Cross-sectional reference values for mid-upper arm circumference, triceps skinfold thickness and arm fat area of Turkish children and adolescents

Mid-upper arm circumference as a screening tool for identifying underweight adolescents

Background

Mid-upper arm circumference (MUAC) is a potentially credible alternative method for body mass index (BMI) to assess nutritional status. We aimed to assess the correlation between MUAC and BMI- Z-score and to identify a reliable MUAC cut-off point to detect underweight (BMI- Z-score of < -2 standard deviation) Sudanese adolescents.

Methods

A cross-sectional study was conducted in eastern Sudan. After obtaining adolescents' age and sex, their weight, height, and MUAC were measured using the standard procedures. The MUAC (cm) cut-off corresponding to underweight was calculated using receiver operating characteristic (ROC) curve analysis.

Results

In total, 390 adolescents were enrolled in the study and 205 (52.6%) of them were females. The median (interquartile range, IQR) age was 15.1 (14.0-16.3) years. The medians (IQR) of MUAC and BMI- Z-score were 22.0 (20.0-24.0) cm and - 0.62 (-1.5-0.3), respectively. MUAC was positively correlated with BMI Z-score in all participants (r = 0.534, p < 0.001), in females (r = 0.715, p < 0.001), and in males (r = 0.404, p < 0.001). Of the 390 enrolled adolescents, 61(15.6%) were underweight. The MUAC cut-off for underweight was ≤21.2 cm in all participants (Youden's Index, YI = 0.50; sensitivity = 82.0%; specificity = 68.0%, AUROCC = 0.78), in females (YI = 0.66, sensitivity = 86.0%, specificity = 80.0%, AUROCC = 0.87), and in males (YI = 0.32, sensitivity = 80.0%, specificity = 52.0%, AUROCC = 0.69).

Conclusion

MUAC has good accuracy results and can be adopted for community-based screening of underweight adolescents.

Reference growth curves to identify weight status (underweight, overweight or obesity) in children and adolescents: systematic review

The identification of somatic growth, through reference curves, can be used to create strategies and public policies to reduce public health problems such as malnutrition and obesity and to identify underweight, overweight and obesity. The purpose of this systematic review was to identify studies providing reference growth curves for weight status in children and adolescents. A systematic search was conducted in eight databases and in gray literature (Google scholar). To assess the risk of bias/methodological quality of studies, the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-sectional Studies (NHLBI) was used. Overall, 86 studies that met the inclusion criteria were included. Through the values   of reference growth curves for the identification of underweight, overweight and obesity, it was possible to verify that there is great variability among percentiles for the identification of underweight, overweight and obesity. The most prevalent percentiles for underweight were P3 and P5; for overweight, the most prevalent was P85 and the most prevalent percentiles for obesity were P95 and P97. The most prevalent anthropometric indicators were Body Mass Index (BMI), Waist Circumference (WC), Body Mass (BM) for age and height for age. Conclusion: Such data can demonstrate that the optimal growth must be reached, through the standard growth curves, but that the reference curves demonstrate a cut of the population growth, raising possible variables that can influence the optimal growth, such as an increase in the practice of physical activities and an awareness of proper nutrition.

Triponderal mass index is as strong as body mass index in the determination of obesity and adiposity

OBJECTIVE

In determining obesity and body adiposity, triponderal mass index (TMI) is as strong an anthropometric measurement as body mass index (BMI). The aim of this study was to develop TMI reference values for Turkish children and adolescents and compare TMI with BMI according to body adiposity and obesity indices.

METHODS

Data from the DAMTCA-II (Determination of Anthropometric Measurements of Turkish Children and Adolescents II) study were used in this cross-sectional study. Data from 4330 children (1931 boys, 2399 girls) ages 6 to 17 y were evaluated, and the TMI percentile values were produced. The predictive power of TMI and BMI for obesity and overweight were done for waist circumference, waist/height ratio, body fat percentage, and upper arm fat area, which are different parameters used to determine body adiposity.

