Next Article in Journal
Lung Thermal Ablation: Comparison between an Augmented Reality Computed Tomography (CT) 3D Navigation System (SIRIO) and Standard CT-Guided Technique
Previous Article in Journal
Stereotactic Thermal Ablation of Liver Tumors: 3D Planning, Multiple Needle Approach, and Intraprocedural Image Fusion Are the Key to Success—A Narrative Review
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Biology
Volume 10
Issue 7
10.3390/biology10070645
biology-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles thumb_up
...
Endorse textsms
...
Comment
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Normative Values of Height, Bodyweight and Body Mass Index of 12–17 Years Population from Extremadura (Spain)

by
Rafael Gómez-Galán
1,
Raquel Pastor-Cisneros
2,*,
Jorge Carlos-Vivas
2,
María Mendoza-Muñoz
2,
José Carmelo Adsuar
1,
Miguel Ángel García-Gordillo
3 and
Laura Muñoz-Bermejo
1
1
Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Cáceres, Spain
2
Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
3
Facultad de Administración y Negocios, Universidad Autónoma de Chile, Sede Talca 3467987, Chile
*
Author to whom correspondence should be addressed.
Biology 2021, 10(7), 645; https://doi.org/10.3390/biology10070645
Submission received: 23 June 2021 / Revised: 3 July 2021 / Accepted: 8 July 2021 / Published: 10 July 2021
(This article belongs to the Section Physiology)
Browse Figure
Review Reports Versions Notes

Abstract

:

Simple Summary

Growth charts constitute an essential tool for monitoring adolescents’ development. The percentile growth charts currently used are based on Basque Country population. Considering socioeconomic differences between Spanish regions, growth chart data could be inappropriate. Thus, a descriptive cross-sectional study with 4130 adolescents was conducted to describe the percentile distribution of adolescents from Extremadura and compares these percentiles with those used as reference. Bodyweight, height and BMI of Extremadura adolescents differ from the reference values currently applied. Thus, the need to use new indicators should be considered, adapted to the physical and anthropometric reality of children and young people to avoid the possible normalization of situations of thinness, overweight or obesity.

Abstract

Background: Growth charts constitute an essential tool for monitoring adolescents’ development. In Extremadura, the percentile growth charts by Faustino Orbegozo Foundation are used. However, they are based on Basque Country population data. Considering socioeconomic differences between Spanish regions, growth chart data could not be appropriate. Aims: to describe the percentile distribution of adolescents from Extremadura and compare these percentiles with those proposed by the Faustino Orbegozo Eizaguirre Foundation that are currently applied in the Extremadura Health Service. Methods: A descriptive cross-sectional study was conducted. A total of 4130 adolescents (12–17 years) participated into the study. Bodyweight and height were assessed. Results: Significant differences were found comparing real measured values with commonly used reference tables for bodyweight at all ages between 12 and 13 years and at 14 years in both gender (p < 0.05). Differences were also found in boys at 15, 16.5 and 17 years (p < 0.05). Regarding height, significant differences were reported at 12, 13, 14.5, 15, 16.5 and 17 years old (p < 0.05) in males; while females’ results only revealed differences at 12, 12.5, 14.5 and 15.5 years (p < 0.05). BMI outcomes showed differences in both gender at 12, 12.5, 13, 14 and 15 years old (p < 0.05). Differences were also found at 16 and 14.5 years for boys and girls, respectively (p < 0.05). Conclusion: Bodyweight, height and BMI of adolescents from Extremadura differ of the reference values currently applied. Hence, this study’s outcomes suggest the need to use new indicators, adapted to the physical and anthropometric reality of children and young people to avoid the possible normalisation of situations of thinness, overweight or obesity.

Graphical Abstract

1. Introduction

Intergenerational changes in bodyweight, height, and body mass index (BMI) have been exposed in different long-term trend studies on physical characteristics of children and adolescents [1,2]. These indices of physical development show upward trends, reflected by increasing height and body mass in successive generations of young people. This phenomenon is widespread in Europe [3].
Focusing in Spain, the 2008 data [4] show a clear long-term acceleration in population’s height and bodyweight compared to other Spanish studies that were carried out 20 years ago in individuals from Catalonia [5,6], observed Galicia [7], Madrid [8], Murcia [9], the Canary Islands [10] and Bilbao [11]. The long-term acceleration of growth is interpreted as higher values for height at all percentiles for both genders, but more accentuated in females. Regarding bodyweight values, an increase has been also observed for percentiles below or equal to the 50th percentile (BMI increase from-0.1 to 1.4) and disproportionately for higher percentiles (BMI increase from 1.5–5.3), particularly for the 97th percentile (BMI increase from 3.7 to 5.3) [4].
Growth charts constitute an essential tool for monitoring children’s and adolescents’ development and are commonly used to diagnose and control changes in height, bodyweight and BMI [12]. In Extremadura, the percentile growth charts and graphs published by the Faustino Orbegozo Eizaguirre Foundation, since its first edition in 1985, have been taken as a reference [13]. Although the Foundation updated the growth charts in 2011 through the Bilbao Growth Study: growth curves and charts (cross-sectional study) [14], currently, the health records of children in Extremadura maintain the use of tables and graphs produced and published in 2004 (FO04) [11] derived from the Growth Curves and Tables Study (longitudinal and cross-sectional studies).
It should be noted that the monitoring of child and adolescent growth in Extremadura is being carried out by means of tables based on anthropometric data from children living in the Basque Country. Considering that differences have been found in the Human Development Index (HDI) between the most developed territories in Spain, such as Basque Country, and others least developed, such as Extremadura [15], the generalization of growth chart based on data from only one region could not be appropriate since the development and growth of young people in both territories could present significant differences adolescents considering the particular living context of every region.
No studies have analysed the percentile distribution of height, bodyweight and BMI of adolescents from Extremadura. Considering that percentiles are useful to compare several population subgroups based on an average, if these populations show differences, such comparison might be biased and inappropriate.
Furthermore, it is important to consider that growth charts are based on BMI. Although the BMI has been widely used as the standard clinic tool for determining the bodyweight status in young people [16,17], the association between this parameter and other body composition variables is unclear [18,19,20]. It may be due to the BMI representing both fat and fat-free mass, being an indicator of bodyweight instead of adiposity [21]. Thus, the use of BMI as only an indicator of bodyweight status may be questioned.
Therefore, this study aims to (1) describe the percentile distribution of adolescents from Extremadura and (2) compare these percentiles with those proposed by the Faustino Orbegozo Eizaguirre Foundation that are currently applied in the Extremadura Health Service.

