a standard in this study

population, hence it is statistically significant.

Amongst other things, the study showed

statistically significant correlations between age and hip

circumference, BMI and hip circumference, BMI and

waist circumference, BMI and MAP, MAP and hip

circumference, MAP and waist circumference, SBP and

hip circumference, SBP and waist circumference, DBP

82

and hip circumference, DBP and waist circumference,

DBP and BMI all at a P value less than 0.05.

5.2 CONCLUSION

Though the findings showed no statistical

significance in the relationship between BMI and age at

menarche, one cannot ignore the relevance of fat

distribution, body adiposity, in determining the age at

menarche as there was statistical significance in the

relationship between the normal BMI and age at

menarche.

5.3 RECOMMENDATIONS

Based on the findings of this research, it is

recommended that further studies be done to determine

other factors affecting age at menarche and also to

confirm known factors that affect age at menarche. It is

also recommend that BMI of young girls be monitored so

as not set off an early age at menarche.

83

REFERENCES

Anderson S. E., Dallal G. E., Must A. (2003):

Relative weight and race influence average age at

menarche: results from two nationally representative

surveys of US girls studied under 25 years apart.

Pediatrics 111 (4 part 1): 844-850/pediatrics.111.4.PMID.

12671122.

Billewicz W. Z., Fellowes H. M., Hytten C. A.,

(1976): Comments on the critical mass and the age of

menarche. Annals Human Biology 3:51-59.

Butler L. M., Potischman N. A., Newman B.,

Millikan R. C., Brogan D., Gammon M. D., Swanson

C. A., Brinton L. A., (2000): Menstrual risks favours

and early-onset breast cancer. Cancer Causes control.

11(5): 451-8.

Cooper G. E., Phross S., Weinberg C., Baird D. W.,

Helan E., and Sandler D., (1998): Menstrual and

reproductive risk factors for ishaemic heart disease.

Epidemiology,10, 225- 259.

Cooper C., Kuh D., Egger P., Wadsworth M., and

84

Barker D., (1996): Childhood age and age at

menarche British Journal of Obstetrics and Gynaecology,

103,814-1.

Douglas J., (1996): The age of rearching puberty:

some associated factors and some educational

implications. Scienti (R) c Basis of Medicine Annual

Reviews, 66,91-105.

Elizondo S. (1992): Age at menarche: Its relation to

linear and ponderal growth. Ann Hum Biol 19: 197-199.

Ellison P. T., (1982): Skeletal growth, fatness, and

menarcheal age: a comparison of two hypothesis. Hum

Biol 54: 269-281

Forbes G. B., (1992): Body size and composition of

premenarcheal girls. American Journal Dis Child 146:63-

66.

Fredriks A. M., Van Buuren S., Fekkes M.,

Verloove-Vanhorick S. P., Wit J. M. (2005): Are

references for waist circumference, hip circumference

and waist hip ratio in Dutch children useful in Clinical

practice? European Journal of Pediatrics 164:216-222.

Frisch R. E., (1994): The right weight: body fat,

85

menarche and fertility. Proc Nutritional Society 53:113-

129.

Frisch R. E., (1994): Menstrual cycle. fatness as a

determinant of minimum weight for height necessary for

their maintenance or onset. Science 185:949-951.

Frisch R. E., (1976): Fatness of girl menarche to age

18 years, with a nomogram. Hum Biol 48: 353-359.

Frisch R. E., Gotz Welbergen A. V., Mcarthur J. W.,

Albright T., Witscht J., Bullen B., Birnholz J., Reed

R.B., Hermann H. (1981): Delayed menarche and

amenorrhea of college athletes in relation to age of

onset of training. J Am Med Asso 246: 1559-1563.

Frisch R.E., Revelle R. (1970): Height and weight at

menarche and a hypothesis of critical body weight and

adolescents events. Science 169: 397-399.

Frisch R. E., Reville R., Cook S. (1973): Components

of weight at menarche and the initiation of adolescent

growth spurt in girls: estimated total water, lean body

weight and fat. Hum Biol 45: 469-483.

86

Frisch R. E., Wyshak G, Vincent L (1980): Delayed

menarche and amenorrhea in ballet dancers. New

England Medical Journal 303: 17-19.

