Một số chỉ tiêu nhân trắc và tình trạng dinh dưỡng của học sinh từ 6-10 tuổi thuộc khu vực miền núi tỉnh Bình Định
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Một số chỉ tiêu nhân trắc và tình trạng dinh dưỡng
của học sinh từ 6 - 10 tuổi thuộc khu vực miền núi
tỉnh Bình Định
Nguyễn Thị Tường Loan
Khoa Giáo dục Tiểu học và Mầm non, Trường Đại học Quy Nhơn
Ngày nhận bài: 30/09/2019; Ngày nhận đăng: 02/12/2019
TÓM TẮT
Mục tiêu của bài báo là đánh giá một số chỉ tiêu nhân trắc, từ đó thấy được tình trạng dinh dưỡng của học
sinh từ 6 - 10 tuổi thuộc khu vực miền núi. Nghiên cứu được tiến hành trên 2.040 học sinh (gồm 1.024 nam và
1.016 nữ) thuộc một số huyện miền núi tỉnh Bình Định theo phương pháp mô tả cắt ngang có so sánh. Kết quả
nghiên cứu cho thấy, các chỉ tiêu nhân trắc cơ bản: chiều cao, cân nặng, vòng ngực, vòng đầu của học sinh khu vực
miền núi tỉnh Bình Định tăng dần theo tuổi và hầu hết các chỉ số đều thấp hơn so với học sinh cùng độ tuổi ở các
khu vực khác trong nước và trên thế giới. Học sinh miền núi tỉnh Bình Định có tỷ lệ suy dinh dưỡng là 21,67%,
tỷ lệ này là khá cao so với cả nước và trong khu vực, vì vậy cần có những kế hoạch đầu tư hơn nữa về mọi mặt
cho các khu vực miền núi, nhằm giúp sự tăng trưởng của học sinh tốt hơn, góp phần nâng cao tầm vóc người Việt
Nam trên cả nước.
Từ khóa: Học sinh tiểu học, học sinh miền núi, học sinh Bình Định, chỉ số nhân trắc, dinh dưỡng học sinh.
*Tác giả liên hệ chính.
Email: loantuong@gmail.com
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Some anthropometric indicators and the nutritional status
of the pupils from 6 to 10 years old in the mountainous
area of Binh Dinh province
Nguyen Thi Tuong Loan
Faculty of Primary School and Preschool Education, Quy Nhon University
Received: 30/09/2019; Accepted: 02/12/2019
ABSTRACT
The objective of the paper is to assess some anthropometric indicators, showing the nutritional status of pupils
from 6 to 10 years old in mountainous areas. The research was conducted on 2,040 pupils (including 1,024 males and
1,016 females) in some mountainous districts of Binh Dinh province using the method of cross-sectional comparison.
The research results show that the basic anthropometric indicators: height, weight, chest, head circumference of
pupils in mountainous areas in Binh Dinh province increase gradually with age and most of the indicators are lower
than those of pupils of the same age in other parts of the country and around the world. Mountainous pupils in Binh
Dinh province have a malnutrition rate of 21.67%, which is quite high compared to that of the whole country and in
the region, so it is necessary to have more investment plans in all aspects for the mountainous areas to help pupils
have the better growth, contributing to raising the stature of Vietnamese people nationwide.
Keywords: Primary pupils, mountainous pupils, Binh Dinh pupils, anthropometric indicators, pupils’nutrition.
1. INTRODUCTION
Anthropometry is one of the biological
April 28, 2011,7 we conducted a research on basic
anthropometric indicators: height, weight, chest,
head circumference of primary pupils, from
that assessing the nutritional status of children
through the topic “Some anthropometric
indicators and the nutritional status of pupils
from 6 to 10 years old in the mountainous
area of Binh Dinh province ” to assess some
anthropometric indicators, from that showing
the nutritional status of pupils from 6 to 10 years
old in mountainous areas of Binh Dinh province.
indicators showing growth and development
in humans. For children, the anthropometric
indicators also show the growth rate and
nutritional status of children, contributing
to the orientation for the development and
stature of the Vietnamese people. However, the
current situation of the growth, development
and nutritional status of primary children in
mountainous areas is still limited, which has
affected quite a lot on the stature of Vietnamese
people and the human strategy in general. In
order to contribute to the implementation of the
“General project on physical development and
stature of Vietnamese people in the period of
2011 - 2030” of the Prime Minister, issued on
2. SUBJECTSAND RESEARCH METHODS
2.1. Subjects and research duration
- Our research subjects are pupils from
6 to 10 years old in primary schools in some
mountainous districts in Binh Dinh province.