2. Materials and Methods

2.1. Study Design

A descriptive cross-sectional study with a 14 month cut-off period was conducted (October 2007 to December 2008). A stratified multistage sampling was used. The units of the successive stages were provinces, healthcare areas, city typology (urban/rural), educational centres (IESO), academic year (classes where the survey is carried out), gender and pupils (surveyable persons).

2.2. Ethics Approval

A favourable report was obtained from the Bioethics Committee of the University of Extremadura, considering that it complied with all the relevant regulations (reference code 11/2006).

2.3. Participants

Thirty-nine secondary schools from Extremadura were contacted to participate in this study. A total of 4130 adolescents (2128 males and 2002 females), aged between 12 and 17 years, participated into this study. Participants had to meet the following eligibility criteria to be included in this project: (1) age: 12 to 17 years; (2) registered and/or resident in the autonomous community of Extremadura; (3) authorised by parents or legal guardians; (5) acceptance of the adolescents to participate in the study.

Sample Size

To provide estimates with a certain degree of reliability of the survey at Autonomous Community level, a sample of 4130 individuals between 12 and 17 years of age has been selected. Based on data from the National Institute of Statistics of Spain (www.ine.es, accessed on 16 June 2021) [22], the population for this age bracket is 74,239 in Extremadura (51.3% males, 48.7% females).
Sections are made within each stratum with probability proportional to its size. Proportional allocation between strata (health areas) was used. Within each stratum, the size of each sub-stratum (rural or urban area) was used. The type of sampling was proportional in age and gender quotas, randomly selected within the educational centre of the determined populations.

2.4. Procedures and Measures

Data collection was carried out in their respective educational institutions by trained and standardised health personnel. The measurements were performed under standardized conditions, following the protocol established in the Data Collection Procedure Manual, developed specifically for Childhood Obesity Surveillance Initiative (COSI) [23]. For measuring bodyweight and height, participants were asked to remove their shoes and socks and any heavy clothes (coats, sweaters, jackets, etc.) or accessory (pockets, belts). Height was measured with a stadiometer (Tanita Tantois, Tanita Corporation, Tokyo, Japan) placed on a vertical surface with the measurement scale perpendicular to the ground. It was measured on a standing position, with shoulders balanced and arms relaxed along the body. The outcome was taken in cm, to the nearest mm. Bodyweight was evaluated using a bioimpedancemeter (Tanita MC-780 MA, Tanita Corporation, Tokyo, Japan) and was recorded in kg, up to the nearest 100 g. BMI was calculated using the formula: bodyweight (kg) divided by height squared (m2).

2.5. Statistical Analyses

All information collected was tabulated in a database specifically designed for this purpose. Statistical analyses were carried out using IBM SPSS Statistics software, version 25. Descriptive statistics were performed for all parameters, including as measures of central tendency the mean and standard deviation (SD) for the dispersion of quantitative variables and percentiles (2, 3, 10, 15, 20, 25, 50, 50, 75, 80, 85, 90, 97 and 98) as measures of position.
Normality and homogeneity of data was checked applying Kolmogorov–Smirnov and Levene’s test, respectively. Then, differences between the Extremadura data and the reference study by Faustino Orbegozo Eizaguirre (currently used by the Extremadura Health Service) were examined by applying an Independent samples T-Test adjusted by age and gender. Alpha level was set at p ≤ 0.05. Hedge’s g effect size (95% confidence interval) was calculated to determine the magnitude of between reference methods comparisons. Effect size thresholds were interpreted, as follow [24]: >0.2, small; >0.5, moderate; >0.8, large.

3. Results

Table 1 shows participant’s characteristics of bodyweight, height and BMI stratified by gender and age. The number of participants assessed for each group is also indicated. Results indicates that boys experience an increase in bodyweight (12.3 kg) and height (10.2 cm) between 13.5 and 15 years old, stabilizing both in posterior ages. With respect to BMI, there is a progressive increase from 12 to 17 years, obtaining the maximum value at 15 years old. Girls’ outcomes show a progressive increase in bodyweight through age increases, obtaining maximum values at 16–16.5 years. Similar results were found for height since a progressive increase until 15 years was reported, when height stabilises. BMI follows a progressive and constant increase until 16 years, where its maximum value is reached.
Table 2 and Table 3 illustrate the comparative of our bodyweight, height and BMI values and others reported in a previous cross-sectional study by Sobradillo et al. [11] for boys and girls, respectively. Between-study comparison outcomes for bodyweight shows significant differences in bodyweight between 12 and 13 years old in both gender (boys: p < 0.001; girls: p < 0.001 to 0.003) and at 14 years old (boys: p = 0.002; girls: p = 0.005). A meaningful difference was also found in boys at 15 (p < 0.001), 16.5 (p = 0.001) and 17 years (p < 0.001). Regarding height, significant differences were reported in boys at 12 (p < 0.001), 13 (p < 0.001), 14.5 (p = 0.027), 15 (p = 0.005), 16.5 (p < 0.001) and 17 (p < 0.001) years, while girls’ outcomes only revealed differences at 12 (p < 0.001), 12.5 (p < 0.001), 14.5 (p < 0.001) and 15.5 (p = 0.009) years. Likewise, BMI comparisons also showed differences between studies. Coincidently, there were significant differences for BMI in both gender at 12 (boys: p = 0.032; girls: p < 0.001), 12.5 (boys: p = 0.001; girls: p < 0.001), 13 (boys: p = 0.027; girls: p = 0.007), 14 (boys: p = 0.007; girls: p < 0.001) and 15 years old (boys: p < 0.001; girls: p = 0.030). Moreover, meaningful differences were found at 16 (p = 0.034) and 14.5 years (p = 0.012) for boys and girls, respectively.
Table 4, Table 5 and Table 6 displays the percentile distribution of bodyweight, height, and BMI, respectively, by gender and age.

