Anthropometric measurement error and the assessment of nutritional status

Anthropometry involves the external measurement of morphological traits of human beings. It has a widespread and important place in nutritional assessment, and while the literature on anthropometric measurement and its interpretation is enormous, the extent to which measurement error can influence both measurement and interpretation of nutritional status is little considered. In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error are critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometric nutritional status discussed. Possible errors are of two sorts; those that are associated with: (1) repeated measures giving the same value (unreliability, imprecision, undependability); and (2) measurements departing from true values (inaccuracy, bias). Imprecision is due largely to observer error, and is the most commonly used measure of anthropometric measurement error. This can be estimated by carrying out repeated anthropometric measures on the same subjects and calculating one or more of the following: technical error of measurement (TEM); percentage TEM, coefficient of reliability (R), and intraclass correlation coefficient. The first three of these measures are mathematically interrelated. Targets for training in anthropometry are at present far from perfect, and further work is needed in developing appropriate protocols for nutritional anthropometry training. Acceptable levels of measurement error are difficult to ascertain because TEM is age dependent, and the value is also related to the anthropometric characteristics of the group or population under investigation. R > 0·95 should be sought where possible, and reference values of maximum acceptable TEM at set levels of R using published data from the combined National Health and Nutrition Examination Surveys I and II (Frisancho, 1990) are given. There is a clear hierarchy in the precision of different nutritional anthropometric measures, with weight and height being most precise. Waist and hip circumference show strong between-observer differences, and should, where possible, be carried out by one observer. Skinfolds can be associated with such large measurement error that interpretation is problematic. Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision. Anthropometry is an important tool for nutritional assessment, and the techniques reported here should allow increased precision of measurement, and improved interpretation of anthropometric data.

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Association between kidney function, nutritional status and anthropometric measures in older people

BMC Geriatrics ◽

10.1186/s12877-020-01699-1 ◽

2020 ◽

Vol 20 (S1) ◽

Cited By ~ 1

Author(s):

Agnieszka Guligowska ◽

◽

Andrea Corsonello ◽

Małgorzata Pigłowska ◽

Regina Roller-Wirnsberger ◽

...

Keyword(s):

Nutritional Status ◽

Serum Albumin ◽

Nutritional Assessment ◽

Short Form ◽

Mini Nutritional Assessment ◽

Overweight And Obesity ◽

Community Dwelling ◽

Albumin Concentration ◽

Anthropometric Measures ◽

Baseline Phase

Abstract Background Different mechanisms connect the nutritional status with the occurrence and the course of chronic kidney disease (CKD). The end-stage renal disease is complicated by catabolic inflammatory reactions and cachexia which leads to malnutrition (undernutrition). On the other hand, obesity is an important risk factor for the development and acceleration of CKD. Methods In the SCOPE study, community-dwelling persons aged 75 years and over, from 6 European countries and Israel were examined at the baseline phase. We assessed the relationship between anthropometric measures (Body Mass Index (BMI), circumferences of arm (AC), waist (WC), hip (HC), and calf (CC), waist-to-hip ratio - WHR, waist-to-height ratio - WHtR, risk of malnutrition (Mini Nutritional Assessment - MNA), serum albumin) and estimated glomerular filtration rate (eGFR) calculated by Berlin Initiative Study (BIS) equation. Results We studied 2151 subjects (932 men and 1219 women) with a mean age of 79.5 ± 5.9 years. A total of 1333 (62%) participants had CKD (GRF < 60 ml/min/1.73 m2). Negative correlations between eGFR and weight, AC, WC, HC, CC, BMI, WHtR were observed. Positive correlation occurred between eGFR and MNA score (Spearman’s rho = 0.11) and albumin concentration (rho = 0.09). Higher weight, AC, WC, HC, CC, BMI and WHtR increased the odds ratio of CKD; higher MNA (OR = 0.98, 95% CI 0.94–1.0) and higher serum albumin (OR = 0.73, 95% CI 0.53–1.0) were weakly associated with reduced odds. The risk of malnutrition was the highest with eGFR < 30 as compared to eGFR > 60 (OR = 2.95, 95%CI = 1.77–4.94 for MNA < 24; OR = 5.54, 95%CI = 1.66–18.5 for hypoalbuminemia < 3.5 g/dL). Conclusion The population of community dwelling people aged 75+ with CKD shows general features of overweight and obesity with a small prevalence of malnutrition. For anthropometric measures, the strongest association with eGFR and the highest odds of CKD were identified using WC, HC, CC and WHtR. Albumin level and MNA, but not MNA Short Form, indicated an increased odds of malnutrition with a decrease in eGFR.

