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Updated: Sep 20, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Is grip strength linked to body composition and cardiovascular risk markers in primary schoolchildren?
Markus Gerber1,2, Serge Ayekoé3, Bassirou Bonfoh4
1University of Basel, Basel, Switzerland markus.gerber@unibas.ch.
Insights
Hand grip strength (HGS) in African children correlates with better body composition, including lower body fat and higher muscle mass. However, HGS did not consistently link to cardiovascular risk markers in this study.
Area of Science:
- Pediatric Health
- Anthropometry
- Cardiovascular Risk Factors
Background:
- Hand grip strength (HGS) is a key indicator of musculoskeletal fitness in children.
- Existing HGS data predominantly comes from Western, high-income countries.
- Sub-Saharan African children's HGS data and its health associations are underrepresented.
Purpose of the Study:
- To investigate the association between HGS and body composition in children from sub-Saharan Africa.
- To examine the relationship between HGS and cardiovascular risk markers in this population.
- To address the lack of HGS data from diverse global regions.
Main Methods:
- Cross-sectional study involving primary school children (grades 1-4) in Côte d'Ivoire, South Africa, and Tanzania.
- Body composition assessed using bioelectrical impedance analysis.
- Cardiovascular risk markers measured via blood pressure and blood tests (cholesterol, triglycerides, glycated hemoglobin).
- HGS measured using a hydraulic hand dynamometer.
Main Results:
- Higher HGS was significantly associated with lower body fat percentage across all sites (p<0.001).
- Increased HGS correlated with higher muscle mass and higher fat-free mass in both boys and girls.
- No consistent association was observed between HGS and the measured cardiovascular risk markers.
Conclusions:
- HGS is a reliable indicator of favorable body composition in sub-Saharan African children.
- Further research is needed to establish reference values for African children.
- Longitudinal studies are required to explore the predictive value of HGS for future cardiovascular health.
Objectives:
Muscular strength represents a specific component of health-related fitness. Hand grip strength (HGS) is used as an indicator for musculoskeletal fitness in children. HGS can also be used as a marker of cardiometabolic risk, but most available HGS data are derived from Western high-income countries. Therefore, this study examines whether HGS is associated with body composition and markers of cardiovascular risk in children from three sub-Saharan African countries.
Design:
Cross-sectional study.
Setting:
Public primary schools (grade 1-4) in Taabo (Côte d'Ivoire), Gqeberha (South Africa) and Ifakara (Tanzania).
Participants:
Data from 467 children from Côte d'Ivoire (210 boys, 257 girls), 864 children from South Africa (429 boys, 435 girls) and 695 children from Tanzania (334 boys, 361 girls) were analysed.
Primary And Secondary Outcome Measures:
Body composition (assessed via bioelectrical impedance analysis) was the primary outcome. Cardiovascular risk markers were considered as secondary outcome. Blood pressure was measured with an oscillometric monitor, and blood markers (cholesterol, triglycerides, glycated haemoglobin) via Afinion point-of-care testing. HGS (independent variable) was assessed with a hydraulic hand dynamometer. Inferential statistics are based on mixed linear regressions and analyses of covariance.
Results:
Across all study sites, higher HGS was associated with lower body fat, higher muscle mass and higher fat-free mass (p<0.001, 3.9%-10.0% explained variance), both in boys and girls. No consistent association was found between HGS and cardiovascular risk markers.
Conclusions:
HGS assessment is popular due to its simplicity, feasibility, practical utility and high reliability of measurements. This is one of the first HGS studies with children from sub-Saharan Africa. There is a great need for further studies to examine whether our findings can be replicated, to develop reference values for African children, to establish links to other health outcomes, and to explore whether HGS is associated with later development of cardiovascular risk markers.
Trial Registration Number:
ISRCTN29534081.
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