4. Discussion

The main findings of the present study show significant differences in bodyweight, height and BMI growth charts between the studied population and the reference parameters applied in the Extremadura Health System [11], for numerous age and gender groups, as previously reported studies in other regions from Spain [4,11]. These studies also showed relevant differences in some age groups for bodyweight, height, and BMI. Thus, these results question the use of one or other data as state-wide references. Therefore, taking as national reference the data reported by only one community or several communities may not be representative for the development of children and adolescents from other regions of the same country. Moreover, the situations of thinness, overweight or obesity could be normalised if inappropriate or unrepresentative benchmarks are applied.
More specifically, when comparing our study with the two previous studies [4,11], results show that bodyweight progressively increases with age in boys, finding a pronounced increase at 15 and 15.5 years old in our study and the study by Sobradillo et al. [11]. However, this pronounced increase was not found by Lezcano et al. [4]. Coincidently, the maximum values for all three studies were reached around 17 years old, being lower in our study. Similarly, the results also show a progressive increase in bodyweight with age in girls. The maximum value is reached at 16 years old and stabilises thereafter, in agreement with previous studies [4,11].
Regarding height, both genders experienced a progressive increase with age, reaching a maximum value at 16 years old. Female results agree with those reported by previous studies [4,11]. In contrast, previous studies reported a considerable increase in height (more than 3 cm) between 16 and 17 years in males [4,11] that was higher than our study outcomes.
As well as bodyweight and height, BMI increased progressively with age, in line with the findings previously presented by Sobradillo et al. [11], with a noticeable increase around 15 and 15.5 years as in our outcomes. However, this increase was not found in the cross-sectional study conducted by Lezcano et al. [4], which only showed a progressive increase in BMI with age. Coincidentally, the three studies showed maximum BMI values at 17 years old. Despite the similarities found between our study and the study by Sobradillo et al. [11], the comparative results show significant greater BMI values compared to the outcomes presented by Sobradillo et al. [11] for several age groups between 12 and 15 years. However, our BMI values were quite similar to those presented by Lezcano et al. [4]. A pronounced increase in females BMI was also observed at 16 years old, reaching a maximum of 22.38 kg/m2, like previous studies [4,11]. Furthermore, significant differences were found between our female BMI outcomes and those reported by Sobradillo et al. [11], for most age groups between 12 and 15 years (Table 3). Contrarily, our BMI outcomes are very similar to those obtained by Lezcano et al. [4], as happens in males.
The differences and similarities found with the studies by Sobradillo et al. [11], and Lezcano et al. [4], respectively, may be due to different reasons. Firstly, the territorial representativeness of the selected sample in every study. While Sobradillo et al. [11] obtained data from children and adolescents from a single region of Spain, Lezcano et al. [4] based their results on several autonomous communities. Furthermore, the disparity in the level of physical-sport activity between the different regions of Spain could also explain these differences. It has been shown that regions with a higher level of organised physical-sports activity have a lower rate of childhood obesity [25]. Specifically, when comparing the regions of Extremadura and Basque Country, a lower percentage of children doing organised sport in Extremadura than in Basque Country was observed (70% vs. 85% in boys and 44% vs. 70% in girls). In fact, the rate of sedentarism is 37% in Extremadura compared to 28% in the Basque Country [25].
It should be known that there are socio-demographic variables, such as socio-economic level or region [26], as well as cultural variables, that must be considered because they affect the problem. These variables must be studied if we want to carry out adequate and effective preventive programmes and strategies [27]. Considering socio-demographic factors, the differences found with respect to anthropometric parameters between children and young people in the communities of the Basque Country and Extremadura could be based, among other reasons, on the economic and educational level of both regions. Data from the State System of Education Indicators of the Ministry of Education [28] indicate that the graduation rate in compulsory secondary education in the Basque Country exceeds 70%, while in Extremadura, it is below the national average. The autonomous community with the highest gross rate of Baccalaureate graduates is the Basque Country and in terms of the rate of higher education graduates the Basque Country is in second place. However, Extremadura is at the bottom of both rankings.
According to Eurostat 2008 [29], the Gross Domestic Product (GDP) of Extremadura is 18,250 million, the GDP per capita is 16,720 euros, the unemployment rate is 18.1% and the risk of poverty is 35.3%; while the Basque Country has a GDP of 66,779 million, a GDP per capita of 30,819 euros, an unemployment rate of 8.5% and a poverty risk of 9.1%.
Furthermore, these differences between regions could also be conditioned by the classification of urban (Basque Country) and rural (Extremadura) environments. In urban environments, the access to sports facilities, team-programmed activities, transport networks, etc., can directly influence adherence to a lifestyle and affect physical activity practices or the following of healthy diets [30,31]. The Quality of Life Indicator [14] established by Eurostat, which is multidimensional in nature (material living conditions, work, health, education, leisure, etc.), could explain the differences between regions in the rates of growth and overweight/obesity in Spain [32,33].
There is also evidence of a direct relationship between long-term acceleration of growth and more favourable socio-economic and health conditions (nutrition and/or absence of disease). Thus, these allow the phenotypic expression of the maximum genetic potential for growth in the child and adolescent population [34]. For example, if we take the Human Development Index of the different Spanish Autonomous Communities as an indicator of educational, economic and health levels, the Basque Country ranks as the most developed Autonomous Community in contrast to Extremadura, which is at the bottom of the list [15]. Therefore, the reference values included in the growth tables may not be applicable from one region to another, mainly due to the difference in context and environments.
In summary, the comparison of anthropometric parameters of children and young people with specific graphs from other communities that do not correspond to their own, can lead to mistakes when these children grow by percentiles higher or lower than those stipulated as maximum or minimum [35]. Moreover, it could normalise situations of anthropometric imbalances. The existence of differences between both percentile distributions could make visible the need to use new indicators, adapted to the physical and anthropometric reality of children and young people to avoid the possible normalisation of situations of thinness, overweight or obesity.
One of the strengths of this study is the representativeness of the sample, as it was 4130 children and young people from Extremadura between 12 and 17 years old, compared to the sample of the study used to elaborate the reference tables by Sobradillo et al. [11] (6443 children and young people from Basque Country aged between 0–18 years). In addition, the comparison has been made between data obtained in similar years and is therefore more reliable. If current data were used to make the comparison, the differences could be even greater probably, due to the increase in obesity levels in recent years [4,8,9,10,11]. Nevertheless, this study also presents several limitations. Considering that the main differences occur at the youngest ages, very markedly in girls, it is necessary to point out that the present study has the limitation of having focused on individuals over 12 years old. Thus, future studies focusing on younger ages than 12 years would be of great interest. Moreover, our study does not allow us to predict how the development of these children and young people will behave, since due to its cross-sectional design it is not possible to know the growth rate of participants. In addition, it should be considered that both girls and boys have not yet been completed the muscle and skeletal development at these ages. Thus, it would be interesting if future studies consider the influence of chronological and biological age on the monitored parameters.