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Assessment of Nutritional Status of School Children in Public and Private Sector Schools by Anthropometry

Annals of Punjab Medical College ◽

10.29054/apmc/2021.1070 ◽

2021 ◽

Vol 15 (1) ◽

pp. 64-68

Author(s):

Qamar Mehboob ◽

Keyword(s):

Nutritional Status ◽

School Children ◽

Private School ◽

Pearson Correlation ◽

Anthropometric Measurement ◽

Z Score ◽

Contributing Factors ◽

Anthropometric Measures ◽

Cross Sectional ◽

Government School

Background: Nutrition is the real determinant of human health. The development of children into healthy adults is dependent on their growth, in a healthy environment and having balanced nutrition. Objective: (1) To determine the association of nutritional status of children with their age, sex and socioeconomic status. (2) To compare the nutritional status of government school children and private school children. Study Design: Comparative cross-sectional. Settings: Study was conducted in two schools of Faisalabad, Pakistan. Government Girls high school, Punjab Medical College (PMC), Colony Faisalabad and The Smart School, Faisalabad. Duration: Eight months from Jan 01, 2020 – Aug 30, 2020. Methodology: The study was conducted on 200 children, including males & females, to compare weights and heights among government (government) and private (private) schools. Age groups ranging from 9 above to 14 years were being studied. The data was collected by taking anthropometric measures, height and weight, of the students. To assess the nutritional status, the anthropometric measurement of WHO 2007 reference was used as Weight for Age Z-score (WAZ), Height for Age Z-score (HAZ) and Body Mass Index (BMI) for Age Z-score (BAZ). Descriptive statistics and Pearson’s correlation test were used for statistical analysis. Data was analyzed statistically by using SPSS version 20. Results: The weight of private school children (39.3400 ± 2.39199) was normal as they have adequate diet as compared to government school children (38.7500 ± 1.43812) while 2% children were over weighted. Height of private school children (147.7600 ± 5.04949) was more as compared to government school children (146.8100 ± 4.34310). Statistically Pearson Correlation between weight of private and government school’s children was highly significant, p=0.000, df= 1, CI= 95%. Demographic information with height and weight of the children were taken. Z-score was calculated and graphs were plotted. A value within ± 2 SD in these graphs was considered as normal. Conclusion: Socio-economic status affects the availability and quality of food. For under-weight Children, unhygienic and low-quality food/stuffs are the major contributing factors.

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Evaluation of Nutritional Status and Methods to Identify Nutritional Risk in Rheumatoid Arthritis and Spondyloarthritis

Nutrients ◽

10.3390/nu12113571 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3571

Author(s):

Marie Njerve Olsen ◽

Randi J. Tangvik ◽

Anne-Kristine Halse

Keyword(s):

Rheumatoid Arthritis ◽

Nutritional Status ◽

Nutritional Assessment ◽

Handgrip Strength ◽

Fat Free Mass ◽

Nutritional Risk ◽

Anthropometric Measures ◽

High Prevalence ◽

Nutritional Risk Screening 2002 ◽

Nutritional Risk Screening

Patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) experience several nutritional challenges and are prone to develop malnutrition. This observational study aimed to perform a comprehensive nutritional assessment of outpatients diagnosed with RA and SpA, as well as to evaluate methods to identify nutritional risk. Nutritional status was investigated by anthropometric measures, body composition (DXA, dual energy X-ray absorptiometry), and handgrip strength (HGS). Nutritional risk was classified by Nutritional Risk Screening 2002 (NRS2002) and malnutrition was defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria and fat-free mass index (FFMI; kg/m2, <16.7 (M), <14.6 (F)). Out of 71 included patients, 46 (66%) were abdominally obese, 28 (39%) were obese in terms of body mass index (BMI), and 33 (52%) were obese in terms of the fat mass index (FMI; kg/m2, ≥8.3 (M), ≥11.8 (F)). Malnutrition was identified according to FFMI in 12 (19%) patients, according to GLIM criteria in 5 (8%) patients, and on the basis of BMI (<18.5 kg/m2) in 1 (1%) patient. None were identified by NRS2002 to be at nutritional risk. Our study revealed high prevalence of abdominal obesity and low FFMI. Waist circumference was a good indicator of FMI. BMI, NRS2002, and HGS did not capture patients with malnutrition identified by DXA.