Fujii K. (2000): Verification for delayed menarche in

female sports athletes. Report by the Ministry of

Education , Science Sports And Culture and by a Grant-

in Aid for Scientific Research (C) (2) No.11680060 from

1999 to 2000. 1-107.

Fujii K., Yamamoto Y. (1995): The analysis of the

growth velocity curve in height based upon the maturity

age. Jpn J Phys Fitness Sports Med 44: 431-438.

Garn S., LA Velle M., Rosenberg, K., and H.

Awthorne V., (1986): Maturational timing as a factor

in female fatness and obesity. American Journal of

Clinical Nutrition, 43, 879-883.

Garrow J. S., Webster J. (1985): Quetelet’s

index(W/H2) as a measure of fatness. Int J Obes 9: 147-

153.

87

Glynn R. J., Christen W. G., Manson J. E., et al.

(1995): Body mass index; An independent predictor of

cataract. Arch Ophthalmol 113: 1131-1137.

Gluckman P. D., Hanson M. A. (2006): Evolution,

development and timing of puberty. Trends endocrine

Metabolism 17: 7-12.

Hernandez M. I., Unanue N., Gaete X., Cassorla F.,

Codner E. (2007): Age of menarche and its

relationship with body mass index and socioeconomic

status. Rev Med Chil 2007, 135: 1429-1436.

Johnston F. E., Malina R. M., Galbraith M. A.,

(1971): Height weight and age of menarche and the

"critical weight" hypothesis. Science 174:1148-1149.

Johnston F. E., Malina R. M., Galbraith M. A.,

(1971): Height, weight, age at menarche and the

“Critical weight” hypothesis. Science 174: 1148.

Johnston F. E., Roche A. F., Schell L. M.,

Wettenhall N. B., (1975): Critical weight at

menarche: Critique of a hypothesis. American Journal of

Dis. Child 129: 19-23.

88

Kaplowitz P. B. (2008): Link between body fat and the

timing of puberty. Pediatrics 2008, 121(Suppl 3): S206-

S217.

Komiya S., Eto C., Otogi K., Teramoto K., Shimizu

F., Shimamoto H. (2000): Gender differences in body

fat of low-high-body-mass children: Relationship with

body mass index. European Journal of Applied

Physiology 82: 16-23.

Magnusson, T. E. (1978): “Age at menarche in

iceland”. American journal of physical anthropology 48

(4):

511-514.DOI:10.1002/ajpa.1330480410.ISSN00029483.P

MID 655271.

McArthur J. W., (1974): Menstrual cycle, fatness as a

determinant of minimum weight for height necessary for

their maintenance or onset. Science 185:949-951.

Matkovich V., IIich J. Z., Skugor M., Badenhop N.

E., Goel P., Clairmont A., Klisovic D., Mahhas R.W.,

Landoll J. D. (1997): Leptin is inversely related to age

at menarche in human females. J Chin Endocrine

Metabolism 82:3239-3245.

89

Merzenich H., Boeing H., Wahrendorf J. (1993):

Dietary fat and sports activity as determinants for age

at menarche. Am J Epidemiol 138:217-224.

Parent A. S., Rasier G., Gerard A., Heger S., Roth

C., Mastronardi C., et al (2005): Early onset of

puberty: tracking generic and environmental factors.

Roberts, D., and Dann, T.,(1975): A 12year study of

menarcheal age. British Journal of Preventive and Social

Medicine,29, 31-39.

Shangold M., Kelly, Berkerley A., Freedman, K.,

and Groshen S., (1989): Relationship between

menarcheal age and adult height. Southern Medical

Journal, 82,443-445.

Sharma, K., Talwar,I., and Sharma , N., (1988):

Age at menarche in relation to body size and physique.

Annals of Human Biology, 15, 431-434.

Simmons K., Greulich W.(1943): Menarcheal age and

the height, weight and skeletal age of girls aged 7 to 17

years. J Pediatr 22: 518-548.

Stark O., Peckham C. S., Moynihan C. (1989):

Weight and age at menarche at menarche. Arch Dis

90

Child 64: 383-387.