*Corresponding author.
Email: loantuong@gmail.com
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Pupils in the research area were free of
chronic disease and were not morphologically
malformed, showed no abnormal physiological
signs, were not absent in surveys and were of
appropriate age.
in the formula we have: n1 = 384.
+ Step 2: There are 5 grades so the sample
size for the study is n2 = n1 x 5 = 1,920.
+ Step 3: Expected to give up 5%, so the
sample size to be collected is n = 1,920 + (1,920 x
5) / 100 = 2,016 pupils. The investigated sample
size that is satisfactory is 2,040 (> 2,016), so the
reliability is guaranteed.
- Research duration: from October 2017
to May 2018.
2.2. Sampling method and sample size
- The sample size was selected randomly
by the method of cross-sectional study design
and large samples were selected based on basic
investigations in biomedicine. Samples were
selected with the following steps:2,4
- Sampling method: Binh Dinh province
has 5 mountainous and midland districts
(collectively referred to as mountainous areas):
An Lao, Hoai An, Tay Son, Van Canh and Vinh
Thanh. Two districts randomly selected were
Van Canh and An Lao; 8 out of 20 primary
schools selected were Canh Vinh 1 Primary
School, Canh Vinh 2 Primary School, Canh Hiep
Primary School, Van Canh 1 Primary School, An
Lao Primary School, An Dung Primary School,
An Tan Primary School and An Vinh Primary
School. Pupils who meet the research criteria
of these schools were included in the study. The
sample is distributed as table 1.
+ Step 1: Calculate sample size by the
formula:
In which: n1 is the smallest research sample
size to be achieved for each grade; p is the normal
pupil rate, choose p = 0.5; d is the absolute error,
choose d = 0.05; is the reliability coefficient
corresponding to 95% reliability = 1.96; replacing
Table 1. Distribution of research samples by gender, age and location
Age
Gender
Total
6
7
8
9
10
Male
Female
Total
205
200
209
200
210
202
412
1.024
1.016
2.040
201
203
202
208
406
403
411
408
2.3. The method of data collection
measuring person must be equal to the bar of the
scale.1,2,3,10
Height: Using a wooden ruler to measure
the height of UNICEF with an accuracy of
0.1 cm. When measuring, pupils stand on a flat
ground, their heels close together, their eyes look
straight, making sure that 4 points: occipital,
back, buttocks and heels touch the ruler. The
upright posture is determined when the canthus
and the upper edge of the ear rim are in the
same horizontal line. The child stands upright,
the shoulders and arms are free on either side of
the person, knees do not sag, move the bar of
the scale silently until it touches the top of the
head of the child. When reading, the eye of the
Weight: Using a Japanese TANITA scale
with an accuracy of 0.1kg. The scale should
be placed on the horizontal plane. Before each
weighing, check the accuracy of the scale. The
child is upright on the scale so that the body
focus falls on the center of the scale. When
weighing, the child wears thin clothes, no hats,
shoes, sandals, away from meals and stands still
in the middle of the scales.1,2,3,10
Chest size: Using a Chinese inelastic
measuring tape with an accuracy of 0.1 cm. Each
measuring tape is not used over 100 times. When
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measuring, the child is in an upright position,
circle the measuring tape perpendicularly to
the spine, passing through the shoulder blade
(at the back) and the breastbone (in front of the
chest) so that the plane of the tape is parallel to
the ground. The measurement is determined by
the average of the chest measurements when the
child inhales and exhales as hard as he can. The
person measured is in an upright position, not
raising his hands up high, his arms stretched out
along his thighs, his posture stands naturally.1,2,3
and gender compared to the reference population
of WHO (2007).6,8,10
- Severe malnutrition: BMI <-3SD;
- Moderate malnutrition: - 3SD ≤ BMI
<-2SD;
- Normality: - 2SD ≤ BMI ≤ + 1SD
- Overweight: + 1SD <BMI ≤ + 2SD;
- Obesity: BMI> + 2SD.