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Malnutrition and obesity in community-dwelling older adults: concomitant conditions? (PEN-3S study)

Proceedings of The Nutrition Society ◽

10.1017/s002966512000556x ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Teresa Madeira ◽

Catarina Peixoto-Plácido ◽

Nuno Sousa-Santos ◽

Nuno Mendonça ◽

Osvaldo Santos ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Screening Tools ◽

World Health ◽

Anthropometric Measures ◽

Community Dwelling Older Adults

AbstractBoth malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The aim of this study was to characterise the nutritional status of community-dwelling older adults (≥ 65 years old) living in Portugal. The study included a nationally representative sample of randomly selected community-dwelling older adults. Trained nutritionists collected data through face-to-face structured interviews regarding sociodemographic characteristics, nutritional status and anthropometric measures (namely, weight and height), among other variables of the PEN-3S study. Nutritional status was assessed by the 18-item Mini Nutritional Assessment (full MNA®), in which a lower score indicates worse nutritional status. The World Health Organisation's (WHO) BMI cut-offs for adults were followed (obesity: BMI ≥ 30Kg/m2). MNA and BMI categories estimates (95% CI) were obtained using Complex Samples analysis (SPSS® 24.0). Non-difference between sexes was analysed with Chi-square tests. Complete information was available for 1110 community-dwelling participants (mean age: 75.9 ± 8.1 years; 48.9% women; 71.4% attended school for < 5 years). According to the MNA, 0.5% (95%CI: 0.2–1.7) were classified as malnourished and 16.0% (12.9–19.7) were at risk of malnutrition. Following WHO's BMI criteria, 0.6% (0.2–1.5) had a BMI ≤ 18.5Kg/m2, 41.9% (37.9–46.0) had a BMI between 25–30Kg/m2, and 36.7% (32.8–40.9) presented a BMI ≥ 30Kg/m2. The prevalence of risk of malnutrition was significantly higher for women (20.1%, 95%CI: 15.4–25.9) than men (10.4%, 7.6–14.1; p < 0.001). The prevalence of obesity was also significantly higher for women (42.2%, 35.9–48.7 versus 29.3%, 24.8–34.2; p = 0.007). Moreover, 13.9% (9.2–20.4) were simultaneously at risk of malnutrition and had a BMI ≥ 30Kg/m2, while no one in this BMI category was classified as malnourished. Although appropriate BMI cut-offs for older adults are still uncertain, these results highlight that a high BMI does not exclude the risk of malnutrition, particularly in women. Therefore, health professionals should routinely screen for malnutrition using multi-component, validated screening tools, irrespective of the BMI. In fact, malnutrition is preventable if detected on time and effective interventions exist. The concomitant presence of malnutrition and obesity may pose additional challenges to the treatment.

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“NUTRITIONAL ASSESSMENT OF CARDIOVASCULAR DISEASE IN THE AREAS OF VISAKHAPATNAM”

10.36106/paripex/8105017 ◽

2021 ◽

pp. 54-56

Author(s):

Vadarevu Sony ◽

Mamidi Alekhya

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Nutritional Status ◽

Dietary Habits ◽

Nutritional Assessment ◽

Saturated Fatty Acids ◽

Anthropometric Measurement ◽

Major Route ◽

The Impact ◽

Rheumatic Heart

Cardiovascular disease (CVD) is one of the most leading causes for morbidity and mortality in the worldwide. Age and other genetic factors are not only primarily responsible other factors including diabetes, hypertension lifestyles are some of the major risk factors associated with CVD. The study was designed to understand the nutritional status of the cardiovascular disease. The present study was an observational study which was carried out in Pinnacle hospital Arilova in Vishakhapatnam Andhra Pradesh. The study was designed to investigate the impact of nutritional status of cardiovascular disease patients in the age group of 40 to 70 years. A total of 100 samples were taken and the data was gathered through qualitative methods like questionnaire and interview methods. Anthropometric measurement, Biochemical parameters, clinical parameters, dietary intake was assessed by 24hours recall method and diet counselling was given. Among 100 samples 76 were male and 24 were female, stated physical status of the sample's states that majority of the samples go for walking (25%) everyday, 27% twice a week. 12% once a week and 36% never go for any physical activity. Majority of the samples (52) suffer from hypertension, (42) with atherosclerosis, (25) samples with myocardia infraction and 18 with angina pectoris, 8 with rheumatic heart disease and 4 with stroke. The study concludes the prevalence of hypertension, kidney disorders and diabetes are increasing with increase in CVD, the sedentary lifestyle and lack of physical exercise was one of the major route causes for CVD. High consumption of saturated fatty acids leads to obesity. Consumption of good dietary habits along with medication with physical activity helps in prevention and treatment of CVD.