5. Conclusions

The findings of this study showed that bodyweight, height and BMI of children and young people from Extremadura differ from the reference values proposed by the Faustino Orbegozo Eizaguirre Foundation that are currently used in the Extremadura Health Service. Moreover, the development-associated changes of children and young people from Extremadura compared to those from Basque Country raise the question of which values should be considered to define the levels of development and growth in the current population. Thus, we conclude that the reference values used by Extremadura Health Service may not be applicable to children and adolescents from Extremadura due to the different contexts of regions.
Hence, this study presents growth tables and graphs adapted to the physical and anthropometric reality of Extremadura adolescents. Therefore, the results presented in this study could be an important contribution to the need to use new indicators, adapted to the physical and anthropometric reality of children and young people to avoid the possible normalisation of situations of thinness, overweight or obesity.

Author Contributions

Conceptualization, R.G.-G. and R.P.-C.; data curation, J.C.-V. and M.Á.G.-G.; formal analysis, J.C.A.; funding acquisition, R.P.-C.; investigation, R.G.-G. and L.M.-B.; methodology, M.M.-M. and L.M.-B.; project administration, R.G.-G., M.Á.G.-G. and L.M.-B.; resources, R.P.-C.; software, J.C.-V.; supervision, J.C.A. and M.Á.G.-G.; validation, M.M.-M.; visualization, M.M.-M.; writing—original draft, R.G.-G., R.P.-C. and M.M.-M.; writing—review and editing, J.C.-V., J.C.A. and L.M.-B. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by Extremadura Health Service, grant number 041/06. The funders played no role in the study design, the decision to publish, or the preparation of the manuscript.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki and was approved by the Bioethics Committee of the University of Extremadura reference code (11/2006).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The datasets used during the current study are available from the corresponding author on reasonable request.

