BODY NUTRITIONAL STATUS IN BULGARIAN PRESCHOOL CHILDREN (SMOLYAN REGION, 1996-2019)

INTRODUCTION

In the beginning of the new century, reports started to appear in the scientific literature in relation to positive secular changes in some features, like height, weight and features of nutritional status, leading to increasing spread of overweight and obesity among the children in pre-school age as well (Ogden et al., 2012).  The continuous drop in age of children with overweight and obesity is part of this probable new century tendency (Zhecheva, Yankova, 2017). We are talking about “secular changes in the way of life”, related to morphological, functional and motor changes having negative impact on health at later age (World Health Organisation, 1995, 1997; Mayscie-Taylor, 1991; Franks et al. 2010; Reilly, Kelly, 2010 ; Biro, Wien, 2010; Goran et al., 2003; van Viet et al., 2010; Kovarova et all., 2002 and other).

But despite of the reasons causing them, the secular processes are continuing and are changing the human as biological species. The above requires continuous monitoring of the growth and development processes in order to update the growth standards, to provide correct and adequate evaluation of the physical development in the modified social and economic conditions of living and to ensure early diagnosis of the deviations in physical development. In relation to that, the studies of the processes of growth in the early age of children, in all their aspect and dimensions, are especially current and valuable both for science and pediatricians.

The PURPOSE of the present study is to investigate the changes in body nutritional status among Bulgarian preschool children in age and secular aspects.

MATERIAL AND METHODS: A transversal anthropometric study of 330 children (161 boys and 169 girls), aged between 3 to 6 years from district of Smolyan was performed in the period 2017-2019 (Sample A). All studied children are clinically healthy and are of Bulgarian origin. The children were distributed in eight age-gender groups (4 groups per each gender) - three-years-old, four-years-old, five-years-old and six-years-old. The average age of the children is 3.5, 4.5, 5.5 and 6.5 years. For the performance of the analysis of the secular changes, earlier anthropometric data, collected by the author, for another 406 children from Smolyan region, aged between 3-6 years, transversally studied in the period 1998-2001 - Sample B (Mladenova, 2003) were also used. Two main anthropometric indicators have been measured for each child, as per the methods of Martin-Saller, 1959: height (cm) and weight (kg). The hеight is measured by original anthropometer GPM (Siber-Hegner Company, Swiss), and the weight by body composition scale analyzer Tanita BC 465 (Tanita, Japan), with precision up to 0.100 g. On this base the body mass index (BMI, kg/m2) was calculated by the formulae. For assessment of body nutritional status the investigated children were grouped into four categories of BMI: underweight, normal weight, overweight and obesity in accordance with the international BMI cut-off points for children (IOTF),(Cole et . 2000; 2007; Cole, Lobstein, 2012). The data have been processed through statistical software package Statistica 10.0 (StatSoft Inc.), by using analysis of variance. The criteria X2 with level of significance of p<0.05 was used for check of the reliability of the group averages.

RESULTS and CONCLUSION:

In summary, the results of the study show that there is a secular changes in the nutritional status among the children of Smolyan region at age 3-6 years during the last 20 years (1998-2019), which are different for the two genders. The body mass index show a significant increase, especially well expressed in 3- and 6-year-old girls and 5- and 6-year-old boys. There is a tendency to reduce the prevalence of underweight, at the expense of the increasing prevalence of overnutrition - overweight and obesity.

The reasons for the higher values of BMI in modern children, and respectively the increased prevalence of overweight and obesity are the result of increased body weight, against the background of constant body height. Weight gain is associated with more fat, accumulating as a result of secular changes in the lifestyle and diet of the current generation of children, combined with hypodynamics. Our results confirm the global trend of increasing values of the body mass index and the spread of overnutrition in less urbanized settlements and populations of small towns and villages, such as ours. The reasons for this drastic change over the last 20 years are the subject of our ongoing study.

ACKNOWLEDGEMENTS: The present study was performed by partial financial support of Fund “Scientific Researches” of Plovdiv University “Paisii Hilendarski”, within contracts number FP19 FS - 004 and FP 21-FS 003.