2.4. Data processing method: The data is
processed in 2 steps is to filter the reasonable
data, then process by Epi Data 3.1 software and
transfer to Stata 10.0 software for analysis.
Head circumference: Using a Chinese
inelastic measuring tape with an accuracy of
0.1 cm. Each measuring tape is not used over
100 times. When measuring, the child is in an
upright position, circle the tape around the head,
the front of the lower edge of measuring tape
is near the eyebrow, and the back of measuring
tape through the occipital. The tester is standing
on the side of the person being measured, paying
attention that the measuring tape is not crooked,
skewed or twisted.5,10
3. RESEARCH RESULTS AND DISCUSSION
3.1. Height of mountainous primary pupils by
age and gender
Height is one of the basic morphological
indicators, used frequently in human
anthropological surveys. The result of the study
of height of 2,040 pupils in the mountainous
districts of Binh Dinh province is shown in
Table 2.
Nutritional status by BMI: Evaluation
of nutritional status based on Z - Score, by age
Table 2. Height of mountainous primary pupils in Binh Dinh province
Height (cm)
n = 1.024)
Male (
n = 1.016)
Female (
2
Total (n= 2.040)
Age
X1 - X1
p
1
± SD
X
Increase
X 1 ± SD Increase
X 2± SD
Increase
6
7
114,24 ± 6,07
120,20 ± 5,70
125,44 ± 6,06
130,08 ± 6,06
134,47 ± 6,13
-
5,96
5,24
4,64
4,39
5,06
113,96 ± 6,21
120,15 ± 5,72
125,14 ± 5,91
130,90 ± 5,90
134,68 ± 5,79
-
114,53 ± 5,92
-
5,73
5,50
3,52
4,98
4,93
- 0,57 > 0,05
- 0,11 > 0,05
- 0,62 > 0,05
1,62 > 0,05
0,42 > 0,05
6,19 120,26 ± 5,68
4,99 125,76 ± 6,22
5,76 129,28 ± 6,12
3,78 134,26 ± 6,48
5,18
8
9
10
Average increase / year
Table 2 shows that the height of pupils
increases from 6 to 10 years old. 6-year-old
children have an average height of 114.24 ± 6.07
cm and 10-year-old children are 134.47 ± 6.13
cm. Females have a lower annual growth rate
than men (females increase 4.93 cm/year, male
increase 5.18 cm/year), girls are higher than
boys (p> 0.05) at the age of 6 to 8 but at 9 and 10
years of age, boys are taller than girls (p> 0.05).
This may be because girls have puberty earlier
than boys so the age of prepuberty also comes
earlier. Comparing with a number of domestic
and foreign research results, we notice that the
group of pupils in our study has lower height than
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3.2. Weight of mountainous primary pupils
by age and gender
pupils in Thu Dau Mot City (2015) and pupils
of many studies in our country….2,3 Compared
to the research results of NCHS (1981), WHO
(2007) and CDC (2007-2010),10 the pupils in our
study were also lower in all age groups, although
these studies were conducted many years ago
(p <0.05).
Besides height, weight is also a basic
anthropometric indicator that clearly shows the
growth of children. The results of the weight
survey of mountainous pupils in Binh Dinh
province are shown in Table 3.
Table 3. Weight of mountainous primary pupils in Binh Dinh province
Weight (kg)
n = 1.024)
n = 1.016)
Female ( 2
-
X1 X2
p
Total (n= 2.040)
Male ( 1
X1 ± SD
Age
± SD
X
Increase
-
Increase
-
X2 ± SD
Increase
-
6
7
8
19,13 ± 4,00
21,24 ± 4,63
23,72 ± 5,19
19,13 ± 4,33
21,46 ± 4,89
23,21 ± 5,03
19,13 ± 3,66
21,03 ± 4,36
24,26 ± 5,31
0,00
0,43
> 0,05
> 0,05
> 0,05
2,11
2,48
2,33
1,75
1,90
3,23
-1,05
9
26,43 ± 5,66
28,24 ± 6,02
2,71
1,81
2,28
27,03 ± 5,41
29,61 ± 6,74
3,82
2,58
2,62
25,85 ± 5,85
26,81 ± 4,77
1,59
0,96
1,92
1,18
> 0,05
> 0,05
10
-0,20
Average increase / year
Table 3 shows that the weight of the child
increases over the years. At the age of 6, the
mountainous pupil in Binh Dinh province had
an average weight of 19.13 ± 4.00 kg but by
the age of 10 was 28.24 ± 6.02 kg. The average
annual increase is 2.28 kg, of which the male
has an average growth rate higher than that of
female (male increases 2.62 kg/year and female
is 1.92 kg/year). The weight of male and female
children at different ages is not much different
(p > 0.05).