Acknowledgments

The authors would like to acknowledge Regional Ministry of Education of Extremadura who have participate in this study.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Johnson, W.; Chumlea, W.C.; Czerwinski, S.A.; Demerath, E.W. Secular trends in the fat and fat-free components of body mass index in children aged 8–18 years born 1958–1995. Ann. Hum. Biol. 2013, 40, 107–110. [Google Scholar] [CrossRef] [Green Version]
  2. Sun, S.S.; Deng, X.; Sabo, R.; Carrico, R.; Schubert, C.M.; Wan, W.; Sabo, C. Secular trends in body composition for children and young adults: The Fels Longitudinal Study. Am. J. Hum. Biol. 2012, 24, 506–514. [Google Scholar] [CrossRef] [Green Version]
  3. Danubio, M.E.; Sanna, E. Secular changes in human biological variables in Western countries: An updated review and synthesis. J. Anthropol. Sci. 2008, 86, 91–112. [Google Scholar]
  4. Lezcano, A.C.; García, J.F.; Ramos, C.F.; Longás, A.F.; López-Siguero, J.P.; González, E.S.; Ruiz, B.S.; Fernández, D.Y.; Español, G.C. Estudio transversal español de crecimiento 2008. Parte II: Valores de talla, peso e índice de masa corporal desde el nacimiento a la talla adulta. An. Pediatr. 2008, 68, 552–569. [Google Scholar] [CrossRef]
  5. Martí-Henneberg, D. Estudio del Crecimiento en la Comunidad Infantil; Facultad de Medicina, Universidad de Barcelona Barcelona: Barcelona, Spain, 1971. [Google Scholar]
  6. De la Puente, M.; Canela, J.; Alvarez, J.; Salleras, L.; Vicens-Calvet, E. Cross-sectional growth study of the child and adolescent population of Catalonia (Spain). Ann. Hum. Biol. 1997, 24, 435–452. [Google Scholar] [CrossRef]
  7. Tojo, R.; Fraga, J.M.; Peña, J. Curvas de Crecimiento; Universidad de Santiago: Santiago de Compostela, Spain, 1981. [Google Scholar]
  8. Moreno, B.; Monereo, S.; Moreno, F.; Desco, M. Curvas de crecimiento de los niños de la Comunidad Autónoma de Madrid. Salud. Rural. 1987, 2, 41–49. [Google Scholar]
  9. Hernández Martínez, A.; Tebar Masso, F.; Serrano Corredor, S.; Alvarez Cantalapiedra, I.; Illan Gomez, M.; Valdea Chavarri, F. Estudio antropométrico de la poblacion escolar de la comunidad autónoma de Murcia. Med. Clin. 1992, 98, 651–655. [Google Scholar]
  10. Suárez, R.; Trujillo, R.; Díaz-Klamas, M.; Toledo, F.; Alguacil, P.; Sierra, A. Estudio del crecimiento de la población pediátrica de la Comunidad Canaria. Madr. Ed. Ergón 1994. [Google Scholar]
  11. Sobradillo, B.; Aguirre, A.; Aresti, U.; Bilbao, A.; Fernández-Ramos, C.; Lizárraga, A.; Lorenzo, H.; Madariaga, L.; Rica, I.; Ruiz, I.; et al. Curvas y tablas de crecimiento. In Estudio Longitudinal y Transversal; Instituto de Investigación sobre Crecimiento y Desarrollo: Bilbao, Spain, 2004. [Google Scholar]
  12. Cole, T.J. The development of growth references and growth charts. Ann. Hum. Biol. 2012, 39, 382–394. [Google Scholar] [CrossRef] [Green Version]
  13. Hernández, M.; Castellet, J.; García, M.; Narvaiza, J.; Rincón, J.; Ruiz, I. Curvas de Crecimiento (0–14 años). Available online: http://www.fundacionorbegozo.com/wp-content/uploads/pdf/estudios2011.pdf (accessed on 16 June 2021).
  14. Ministerio de Asuntos Económicos y Transformación Digital. Indicadores de Calidad de Vida/Análisis Multidimensional (2008–2019); Instituto Nacional de Estadística (INE): Madrid, Spain, 2020.
  15. Castro, M.Á.P.; Maslouhi, M.M.; Alonso, M.Á.M.; Mimón, M.M.; Casillas, C.M. Nivel de desarrollo humano en las Ciudades Autónomas españolas: Comparativos con las CC. AA. y Marruecos. In Anales de Pediatría; Elsevier: Amsterdam, The Netherlands, 2017; p. 21. [Google Scholar]
  16. Krebs, N.F.; Himes, J.H.; Jacobson, D.; Nicklas, T.A.; Guilday, P.; Styne, D. Assessment of child and adolescent overweight and obesity. Pediatrics 2007, 120, S193–S228. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  17. Department of Health and Human Services, Centers for Disease Control and Prevention. Body Mass Index: Considerations for Practitioners. Available online: https://www.cdc.gov/obesity/downloads/bmiforpactitioners.pdf (accessed on 16 June 2021).
  18. Katzmarzyk, P.T.; Barreira, T.V.; Broyles, S.T.; Chaput, J.-P.; Fogelholm, M.; Hu, G.; Kuriyan, R.; Kurpad, A.; Lambert, E.; Maher, C. Association between body mass index and body fat in 9–11-year-old children from countries spanning a range of human development. Int. J. Obes. Suppl. 2015, 5, S43–S46. [Google Scholar] [CrossRef] [Green Version]
  19. Wang, J.; Wang, H.; Liu, J.; Ma, J. The association between body mass index, waist circumference with body fat percent, and abdominal fat rate in overweight and obese pupils. Chin. J. Prev. Med. 2013, 47, 603–607. [Google Scholar]
  20. Widhalm, K.; Schönegger, K. BMI: Does it really reflect body fat mass? J. Pediatr. 1999, 134, 522. [Google Scholar] [CrossRef]
  21. Okada, T.; Kuromori, Y.; Miyashita, M.; Yoshino, Y.; Iwata, F.; Hara, M.; Harada, K. Assessment of individual changes in body fatness in boys during early pubertal period. Pediatr. Int. 2005, 47, 495–497. [Google Scholar] [CrossRef]
  22. (INE), I.N.d.E. Población por Comunidades y Ciudades Autónomas y Sexo. Available online: www.ine.es (accessed on 15 April 2021).
  23. Wijnhoven, T.M.; van Raaij, J.M.; Spinelli, A.; Starc, G.; Hassapidou, M.; Spiroski, I.; Rutter, H.; Martos, É.; Rito, A.I.; Hovengen, R. WHO European Childhood Obesity Surveillance Initiative: Body mass index and level of overweight among 6–9-year-old children from school year 2007/2008 to school year 2009/2010. BMC Public Health 2014, 14, 806. [Google Scholar] [CrossRef] [Green Version]
  24. Cohen, J. Statistical Power Analysis for the Behavioral Sciences, 2nd ed.; Psychology Press: Hillsdale, NJ, USA, 1988. [Google Scholar]
  25. Los Hábitos Deportivos de la Población Escolar en España; Consejo Superior de Deportes: Madrid, Spain, 2011.
  26. Bartrina, J.A.; Rodrigo, C.P.; Barba, L.R.; Majem, L.S. Epidemiología y factores determinantes de la obesidad infantil y juvenil en España. Rev. Pediatr. Aten Primaria 2005, 7, S13–S20. [Google Scholar]
  27. Salas-Salvadó, J.; Rubio, M.A.; Barbany, M.; Moreno, B.; de la SEEDO, G.C. Consenso SEEDO 2007 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervención terapéutica. Med. Clín. 2007, 128, 184–196. [Google Scholar] [CrossRef]
  28. Educativa, I.N.d.E. Sistema Estatal de Indicadores de la Educación. Edición 2009; INSTITUTO DE EVALUACIÓN: Madrid, Spain, 2009. [Google Scholar]
  29. E.C.E. Comparar Comunidades Autónomas País Vasco vs. Extremadura. 2008. Available online: https://datosmacro.expansion.com/ccaa/comparar/pais-vasco/extremadura?sc=XE15 (accessed on 16 June 2021).
  30. Wang, J.; Williams, M.; Rush, E.; Crook, N.; Forouhi, N.G.; Simmons, D. Mapping the availability and accessibility of healthy food in rural and urban New Zealand–Te Wai o Rona: Diabetes Prevention Strategy. Public Health Nutr. 2010, 13, 1049–1055. [Google Scholar] [CrossRef] [Green Version]