Thomas F., Renaud F., Benefiee E., De Meeus T.,

Gluegan J. F. (2001): International variability of ages

at menarche and menopause. patterns and

determinants. Hum Biology 73: 271-290.

Vant's Hof M. A., Roede M. J. (1977): A Monte Carlo

test of weight as a critical factor in menarche, compared

with bone age and measures of height, width, and

sexual development. Annals of Human Biology 4: 581-

585.

Wyshak, G., and Frisch, R., (1982): Evidence for

secular trend in age at menarche. New England Journal

of Medicine, 306, 1033-1035.

X. Du, H. Greenfield, D. R. Fraser, K. Ge, W.

Zheng, L. Huang, Z. Liu (2003): “Low body weight

and its association with bone health and pubertal

maturation in Chinese girls”. European Journal of Clinical

Nutrition 57, 693-700. DOI: 10.1038/sj.ejcn.1601599.

91

APPENDIX ONE

QUESTIONNAIRE

Dear respondents,

Your cooperation is being solicited in the filling of

this questionnaire, with the assurance that all

information provided within are confidential and strictly

for medical research and shall be treated accordingly.

Please tick (√ ) in the box your answers, and skip

sectionD

SECTION A

92

Biodata

(1) Age…………….

(2) Gender: Female ( )

(3) Educational Status: SS1 ( ), SS2 ( ), SS3 ( )

(4) Ethnicity: Ishan ( ), Benin ( ), Hausa ( ), Yoruba ( ), others (specify)………..

(5) Parent’s occupation: Father……………….

Mother………………..

(6) What type of house do you live in? Single Room ( ), Self Contained ( ), Flat ( ),

Duplex ( ), Mansion ( ).

SECTION B

Level of activity

(7) Means of commuting: On foot most times ( )

Public transport most times ( )

Personal car- Type of car ( )…………………………..

Dropped off ( )

(8) Do you involve in any type of sporting activity (Exercise), Yes( ) No ( )

If yes, specify………………………………………………….

(9) How often do you exercise? Daily( )

Bi weekly ( )

Weekly ( )

Monthly ( )

93

SECTION C

Nutritional Data

(10) How many times do you eat a day on the average?

Once ( ), Twice ( ), Thrice ( ), More than three times ( ), Not regularly ( )

(11) What Food do you eat most frequently (STAPLE)?...........................

Is it your preferred diet?.................

(12) Are you on a diet or any weight modulator? Yes ( ), No ( ).

If Yes, what type?......................

(13) How often do you go to a food outlet to eat?

Daily ( ), Once a week ( ), Twice a week ( ), Weekly ( ), Monthly ( )

(14) Can you list the types of food you will like to eat if taken to such an outlet

……………………………………………………

……………………………………………………

……………………………………………………

(15) Do you take alcohol? Yes ( ), No ( )

(16) Does any member of your family have hypertension? Yes ( ), No ( ), Don’t

Know( )

(17) Is any member of your family obese? Yes ( ), No ( ), Don’t Know ( )

SECTION D

Anthropometry/Blood pressure

94

(18) Weight………….…Kg

(19) Height……………..m

(20) BMI………………..

(21) Blood pressure (a) Systolic……………(b) Diastolic………………(c) MAP

(22) Waist circumference……………………cm

(23) Hip circumference…………………cm

(24) Hip/Waist ratio…………………..

SECTION E

General

(25) Do you know your blood group? Yes ( ) No ( )

If yes, indicate type……………….

(26) Do you know your Genotype? Yes ( ) No ( )

If yes, indicate type……………….

(27) At what age did you experience your first menstrual period?...................yrs

(28) Are you sexually active? Yes ( ), No ( ).

(29) Do you use protection? Yes ( ), No ( ).

(30) Do you use pills? Yes ( ), No ( ).

(31) Do you know about HIV/AIDs? Yes ( ), No ( ).

95

(32) What causes HIV/AIDs?.......................................................

(33) Can HIV/AIDS be cured?.........................................

(34) How can HIV/AIDs be contracted?.......................................

(35) How can HIV/AIDs be prevented?........................................

96

Documents

Lawson's Project complete