was 2.7 kg/year; 2009 was 2.37 kg/year; 2013
was 2.22 kg/year; 2015 was 2.99 kg/year and
in our study was 2.28 kg/year. Comparing the
weight of primary pupils in Binh Dinh province
in 20098 with current mountainous pupils shows
that after nearly 9 years their weight did not
increase (p < 0.05). Thus, in the same study area,
the weight of the mountainous group of pupils
is lower than the average weight of pupils of the
same age in the province, this is explained by
the limitations of socio-economic conditions of
mountainous districts. The weight of pupils of
the same age in our study is also lower than that
of foreign organizations such as NCHS, WHO
and CDC (with p < 0.05).10
Pupils in mountainous areas in Binh Dinh
province have an increasing weight of 6-10 years
old, consistent with previous studies....1,2,3,6,10 The
highest increase is for females at the age of 7 and
for males at the age of 9. At all ages, pupils in
mountainous Binh Dinh province have a higher
weight than that in the research results in 2002
and 2003 (p < 0.05) and lower than that in the
results of recent years (2009, 2013, 2015) with
p < 0.05. The average increase of pupils in 2002
was 2.63 kg/year; 2003 was 1.67 kg/year; 2007
The third important anthropometric
indicator of physical strength of each person is
chest size. The average chest size of 2,040 pupils
in the mountainous area of Binh Dinh province
is shown in Table 4.
3.3. Chest size of mountainous primary pupils
by age and gender
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Table 4. Average chest size of mountainous pupils in Binh Dinh province
Chest size (cm)
n = 1.024)
Male ( 1
n = 1.016)
Female ( 2
-
Age
X1 X2
p
Total (n= 2.040)
± SD
X
Increase
X1 ± SD
Increase
-
X2 ± SD
59,25 ± 4,62
59,73 ± 5,06
61,54 ± 6,05
Increase
-
6
7
8
59,19 ± 5,11
59,79 ± 5,06
61,05 ± 6,01
-
59,14 ± 5,57
59,85 ± 5,06
60,57 ± 5,94
-0,11 > 0,05
0,12 > 0,05
-0,97 > 0,05
0,60
1,26
0,71
0,48
0,72
1,81
9
63,16 ± 6,08
64,56 ± 6,38
2,11
1,40
1,34
64,73 ± 5,88
65,18 ± 7,08
4,16
0,45
1,51
61,65 ± 5,91
63,91 ± 5,50
0,11
2,26
1,17
3,08 > 0,05
1,27 > 0,05
10
Average increase / year
The chest size indicator of mountainous
pupils in Binh Dinh province at the age of 6 is
59.19 ± 5.11 cm, at 7 years old - 59.79 ± 5.06 cm;
at 8 years old - 61.05 ± 6.01 cm; at 9 years old -
63.16 ± 6.08 cm and at 10 years of age is 64.55 ±
6.38 cm. The difference in chest size in male and
female is not statistically significant (p> 0.05).
Males have the fastest chest size growth at 9
years old and females at 10 years old.
average growth rate of 0.46 cm/year. In general,
the average circumference of pupils from 6 to
10 years old in Binh Dinh province is 51-54 cm,
which is higher than that of pupils at the same
age of Vietnamese standard in GTSH (p < 0.05).1
According to the research in 2012 by
Dinh Ngoc De, the average size of the head
circumference of children from 6 to 12 years old
is 50 - 52 cm. Other researches suggest that the
average head circumference for 6 to 10 years old
pupils is 50 - 54 cm. The results of the head size
survey by WHO are as follows: at 6 years of age
is 48 - 52.5 cm, at 7 years olds: 48.2 - 54 cm, at
8 years old: 48.6 - 54.2 cm, at 9 years old: 48.8 -
54.6 cm and at 10 years of age is 48.9 - 54.8 cm.