RESULTS

The 3rd, 5th, 10th, 25th, 50th, 75th, 85th, 90th, 95th, and 97th TMI percentiles and mean values were calculated for all children's age and sex. TMI cutoff values were calculated by receiver operating characteristic analysis regarding waist/height ratio 0.5, waist circumference ≥90 percentile, arm fat area ≥85 percentile, and body fat percentage ≥85. TMI and BMI area under the curve values were similar for each of these four measurements. TMI was as robust an index as BMI in demonstrating obesity and adiposity for all age groups in boys and girls. It was concluded that the values >90th percentile (median 15.8 kg/m³) in girls aged ≤10 y, 95th percentile (median 16.2 kg/m³) in girls aged >10 y, >85th percentile (median 14.9 kg/m³) in boys aged ≤12 y and 75th percentile (median value 14.5 kg/m³) in boys aged >12 y are critical values for TMI when evaluating adiposity and obesity.

CONCLUSIONS

We considered that TMI is as effective as BMI in terms of waist/height ratio, waist circumference, arm fat area, and body fat percentage in determining overweight and obesity in children. The ages at which TMI showed distinct variation were determined for both sexes.

Four-site skinfolds thickness percentiles of schoolchildren and adolescents in Turkey

OBJECTIVE

The primary purpose of the current study was to establish Turkish smoothed centile charts and Lambda, Mu, Sigma (LMS) tables for four-site skinfold thickness based on a population-based sample, and secondary purpose was to elaborate a reference for the percentage of body fat.

DESIGN

A cross-sectional and descriptive study was conducted between January and May 2017. Triceps, biceps and subscapular, suprailiac skinfold thicknesses were measured using Holtain skinfold caliper. Age- and gender-specific percentile values were determined with the LMS method, and body fat percentage was calculated using the Westrate and Deurenberg equation.

SETTING

Afyonkarahisar province in Turkey.

PARTICIPANTS

The current study was conducted on 4565, 6-18-year-old students.

RESULTS

The triceps, biceps and subscapular skinfolds of the girls were higher than the boys. From the age of seven, the sum of four skinfold thicknesses of the girls was more than those of the boys. This difference became more evident after the age of 12. Although fat percentages of girls showed a fluctuating change, it decreased with the age in boys. Westrate and Deurenberg equation fat percentages of girls until adolescence were lower than boys, but increased after 12 years of age and exceeded that of boys.

CONCLUSIONS

The current study has provided sex- and age-specific reference values for skinfold thickness and has shown that obesity in girls is higher than in boys in schoolchildren in Afyonkarahisar. The current study has also shown that skinfold thickness measurements are a valuable tool for screening obesity in children.

Normal Ranges of Upper Extremity Length, Circumference, and Rate of Growth in the Pediatric Population

Background: Upper extremity length and circumference abnormalities are present in a number of conditions in the pediatric population. In most cases, upper limb hypoplasia and hypertrophy are diagnosed when one limb appears substantially different from the other during physical examination. However, occasionally when this discrepancy exists, it can be difficult to determine which limb is the abnormal one. The purpose of this study was to establish normal values for upper extremity length, circumference, and rate of growth in children aged 0 to 17 years. Methods: In all, 377 participants had 4 measurements taken of each upper extremity: upper arm length, upper arm circumference, forearm length, and forearm circumference. Statistical analysis was performed to identify differences and rates of growth. Results: Mean values for arm and forearm length and circumference for each age, 0 to 17 years, were established. The determination of a child's expected arm length is dependent on his or her height, age, and sex, while the calculation of a child's expected forearm length depends on his or her weight, age, and sex. Male and female arms and forearms have similar growth rates of lengths and circumferences. No significant differences were found between right and left extremities for each of the 4 measurements taken. Conclusions: Contralateral limbs can be used for comparison of length and circumference of the arm and forearm in cases of unilateral upper extremity abnormality. The establishment of normal values for upper extremity length, circumference, and growth rate will be a useful diagnostic tool for upper extremity hypoplasia and hypertrophy.

