ABSTRACT
Assessment of nutritional status of children and adolescents is a good indicator of socioeconomic growth of a community. The best worldwide indicator of children and adolescents' well-being is growth. The assessment of growth provides information about health and nutritional status of children and adolescents. In Nigeria, little attention is paid to the growth of children > 5 years. As a result, data on growth and nutritional status of children and adolescents in Nigeria are limited. Anthropometric measures have long been used for assessments of growth and nutritional status, but percentile ranges for healthy Nigerian children and adolescents are currently unavailable. Anthropometric and sociodemographic data from 7,321 children and adolescents from Nasarawa State were collected from preschool, nursery, primary, junior and senior secondary schools from Lafia (urban setting) and Doma (rural setting) Local Government Areas. The nutritional status was examined by converting measurementsto z-scores using the World Health Organization growth reference. z-scores for height <�’2 and <�’3 were considered as moderate stunting and severe stunting (that is, shortstature); BMI z-scores <�’2 and <�’3 were considered as moderate thinness and severe thinness (or underweight) and those> +1 and > +2 as overweight and obesity, correspondingly. Meanz-scores and the prevalence below or above these cut-offswere calculated by age and sex. Deviation from the expectedmean of zero was tested with a one-sample t-test within agegroups, and differences in mean z-scores between boys andgirls with an unpaired sample t-test.The Lamda, Mu and Sigma (LMS) method was used to constructsix (6) smoothed-percentile reference curves and the LMS parameters needed for z-score estimation by age and sex were generated. The prevalence of moderate and severe stunting for the overall population are 20.3% and 6.5%, respectively, whereas, the prevalence of moderate and severe thinness for the combined population were 32.6% and 14.2%respectively. The prevalence of overweight and obesity were respectively 2.7% and 0.6%. The prevalence of stunting and thinness were higher in boys (21.1% and 36.1% respectively) than in girls (18.0% and 29.5% respectively). Compared to the WHO reference, percentiles of height and BMI of children and adolescents from Nasarawa State were generally lower. This difference was appreciably more pronounced in boys than in girls. Age- and sex-specific-smoothed-percentiles and corresponding LMS variables for height, weight, BMI, skinfold thicknesses (biceps, triceps, sub-scapular and supra-iliac), MUAC and its derived measures (UAMA and UAFA) were fitted. Multiple logistic regression demonstrated that moderate stunting was affected by father's educational background, compared to mother's level of education. In contrast, severe stunting had stronger association with mother's level of education than father's educational background. However, ethnicity was not associated with stunting. Parent's educational background was not associated with moderate thinness. However, father's level of education showed stronger association with severe thinness compared to mother's level of education. Moreover, stepwise logistic regression showed the order of influence of parent's level of education as mothers with no formal education > father with no formal education > father attaining primary education > mother attaining secondary education. In conclusion, this study revealed a high prevalence of stunting, thinness and low level of overweight and obesity among children and adolescents from Lafia and Doma Local Government Areas indicating growth faltering and malnutrition. Children and adolescents from these Local Government Areas fall below WHO centile references. This study established up-to-date centile curves for height, weight, BMI, MUAC and its derived measures and skinfold thicknesses. These reference curves describe the current status of these anthropometric markers and can be used as a basis for comparison in future studies.