Turkish primary pupils in 2015 have a head size
of 48 - 56.5 cm...5,9,10 Head circumference, body
size and memory have a positive correlation, so it
is important to pay attention to diet and safety to
help the child’s brain develop well. On the other
hand, it is necessary to enhance memory training
for children through intellectual activities such as
learning, games ... Thus, the head circumference
of pupils from 6 to 10 years old in mountainous
areas in Binh Dinh province is within normal
limits. Based on height and weight criteria, we
determine BMI, from that assessing nutritional
status of pupils.
The increase in chest size of male pupils is
higher than that of female pupils (male increases
an average of 1.51 cm/year; female is 1.17 cm/year).
Comparing the growth of chest size of
primary pupils in mountainous areas of Binh
Dinh province with other studies shows that
pupils in our study have lower average chest size
than that in the research results in pupils of the
same age in the province and city of Thu Dau
Mot in 2015 (p < 0.05).3
3.4. Head circumference of mountainous
primary pupils by age and gender
Table 5 shows that the head circumference
of pupils increases gradually with age with
not much increase. 6-year-old children have a
circumference of 51.16 ± 1.45 cm for boys and
51.11 ± 1.68 cm for girls; up to 10 years of age,
the male has a head circumference of 53.38 ±
1.70 cm and the female is 52.55 ± 1.45 cm; the
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Table 5. Average head circumference of mountainous pupils in Binh Dinh province
Head circumference (cm)
-
Age
X1 X2
p
n = 1.024)
n = 1.016)
Female (
2
Total (n= 2.040)
Male (
1
± SD
X
Increase
-
X1 ± SD
Increase
-
X2 ± SD
Increase
-
6
7
51,14 ±1,57
51,60 ±1,61
51,74 ±1,69
52,62 ±1,93
52,97 ±1,63
51,16 ± 1,45
51,52 ± 1,46
51,74 ± 1,57
53,29 ± 1,85
53,38 ± 1,70
51,11 ± 1,68
51,68 ± 1,74
51,74 ± 1,62
51,98 ± 1,79
52,55 ± 1,45
0,05 > 0,05
-0,16 > 0,05
0,00 > 0,05
1,31 > 0,05
0,83 > 0,05
0,46
0,14
0,88
0,35
0,46
0,36
0,22
1,55
0,09
0,56
0,57
0,06
0,24
0,57
0,36
8
9
10
Average increase / year
and moderate malnutrition, accounting for
5.49% and 16.18% respectively. Of which, male
children account for a higher proportion than
female children.
3.5. Nutritional status of mountainous pupils
in Binh Dinh province
Table 6 shows that mountainous pupils
have a high proportion of severe malnutrition
Table 6. Nutritional status of mountainous pupils in Binh Dinh province
n =1.024)
n = 1.016)
Total (n= 2.040)
Male (
Female (
1
2
Nutritional status
n
%
n
%
n
%
Severe malnutrition
Moderate malnutrition
Normality
112
330
1364
162
72
5,49
16,18
66,86
7,94
68
167
661
77
6,64
16,31
64,55
7,52
44
163
703
85
21
4,33
16,04
69,19
8,37
2,07
Overweight
Obesity
3,53
51
4,98
Primary pupils in Binh Dinh province
in 2009 had an average malnutrition rate of
22.23% but by 2016 it was only 11.18%;8 This
shows that the malnutrition rate among pupils of
this age has decreased significantly. However,
mountainous pupils in our study account for
a malnutrition rate of 21.67% (p > 0.05). This
shows that the malnutrition rate of pupils in the
province has decreased but it has only decreased
in urban and rural areas; mountainous areas have
hardly decreased.