  31. Hoekman, R.; Breedveld, K.; Kraaykamp, G. Sport participation and the social and physical environment: Explaining differences between urban and rural areas in The Netherlands. Leis. Stud. 2017, 36, 357–370. [Google Scholar] [CrossRef] [Green Version]
  32. Serra Majem, L.; Ribas Barba, L.; Aranceta Bartrina, J.; Pérez Rodrigo, C.; Saavedra Santana, P.; Peña Quintana, L. Obesidad infantil y juvenil en España. Resultados del Estudio enKid (1998–2000). Med. Clín. 2003, 725–732. [Google Scholar] [CrossRef]
  33. Ministerio de Sanidad, Consumo y Bienestar Social. Encuesta Nacional de Salud; Gobierno de España: Madrid, Spain, 2017.
  34. Durá Travé, T. ¿ Son válidas las curvas y tablas de crecimiento españolas actuales? Nutr. Hosp. 2012, 27, 244–251. [Google Scholar]
  35. Galdeano, P.A.; Abad, M.M.; Alonso, Á.A.; Irureta, S.J.; Goikoetxea, B.C.; Ruiz, S.G.; Miranda, S.J. Efecto del cambio de gráficas de crecimiento de referencia en la prevalencia de talla baja. An. Pediatr. 2020, 92, 28–36. [Google Scholar] [CrossRef] [PubMed]
Table
Table 1. Participants’ anthropometry stratified by age and gender.
Table 1. Participants’ anthropometry stratified by age and gender.
Bodyweight (kg)Height (cm)BMI (kg/m2)
AgenMean (SD)AgenMean (SD)AgenMean (SD)
Boys Boys Boys
1220747.89 (19.55)12207153.61 (8.07)1220720.15 (3.43)
12.510951.24 (12.23)12.5109155.48 (8.28)12.510921.05 (3.95)
1320752.38 (12.32)13207159.00 (8.34)1320720.59 (3.96)
13.521953.15 (11.41)13.5219160.31 (8.42)13.521920.54 (3.39)
1420659.10 (14.23)14206165.25 (8.16)1420621.49 (4.30)
14.521258.29 (11.97)14.5212166.24 (7.88)14.521220.96 (3.34)
1524165.45 (13.55)15241170.55 (8.02)1524122.42 (3.99)
15.520664.41 (13.62)15.5206170.33 (7.71)15.520622.09 (3.86)
1621265.89 (11.60)16212172.19 (6.70)1621222.16 (3.30)
16.519665.43 (12.32)16.5196171.27 (8.01)16.519622.22 (3.36)
1711365.45 (11.90)17113170.87 (7.64)1711322.33 (3.4)
Girls Girls Girls
1219048.93 (10.23)12190155.34 (6.54)1219020.19 (3.59)
12.511650.87 (10.69)12.5116156.33 (6.33)12.511620.73 (3.72)
1318951.47 (10.25)13189157.57 (6.20)1318920.67 (3.62)
13.520551.98 (9.46)13.5205158.90 (5.91)13.520520.57 (3.52)
1419654.22 (9.30)14196160.47 (6.20)1419621.05 (3.44)
14.519554.32 (9.40)14.5195160.29 (6.35)14.519521.11 (3.27)
1521356.85 (10.14)15213161. 35 (6.71)1521321.79 (3.35)
15.520654.88 (7.98)15.5206161.20 (5.91)15.520621.14 (3.06)
1619058.76 (11.24)16190161.89 (6.15)1619022.38 (3.82)
16.520357.19 (10.54)16.5203161.51 (6.43)16.520321.90 (3.76)
179956.08 (8.03)1799162.64 (6.38)179921.18 (2.65)
Table
Table 2. Between-study comparison for bodyweight, height and BMI in boys.
Table 2. Between-study comparison for bodyweight, height and BMI in boys.
BoysExtremaduraSobradillo et al. [11]
N2128 (12 to 17 years)6443 (0 to 18 years)
Age (years)Mean (SD)Mean (SD)pHedge’s g (95% CI)
Bodyweight (kg)1247.89 (19.55)44.54 (9.39)<0.001 **0.20 (−0.05; 0.44)
12.551.24 (12.23)46.87 (7.96)<0.001 **0.41 (0.12; 0.70)
1352.38 (12.32)49.32 (9.63)<0.001 **0.26 (0.00; 0.53)
13.553.15 (11.41)53.27 (10.55)0.879−0.01 (−0.26; 0.24)
1459.10 (14.23)55.96 (10.37)0.002 **0.24 (−0.02; 0.49)
14.558.29 (11.97)57.95 (12.11)0.6800.03 (−0.26; 0.31)
1565.45 (13.55)59.71 (11.65)<0.001 **0.44 (0.19; 0.69)
15.564.41 (13.62)65.36 (10.57)0.322−0.07 (−0.34; 0.19)
1665.89 (11.60)64.98 (11.82)0.2510.08 (−0.18; 0.34)
16.565.43 (12.32)68.27 (11.83)0.001 **−0.23 (−0.46; −0.01)
1765.45 (11.90)70.76 (11.30)<0.001 **−0.45 (−0.73; −0.18)
Height (cm)12153.61 (8.07)150.10 (6.90)<0.001 **0.45 (0.21; 0.70)
12.5155.48 (8.28)153.95 (7.42)0.0550.19 (−0.09; 0.48)
13159.00 (8.34)156.87 (9.12)<0.001 **0.25 (−0.02; 0.51)
13.5160.31 (8.42)160.97 (8.23)0.2481.11 (0.85; 1.38)
14165.25 (8.16)164.13 (8.22)0.0500.14 (−0.12; 0.39)
14.5166.24 (7.88)165.04 (8.41)0.027 *0.15 (−0.14; 0.44)
15170.55 (8.02)168.79 (8.31)0.005 **0.22 (−0.03; 0.47)
15.5170.33 (7.71)170.94 (6.92)0.258−0.08 (−0.35; 0.18)
16172.19 (6.70)172.98 (6.64)0.089−0.12 (−0.38; 0.14)
16.5171.27 (8.01)175.32 (6.54)<0.001 **−0.54 (−0.77; −0.31)
17170.87 (7.64)176.04 (7.35)<0.001 **−0.69 (−0.97; −0.41)
BMI (kg/m2)1220.15 (3.43)19.64 (3.19)0.032 *0.15 (−0.09; 0.40)
12.521.05 (3.95)19.71 (2.56)0.001 **0.39 (0.10; 0.68)
1320.59 (3.96)19.98 (2.84)0.027 *0.16 (−0.10; 0.43)
13.520.54 (3.39)20.32 (3.09)0.3260.07 (−0.19; 0.32)
1421.49 (4.30)20.67 (2.89)0.007 **0.21 (−0.05; 0.46)
14.520.96 (3.34)21.12 (3.38)0.484−0.05 (−0.33; 0.24)
1522.42 (3.99)20.89 (2.89)<0.001 **0.41 (0.16; 0.66)
15.522.09 (3.86)22.33 (3.09)0.378−0.07 (−0.33; 0.20)
1622.16 (3.30)21.68 (3.58)0.034 *0.14 (−0.12; 0.40)
16.522.22 (3.36)22.13 (3.17)0.6980.03 (−0.20; 0.25)
1722.33 (3.4)22.83 (3.40)0.124−0.15 (−0.42; 0.13)
* Significant correlation at level 0.05. ** Significant correlation at level 0.01.
Table
Table 3. Between-study comparison for bodyweight, height and BMI in girls.
Table 3. Between-study comparison for bodyweight, height and BMI in girls.
GirlsExtremaduraSobradillo et al. [11]
N2002 (12 to 17 years)6443 (0 to 18 years)
Age (years)Mean (SD)Mean (SD)pHedge’s g (95% CI)
Bodyweight (kg)1248.93 (10.23)44.00 (7.31)<0.001 **0.52 (0.24; 0.79)
12.550.87 (10.69)44.99 (8.88)<0.001 **0.58 (0.27; 0.89)
1351.47 (10.25)49.21 (8.45)0.003 **0.23 (−0.08; 0.54)
13.551.98 (9.46)52.13 (8.08)0.823−0.02 (−0.31; 0.28)
1454.22 (9.30)52.32 (7.96)0.005 **0.21 (−0.09; 0.51)
14.554.32 (9.40)54.14 (8.59)0.7790.02 (−0.26; 0.29)
1556.85 (10.14)55.29 (9.42)0.1550.16 (−0.12; 0.43)
15.554.88 (7.98)54.69 (7.33)0.7290.02 (−0.27; 0.32)
1658.76 (11.24)57.84 (8.96)0.2560.08 (−0.26; 0.43)
16.557.19 (10.54)56.62 (6.70)0.4380.06 (−0.21; 0.33)
1756.08 (8.03)56.35 (8.47)0.744−0.03 (−0.31; 0.25)
Height (cm)12155.34 (6.54)152.25 (7.31)<0.001 **0.46 (0.18; 0.73)
12.5156.33 (6.33)153.40 (8.88)<0.001 **0.40 (0.09; 0.71)
13157.57 (6.20)156.74 (8.45)0.0680.12 (−0.19; 0.43)
13.5158.90 (5.91)159.13 (8.08)0.582−0.04 (−0.33; 0.26)
14160.47 (6.20)161.03 (7.96)0.210−0.08 (−0.38; 0.21)
14.5160.29 (6.35)162.35 (8.59)<0.001 **−0.30 (−0.57; −0.02)
15161. 35 (6.71)161.00 (9.42)0.4390.05 (−0.23; 0.32)
15.5161.20 (5.91)162.28 (7.33)0.009 **−0.17 (−0.47; 0.12)
16161.89 (6.15)161.68 (8.96)0.6560.03 (−0.31; 0.37)
16.5161.51 (6.43)162.14 (6.70)0.169−0.10 (−0.37; 0.17)
17162.64 (6.38)162.56 (8.47)0.8930.01 (−0.27; 0.29)
BMI (kg/m2)1220.19 (3.59)18.91 (2.45)<0.001 **0.38 (0.11; 0.66)
12.520.73 (3.72)19.02 (2.87)<0.001 **0.49 (0.18; 0.80)
1320.67 (3.62)19.96 (2.79)0.007 **0.20 (−0.11; 0.51)
13.520.57 (3.52)20.55 (2.70)0.9310.01 (−0.29; 0.30)
1421.05 (3.44)20.15 (2.69)<0.001 **0.27 (−0.03; 0.57)
14.521.11 (3.27)20.52 (2.96)0.012 *0.18 (−0.09; 0.46)
1521.79 (3.35)21.29 (3.16)0.030 *0.15 (−0.13; 0.43)
15.521.14 (3.06)20.75 (2.35)0.0650.13 (−0.16; 0.43)
1622.38 (3.82)22.06 (2.59)0.2490.09 (−0.25; 0.43)