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Oral Health Status in Relation to Nutritional Status among 9 years old school Children in Dewanyiah City/Iraq

Mustansiria Dental Journal ◽

10.32828/mdj.v14i1.763 ◽

2019 ◽

Vol 14 (1) ◽

pp. 80

Author(s):

Dr. Zahraa Ali Al-Awadi ◽

Dr. Baydaa Hussien Hussien

Keyword(s):

Oral Health ◽

Dental Caries ◽

Nutritional Status ◽

Oral Health Status ◽

Health Condition ◽

Primary Dentition ◽

Anthropometric Measurement ◽

Oral Diseases ◽

Gingival Health ◽

Significant Difference

Background: Although they are not life threatening, dental caries and periodontaldisease are the most predominant and widely spread oral diseases throughout theworld. The aims of the study included the investigation of the prevalence andseverity of dental caries, gingivitis and dental plaque in relation to gender,furthermore, nutritional status was assessed in relation to oral health condition(dental caries).Materials and Methods: This oral health survey was conducted among primaryschool children aged 9 years old in Dewanyiah city in Iraq. The total samplecomposed of 600 child (320 males and 280 females) selected randomly fromdifferent school in Dewanyiah city. Diagnosis of dental caries was according tothe criteria described by WHO (1987). Plaque index of Silness and Loe (1964)was used for plaque assessment, gingival index of Loe and Silness (1963) wasfollowed for recording gingival health condition. Nutritional status was assessedaccording to body mass index (BMI) indicator using anthropometric measurement(height and weight).Results: Results showed that the prevalence of dental caries was 85% for 9 year-oldschool children. Regarding primary and permanent dentition, dental caries washigher among females compared to males with statistically significant difference(P<0.05) for primary dentition, on the other hand, males showed higher values offilled surfaces compared to females with statistically significant difference(P<0.05) for primary dentition and highly significant difference (P<0.01) forpermanent dentition. Finding of this study revealed that 100% of the children hadgingival inflammation. Furthermore, the values of plaque and gingival indiceswere higher among males compared to females with statistically highly significantdifferences (P<0.01). In current study, the prevalence of malnutrition described bythe BMI indicator was 5.3%. For total samples no significant difference wasrecorded in dmfs /DMFS values among wasting and well nourished children(P>0.05).Conclusion: A high prevalence of dental caries and gingivitis were recorded.Improvement in the prevention educational programs is needed among schoolchildren.

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Mid upper arm circumference as an alternative measure to assess the nutritional status of adolescents: a study in India based on NFHS-4 data

Journal of Biosocial Science ◽

10.1017/s0021932021000298 ◽

2021 ◽

pp. 1-12

Author(s):

Aparna Roy ◽

T. V. Sekher

Keyword(s):

Nutritional Status ◽

Sensitivity And Specificity ◽

Measurement Data ◽

Anthropometric Measurement ◽

Alternative Measure ◽

Upper Arm ◽

Male Adolescents ◽

Arm Circumference ◽

Mid Upper Arm Circumference ◽

The Relationship

Abstract Use of body mass index (BMI) to assess the nutritional status of adolescents requires many resources, especially for country-level assessment. This study aimed to determine the relationship between BMI and mid upper arm circumference (MUAC) among adolescent males and females in India and to examine whether MUAC effectively represents the nutritional status of adolescents. The study utilized anthropometric measurement data collected by India’s National Family Health Survey-4 (2015–16). The weighted sample for analysis included 91,315 female and 14,893 male adolescents. The BMI and MUAC measurements showed a positive correlation in both female and male adolescents. Using BMI-for-age Z-score classifications, 12.7% of the adolescents were undernourished. Using MUAC (in cm) as per NACS (Nutrition Assessment, Counselling, and Support) guidelines and Mramba et al. (2017) classified 22.9% and 3.7% of the adolescents as undernourished respectively. Finally, using the MUAC-for-age Z-score classification, 98.4% of adolescents were determined to be normal and 1.7% undernourished. Sensitivity and specificity tests of the MUAC cut-offs, in comparison with BMI cut-offs, showed that all three MUAC cut-off classifications had high specificity (NACS cut-off: 81.3%; Mramba et al. cut-off (cm): 97.7%; Mramba et al. cut-off (Z-score): 99.1%). The NACS cut-off had moderately high sensitivity (52.2%) but the Mramba et al. cut-offs had low sensitivity (13.3% for the centimetre cut-off and 6.6% for the Z-score cut-off). Sensitivity and specificity tests proved the relationship between BMI and MUAC, and that MUAC represents adolescent nutritional status with considerable efficiency. With further research, it may be established that MUAC is a better and promising measure of adolescent nutrition, having the advantage of needing fewer resources for data collection. The MUAC has the potential to offer a simple and low-resource alternative to BMI to assess nutritional status among adolescents in poor countries.