and 18.1%. The highest rate of malnutrition is
in mountainous areas, then to rural areas and
the lowest is urban areas. Meanwhile, the ratio
of overweight - obesity is highest in urban areas
and lowest in mountainous areas.6
The situation of malnutrition, overweight
and obesity of children varies by ecological
region and time of study. In 2011, the survey
result of stunting children in 6 provinces
(Hanoi, Ha Nam, Quang Binh, Hue, Ho Chi
Minh City and Ben Tre) in Vietnam was 13.7%
at the age of 6 - 9 and 18.2% at the ages of
9 - 11. In 2012, among primary pupils in district
5 Ho Chi Minh City 2.3% were malnourished,
and 21.2% were overweighed. In 2014, research
results at some primary schools in Nghia Dan,
From 2010 to 2012, a study of 3,600
children aged between 0.5 and 11 in urban
and rural areas showed that the proportion of
malnourished children in 2000, 2010 and 2011
gradually decreased, respectively 30.8%; 21.5%
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Nghe An showed that 21.5% of the pupils had
low weight and stunting pupils accounted for
17.8%.6 In 2015, the number of malnourished
primary pupils in Hai Phong was 2.15%, in Thu
Dau Mot was 5.7% in boys and 8.91% in girls....3
In general, primary pupils in the mountainous
areas of Binh Dinh province nowadays have
a quite high rate of malnutrition (21.67%)
compared to the whole province, other provinces
in the country and in the region.10
- Malnutrition status accounts for 21.67%.
This is a relatively high rate compared to the
current rate of the whole province and the whole
country.
REFERENCES
1. Ministry of Health. Biological values of ordinary
Vietnamese in the 90s - XX century, Medical
Publishing House, Hanoi, 2003.
2. Tran Long Giang, Mai Van Hung. Research on
morphological indicators of students from 6 - 17
years old in Yen Bai province, Vietnam Journal
of Medicine, 2013, 141, 45-57.
The basic anthropometric indicators of
pupils from 6 to 10 years old in mountainous
areas of Binh Dinh province are higher than
that of the Vietnamese biological values (2003)
but lower than that of pupils of the same age
according to recent domestic studies2,3 and
foreign organizations.10 The situation of severe
and moderate malnutrition of children is quite
high. Therefore, organizations and authorities
need to have more policies on economy, culture
and society to support the lives of people in
mountainousareas,andneedtoplankeystrategies
such as health, nutrition and education… to help
children and people in these areas have a better
life, higher incomes, stable jobs, contribute
to raising awareness and improving life for
themselves and the community in order to
implement the project on physical development
and stature of the Vietnamese successfully.
3. Nguyen Thi Thu Hien, Nguyen Thi Thuy Hiep.
Research on physical fitness of elementary
students in Thu Dau Mot City, Binh Duong
province, Thu Dau Mot University Magazine,
2015, 3(22), 43-50.
4. Nguyen Truong Nam. Methods of determining
sample size, Institute of Medical and Social
Research, 2014.
5. Nguyen Thi Thu Phuong, Vo Truong Nhu
Ngoc. Head - face growth, Vietnam Education
Publishing House, 2013.
6. Tran Dinh Thoan and coworker. Commenting
on the nutritional status of primary children in
Tien Hai district, Thai Binh province through a
number of anthropometric indicators, Journal of
Practical Medicine, 2013, 5(869), 155-157.
7. Prime Minister. Decision on approving the
“General project on physical development and
stature of Vietnamese people in the period of
2011 - 2030”, Hanoi, April 28, 2011.
4. CONCLUSION
-Anthropological indicators of pupils from
6 to 10 years old in the mountainous districts of
Binh Dinh province gradually increase with age.
The average height of children from 6 to 10 years
old is 114.24 cm; 120.20 cm; 124.44 cm, 130.08
cm and 134.47 cm respectively. Average weight
is 19,13 kg; 21.24 kgs; 23.72 kg; 26.43 kg and
28.24 kg respectively. The average chest size is
59.19 cm; 59.79 cm; 61.05 cm; 63.16 cm and
64.56 cm respectively. The head circumference
increases gradually: at 6 years of age is 51.14
cm; at 7 years old - 51.60 cm; at 8 years old -
51.74 cm; at 8 years old is 52.62 cm and at 10
years of age is 52.97 cm.
8. Vo Van Toan. Research on malnutrition and
obesity situation in elementary children in Binh
Dinh and propose preventive measures. Theme of
Science and Technology recognized by Minister
of Education, Quy Nhon University, 2009.
9. Medlineplus. Head circumference, Bethesda,
MD: National Library of Medicine; Available,
2014.
10. Neyzi O. et al. Reference Values for Weight,
Height, Head Circumference, and Body Mass
Index in Turkish Children, J Clin Res Pediatr
Endocrinol 2015; 7(4), 280-293, DOI: 10.4274 /
jcrpe .2183, 2015.
94
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