16.521.90 (3.76)21.56 (2.49)0.1960.10 (−0.17; 0.37)
1721.18 (2.65)21.32 (2.88)0.601−0.05 (−0.33; 0.23)
* Significant correlation at level 0.05. ** Significant correlation at level 0.01.
Table
Table 4. Percentile distribution outcomes of bodyweight by gender and age.
Table 4. Percentile distribution outcomes of bodyweight by gender and age.
Bodyweight (kg)
Age (years)nP2P3P10P15P20P25P50P75P80P85P90P97P98
Boys
1220731.81032.77235.58036.72037.66039.50046.10055.60056.84058.50062.34070.67276.788
12.510934.06034.60037.30038.85039.70042.70049.00057.90060.00063.45068.40079.92085.440
1320733.11233.96838.96040.50042.24043.80050.50058.60060.50063.00071.06081.02086.408
13.521935.28035.92040.20041.70043.00043.80052.00060.00063.50064.70069.40075.12075.620
1420636.64237.16843.50045.51047.42049.57557.65065.25069.22072.07081.45093.81799.010
14.521237.63038.73945.00046.30048.58050.27557.15064.52566.12070.61075.00085.68890.090
1524141.02442.95250.34053.03054.24055.75063.70073.60077.30079.11082.68093.0186.448
15.520642.34243.60548.42050.80553.24055.50061.40072.32575.60079.05585.04095.29096.944
1621246.90448.28053.53055.00056.30058.00064.15071.30073.50077.40580.63094.85499.498
16.519646.27047.23750.74053.91055.68057.37563.85070.65072.84077.89082.09097.427100.000
1711344.14044.62649.28053.43057.08058.15064.50071.00073.10076.80083.40093.74096.152
Girls
1219031.04631.57336.13038.09539.54042.00048.00056.05058.44060.00062.18069.40871.606
12.511630.25833.77138.71042.05043.40045.32548.80056.17558.30061.18062.62081.72784.682
1318933.72034.40040.50042.55044.00044.80049.30055.70058.70060.00065.50074.90081.920
13.520534.03236.44441.96042.98044.00045.35051.00057.55058.98060.55063.54073.81079.280
1419637.48039.96544.50045.50046.40047.80053.00058.67561.42063.24568.64075.81879.048
14.519538.17639.06442.56044.44046.72048.00053.00059.00061.26064.94067.44075.28877.564
1521342.61243.08446.22047.20048.08049.20055.20061.45064.84068.43070.30080.39285.720
15.520642.02842.50045.28047.10547.88048.92554.00059.82561.00062.30064.53073.97975.944
1619041.48241.96547.26049.26550.22051.37557.15063.00064.86070.00073.71086.84390.292
16.520341.50841.69646.14047.96048.98050.10055.50061.80064.54067.24071.28084.19287.184
179940.20042.00046.00047.50048.30050.00055.40061.50062.90063.20066.50075.20076.100
Table
Table 5. Percentile distribution outcomes of height by gender and age.
Table 5. Percentile distribution outcomes of height by gender and age.
Height (cm)
Age (years)nP2P3P10P15P20P25P50P75P80P85P90P97P98
Boys
12207139.160140.000143.000145.000146.000148.000153.000159.000161.000162.000163.200170.000172.520
12.5109138.600141.000147.000147.500149.000151.000155.000160.500163.000165.000167.000171.700172.800
13207140.000141.480148.000150.000152.000154.000160.000164.000166.000168.000169.000174.000176.000
13.5219144.000146.600150.000150.000152.000154.000160.000166.000168.000170.000172.000177.400178.600
14206147.000147.210154.700157.000159.000160.000166.000171.000172.000173.000174.000180.000181.000
14.5212147.260149.390156.000158.000160.000162.000166.000172.000173.000174.050176.000180.000182.000
15241151.840153.000161.000163.000164.000166.000171.000176.000177.000179.000180.000185.000187.000
15.5206154.000154.000160.700162.000164.000165.000171.000175.000177.000178.000180.000184.790185.860
16212155.780160.000164.000166.000167.000168.250172.000176.000177.000178.000180.000186.610187.740
16.5196150.880152.910160.700165.000166.000167.000172.000176.000178.000179.000181.000185.000187.060
17113149.840152.420162.000164.000165.000166.000171.000176.500178.000178.000179.600185.000185.000
Girls
12190141.000142.000146.000149.000150.000150.750156.000160.000161.000162.350163.000167.270168.000
12.5116143.000143.510147.000150.000151.000152.250156.000160.000162.000164.000165.300168.000168.000
13189143.000144.700150.000150.500152.000154.000158.000162.000163.000164.000166.000168.600170.000
13.5205147.000147.180152.000153.000154.000155.000159.000163.000163.000164.000166.000171.820172.000
14196148.680150.000152.000154.000155.000156.000160.000165.000166.000167.000168.000173.180177.060
14.5195147.260149.880152.600154.000155.000157.000160.000164.000166.000167.000169.000173.000173.240
15213147.280149.420153.000155.000156.000157.000161.000165.000167.000168.000170.000174.580175.000
15.5206150.000150.210154.000155.050157.000157.000161.000165.000166.000167.000168.000173.000174.000
16190150.000150.000155.000156.000157.000158.000161.000165.000167.000168.000169.000176.000178.180
16.5203146.160148.000154.000156.000157.000158.000161.000165.000166.000167.000169.600175.880176.920
1799150.000150.000153.000156.000157.000158.000163.000167.000168.000170.000170.000175.000178.000
Table
Table 6. Percentile distribution outcomes of BMI by gender and age.
Table 6. Percentile distribution outcomes of BMI by gender and age.
BMI (kg/m2)
Age (years)nP2P3P10P15P20P25P50P75P80P85P90P97P98
Boys
1220715.13715.35116.29016.87517.18717.48319.37722.29022.95223.59025.34727.70828.294
12.510915.41615.48516.35817.10017.52118.04320.44423.59924.65425.50126.74829.86830.566
1320714.95015.40016.50317.01017.31517.83219.52722.32123.07024.53625.91030.22632.184
13.521915.17715.71516.97417.20717.77318.14619.56222.64823.19324.84425.78128.25728.728
1420615.97816.13217.21817.62718.06018.44820.34723.02224.32525.29328.37232.85733.781
14.521215.65116.11117.01717.77818.25018.57020.66022.68623.44024.37925.36929.01629.808
1524116.12716.35518.04318.60118.90219.50021.81224.74825.79226.61327.75031.38532.037
15.520616.62616.79217.89118.26918.53318.95221.28524.84625.58426.59528.19030.21331.838
1621216.90917.13718.40819.31819.61120.11221.67223.51524.04625.03726.14130.59831.166
16.519616.78217.12618.35519.00019.42719.89321.58923.68824.47525.56427.65930.54831.403
1711317.23517.64418.52818.83319.66420.42421.91323.69324.62925.71426.06131.87433.669
Girls
1219014.19914.61816.19816.64616.97517.51219.60522.49923.16824.35825.58527.63128.823
12.511614.61515.48716.63117.36617.76318.37620.00122.75723.53124.65625.56030.85432.022
1318915.34915.66516.76517.24417.82518.24420.25822.00122.49123.79425.33029.89331.566
13.520515.25615.46816.71517.13617.50118.10219.97922.73723.26224.20425.06528.57929.569
1419615.44615.76017.42217.81018.33918.66320.35522.62423.38024.26026.15629.64630.279
14.519515.96116.12817.33917.93318.54018.84420.43123.00323.80024.63326.00228.50329.154
1521316.80717.05618.00318.70118.99119.39321.27123.55224.29825.38826.19829.79530.108
15.520616.30816.72817.84918.25618.63619.01720.73322.61523.10324.08625.37328.66529.514
1619016.73717.10618.51618.88119.28119.83521.73224.03524.59425.21227.76931.87933.589
16.520316.53616.86218.17918.74919.24819.57720.88923.51024.26325.09426.97031.63532.919
179916.62017.31318.17818.68118.93319.26720.64322.84623.35324.13224.65428.02528.805
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Share and Cite