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Monitoring of metabolic adverse events of second-generation antipsychotics in a naive paediatric population followed in mental health outpatient and inpatient clinical settings: MEMAS prospective study protocol

BMJ Open ◽

10.1136/bmjopen-2020-040764 ◽

2021 ◽

Vol 11 (1) ◽

pp. e040764

Author(s):

Marie-Line Menard ◽

Drigissa Ilies ◽

Pascale Abadie ◽

Thaïna Jean-Baptiste ◽

Rachel Choquette ◽

...

Keyword(s):

Adverse Events ◽

Study Protocol ◽

Repeated Measures ◽

Second Generation ◽

Paediatric Population ◽

Anthropometric Measures ◽

Cardiovascular Morbidity And Mortality ◽

Second Generation Antipsychotics ◽

Registration Number ◽

Prospective Longitudinal

IntroductionSecond-generation antipsychotics (SGAs) are widely used in the paediatric population. It is currently established that SGAs may induce metabolic adverse events (AEs) such as weight gain, perturbation of blood lipids or glucose with risk of potential cardiovascular morbidity and mortality. The Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in children (CAMESA) has published recommendations for monitoring the metabolic AEs of SGAs. Factors that may be associated with the onset of SGA’s metabolic AEs and long-term consequences are less studied in the literature. The objectives of our research are to evaluate some factors that can influence the development of the SGA’s metabolic AEs and to study clinical adherence to CAMESA guidelines.Methods and analysisThe Monitoring des Effets Métaboliques des Antipsychotiques de Seconde Génération study is a multicenter, prospective, longitudinal observational study with repeated measures of metabolic monitoring over 24 months. Two recruiting centres have been selected for patients under 18 years of age, previously naive of antipsychotics, starting an SGA or who have started an SGA for less than 4 weeks regardless of the diagnosis that motivated the prescription. Assessments are performed for anthropometric measures, blood pressure, blood tests at baseline and 1, 2, 3, 6, 9, 12 and 24 months of follow-up.Ethics and disseminationThe study protocol was approved by the CHU Sainte-Justine’s Research Ethics Board (MP-21-2016-1201) in 2016 and obtained institutional suitability for the ‘Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l’Île-de-Montréal’ Research Center in May 2018. For all participants, written consent will be obtained from parents/caregivers as well as the participant’s assent in order to enable their participation in this research project. The results of this research will be published.Trial registration numberClinicalTrials.gov (number NCT04395326).

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The importance of dysphagia screening and nutritional assessment in hospitalized patients

Einstein (São Paulo) ◽

10.1590/s1679-45082018ao4189 ◽

2018 ◽

Vol 16 (2) ◽

Cited By ~ 5

Author(s):

Patrícia Amaro Andrade ◽

Carolina Araújo dos Santos ◽

Heloísa Helena Firmino ◽

Carla de Oliveira Barbosa Rosa

Keyword(s):

Nutritional Status ◽

Global Assessment ◽

Assessment Tool ◽

Nutritional Assessment ◽

Cross Sectional Study ◽

Hospitalized Patients ◽

The Body ◽

Subjective Global Assessment ◽

Cross Sectional ◽

Knee Height

ABSTRACT Objective: To determine frequency of dysphagia risk and associated factors in hospitalized patients as well as to evaluate nutritional status by using different methods and correlate the status with scores of the Eating Assessment Tool (EAT-10). Methods: This was a cross-sectional study including 909 inpatients of a philanthropic hospital. For the diagnosis of dysphagia we used an adapted and validated Brazilian version of the Eating Assessment Tool (EAT-10). The nutritional status was evaluated through the subjective global assessment, and anthropometric measurements included weight, calf and arm circumference, and knee height. The Mann-Whitney test, associations using the Pearson’s χ2 and Spearman’s correlation were used to verify differences between the groups. Results: The prevalence of dysphagia risk was 10.5%, and aging was the associated factor with this condition. Patients at risk presented lower values of arm and calf circumference, variables that correlated inversely with the Eating Assessment Tool (EAT-10) score. Malnutrition was observed in 13.2% of patients based on the subjective global assessment and in 15.2% based on the Body Mass Index. Conclusion: Screening for dysphagia and malnutrition should be introduced in hospitals routine to avoid or minimize damages caused by dysphagia or malnutrition, especially among older people.

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