Evaluation of upper arm muscle and fat area of children and adolescents from Ankara, Turkey

Arm anthropometry is a commonly used method for determining the nutritional status of children and adolescents. The purpose of the study is to evaluate the arm anthropometry of 1484 children and adolescents (760 boys and 724 girls) aged between 6–17 years. The sample groups are selected who are living in Ankara to establish local reference values. In order to determine upper Arm Muscle Area (AMA) and upper Arm Fat Area (AFA), height, weight, upper arm circumference and triceps skinfold thickness measurements were taken in accordance with International Biological Program (IBP) protocols. Smoothed percentiles of AMA and AFA were obtained. Body mass index was calculated with weight and height measurements (kg/m2). Fat mass (FM) and fat free mass (FFM) were measured using bio-impedance analyzer. According to the obtained results, arm muscle area values were higher in boys and arm fat area was higher in girls. In addition, sex difference in these variables increased with age. There was a high positive correlation between body mass index (BMI) and AMA, AFA. It has been found that there is a difference in AMA and AFA values for Ankara children compared to previous studies in Turkey.

Age and sex specific variations in body composition in Indian urban Bengali Hindu children, adolescents and young adults aged 7–21 years

Childhood and adolescent obesity is a public health concern worldwide. However, little attention has been paid on status of overweight and body composition of Indian Bengali urban middle and high SES population. The objective was to determine the prevalence of overweight and body composition status by age and sex in children, adolescents and young adults. This cross-sectional study was carried out among 4194 unmarried school and college students (1999 males and 2195 females) aged 7–21 years belonging to the Bengali Hindu Population in Kolkata, India. The survey period was from 1999 to 2011. Anthropometry of participants were measured. Age and sex specific ≥85 percentile of body mass index (BMI) for children (<18 years of age) and BMI ≥23 kg/m2 (≥18 years of age) for adults were used to define overweight. Fat percent, upper arm fat area (UAFA) and upper arm muscle area (UAMA) were estimated. Simple linear regression was performed to check trend of changes with age. The overall prevalence of overweight was 14.8% in both sexes. Mean fat percent was higher in females than males (23.5% vs 13.5% respectively; p<0.001) and it increased by 0.18% (0.02) in males and 0.56% (0.02) in females per year (both p<0.001). UAMA gradually increased with age in both sexes and increasing rate per year was by 2.07 (0.04) cm2 in males and 1.19 (0.04) cm2 in females (both p<0.001). However, UAFA increased by 0.41 (0.03) cm2 and 0.90 (0.03) cm2 every year in males and females respectively (both p<0.001). Sum of biceps, triceps, subscapular and suprailliac skinfolds increased by 1.66 (0.06) mm and 0.5 (0.07) mm per year in females and males respectively (both p<0.001). Overall prevalence of overweight was the same in both sexes but adipose tissue was higher and muscularly was lower in females than males.

Use of upper arm anthropometry, upper arm muscle area-by-height (UAMAH) and midupper- arm-circumference (MUAC)-for-height as indicators of body composition and nutritional status among children

Upper arm anthropometry has a potential role to provide useful estimations of body composition and nutritional status. Aims of the present cross-sectional study were to assess body composition and nutritional status of rural school-going children using upper arm anthropometric measures such as upper arm muscle area-by-height (UAMAH) and mid-upper arm circumference (MUAC) for-height. The present cross-sectional study was conducted among 1281 children of West Bengal, India (boys 619, girls 662) aged 5-12 years and selected using a stratified random sampling method. Anthropometric measurements of height, weight, MUAC and triceps skinfold (TSF) were recorded. Body composition and nutritional status were assessed using upper arm muscle area (UMA), upper arm fat area (UFA), UAMAH and MUAC-forheight. Age-sex-specific overall adiposity in TSF, UFA, arm fat index and upper-arm fat area estimates were higher among girls than boys (p<0.01), but UMA and upper-arm muscle area estimates were observed to be higher among boys than girls (p<0.05). High prevalence of undernutrition was found among both boys (53.15%) and girls (41.69%) using UAMAH (p<0.01). The overall prevalence of low MUAC-forheight was higher among boys (28.59%) than girls (25.68%) (p>0.05). Upper arm anthropometric measures, UAMAH and MUAC-for-height are useful for assessment of body composition and nutritional status among children.

Neck Circumference to Assess Obesity in Preschool Children

OBJECTIVE

Limited information is available about the use of neck circumference (NC) to assess obesity in preschool children. This study aims to provide NC percentiles and determine the cut-off levels of NC as a measure to assess obesity in preschool children.