MDPI and ACS Style

Gómez-Galán, R.; Pastor-Cisneros, R.; Carlos-Vivas, J.; Mendoza-Muñoz, M.; Adsuar, J.C.; García-Gordillo, M.Á.; Muñoz-Bermejo, L. Normative Values of Height, Bodyweight and Body Mass Index of 12–17 Years Population from Extremadura (Spain). Biology 2021, 10, 645. https://doi.org/10.3390/biology10070645

AMA Style

Gómez-Galán R, Pastor-Cisneros R, Carlos-Vivas J, Mendoza-Muñoz M, Adsuar JC, García-Gordillo MÁ, Muñoz-Bermejo L. Normative Values of Height, Bodyweight and Body Mass Index of 12–17 Years Population from Extremadura (Spain). Biology. 2021; 10(7):645. https://doi.org/10.3390/biology10070645

Chicago/Turabian Style

Gómez-Galán, Rafael, Raquel Pastor-Cisneros, Jorge Carlos-Vivas, María Mendoza-Muñoz, José Carmelo Adsuar, Miguel Ángel García-Gordillo, and Laura Muñoz-Bermejo. 2021. "Normative Values of Height, Bodyweight and Body Mass Index of 12–17 Years Population from Extremadura (Spain)" Biology 10, no. 7: 645. https://doi.org/10.3390/biology10070645

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop