BODY MASS INDICES AND 2-HOUR POSTPRANDIAL BLOOD GLUCOSE LEVELS IN PRIMARY SCHOOL PUPILS IN RURAL AND URBAN COMMUNITIES IN DELTA STATE

Abstract

Malnutrition, both obesity/overweight and undernutrition are now problems of public health
importance. These malnutrition states are associated with plethora of adverse conditions, like
derangements in glucose regulation. Studies have shown that chronic undernutrition can
cause pancreatic atrophy leading to impaired glucose tolerance or diabetes mellitus, while
obesity/overweight can cause insulin resistance which can also lead to impaired glucose
tolerance or diabetes mellitus.
This study aimed at determining the body mass indices of school aged children and using
these to determine their nutritional states. It was also aimed at determining their 2-hour
postprandial blood glucose level and to find if any relationship exists between their blood
glucose values and nutritional states.
School aged children between 6 and 12years in Illah (rural) and Asaba (urban) communities
of Delta State were studied. Their weights and heights were measured using the SECA 750
mechanical weighing scales and SECA 213 stadiometer respectively. Thereafter, the body
mass index (BMI) for each subject was calculated. This was further used to calculate the
WHO BMI z score for each subject. The z score was used to categorize subjects into obese,
overweight, normal weight, thin or severely thin.
Afterwards, a 2-hour postprandial blood glucose test was carried out. This was done by
giving the subjects a meal of rice to eat to their fill. At exactly 2 hours from the time of
commencement of the meal, their blood glucose levels were measured using the Accuchek
glucometer.
Six hundred and forty-six subjects participated in the study. The mean BMI of subjects from
Asaba of 16.71±2.49kg/m2 was significantly higher than the 15.63±2.43kg/m2 of the Illah

subjects (p=0.000). In the study population, thinness had the highest prevalence (16.9%),
followed by overweight (12.2%). In Asaba, the prevalence of overweight (16.6%) outstripped
that of thinness (9.1%) and obesity (2.2%). In Illah, prevalence of thinness (24.5%) was
higher than that of overweight (8.0%), obesity (0.6%) and severe thinness (0.6%). Severe
thinness was exclusive to this community.
The mean 2-hour postprandial blood glucose value for the general population was
84.17±14.26mg/dl. Prevalence of IGT in this study was 0.9% (6/646), and IGT was
exclusively found amongst males.
No correlations were found between the 2HPP and BMI z scores of subjects (severely thin,
thin, normal, overweight and obese subjects). However, the prevalence of IGT was highest
among thin subjects (1.8%) followed by overweight (1.3%), with those with normal weights
having the least prevalence (0.7%).
The prevalence of overweight was higher in children in the urban than the rural community,
and the difference in prevalence between the communities was significant. Thinness was the
major malnutrition problem in the rural area, its prevalence in the rural community was
greater than that in the urban community and this was statistically significant. Although both
were significant, thin children had higher likelihood of developing impaired glucose tolerance
than overweight children.
Undernutrition and overnutrition are problems in our communities; this study recommends
that prompt measures to address these should be put in place to avoid early and future
complications. Undernourished children are also at risk of developing glucose regulation
problems. This risk should be considered when thin children are evaluated.

BODY MASS INDICES AND 2-HOUR POSTPRANDIAL BLOOD GLUCOSE LEVELS IN PRIMARY SCHOOL PUPILS IN RURAL AND URBAN COMMUNITIES IN DELTA STATE