METHODS

The data were obtained from the Anthropometry of Turkish Children aged 0-6 years (ATCA-06) study database. A total of 21 family health centers were chosen and children aged 2-6 years old from all socioeconomic levels were randomly selected from the lists of district midwives; 1766 children (874 male and 892 female; 88.3% of sample size) were included in the study. The smoothed centile curves of NC were constructed by the LMS method. Receiver operating characteristic (ROC) analysis was performed to calculate cut-off points for NC using body mass index ≥95^th percentile.

RESULTS

Mean NC was greater in males than females. Cut-off values for obesity were found to be statistically significant in both genders other than 3 years old boys. The NC percentiles of Turkish preschool children were slightly greater than those of other European preschool children in both genders. This difference disappeared around the adiposity rebound period. The 97th percentile values for Turkish preschool children continue to be greater in both genders.

CONCLUSION

NC may be useful to define obesity in preschool children. Since ethnic and various other factors may have a role in incidence of obesity, local reference data are important in assessment of obesity.

Can mid-upper arm circumference and calf circumference be the proxy measures to detect undernutrition among elderly? Findings of a community-based survey in rural Puducherry, India

Introduction:

Major proportion of the elderly with under nutrition is undetected in the community. One of the feasible ways to detect under nutrition among elderly would be screening in the field settings. in this study, we aimed to identify the utility of alternate anthropometric measures such as mid-upper arm circumference (MUAC), calf circumference, and skin fold thickness in identifying under nutrition among elderly.

Materials and Methods:

A community-based cross-sectional survey was done among elderly in one of the randomly selected subcenters. Anthropometric measures such as weight, arm span, MUAC, and triceps skinfold thickness were measured as per the standard measurement guidelines by a trained medical graduate. The elderly were identified as undernourished if body mass index (BMI) is <18.5 kg/m². Utility of alternate anthropometric markers against BMI is represented by area under the curve (AUC) value from receiver operating characteristic curve and correlation coefficient (r).

Results:

Mean MUAC, calf circumference, and triceps skinfold thickness measured among 271 elderly were 25.6 cm ± 3.7 cm, 27.6 cm ± 3.7 cm, and 3.0 mm ± 1.3 mm, respectively. Among all three proxy anthropometric measures, MUAC had the highest AUC value (AUC = 0.88) Triceps skinfold thickness had the least AUC (AUC = 0.61). The correlation of anthropometric measurements such as MUAC, calf circumference, and triceps skinfold thickness with BMI was 0.74, –0.04, and 0.64, respectively.

Conclusion:

As MUAC and calf circumference are easy to measure and they are highly correlating with BMI, they can be used routinely by peripheral field workers to assess undernutrition in elderly during their regular house visits.

Triceps and Subscapular Skinfold Thickness Percentiles and Cut-Offs for Overweight and Obesity in a Population-Based Sample of Schoolchildren and Adolescents in Bogota, Colombia

The assessment of skinfold thickness is an objective measure of adiposity. The aims of this study were to establish Colombian smoothed centile charts and LMS L (Box-Cox transformation), M (median), and S (coefficient of variation) tables for triceps, subscapular, and triceps + subscapular skinfolds; appropriate cut-offs were selected using receiver operating characteristic (ROC) analysis based on a population-based sample of children and adolescents in Bogotá, Colombia. A cross-sectional study was conducted in 9618 children and adolescents (55.7% girls; age range of 9-17.9 years). Triceps and subscapular skinfold measurements were obtained using standardized methods. We calculated the triceps + subscapular skinfold (T + SS) sum. Smoothed percentile curves for triceps and subscapular skinfold thickness were derived using the LMS method. ROC curve analyses were used to evaluate the optimal cut-off point of skinfold thickness for overweight and obesity, based on the International Obesity Task Force definitions. Subscapular and triceps skinfolds and T + SS were significantly higher in girls than in boys (p < 0.001). The ROC analysis showed that subscapular and triceps skinfolds and T + SS have a high discriminatory power in the identification of overweight and obesity in the sample population in this study. Our results provide sex- and age-specific normative reference standards for skinfold thickness values from a population from Bogotá, Colombia.

Malnutrition and Obesity in Children With ADHD

OBJECTIVE

Low threshold of dissatisfaction and frustration in child and adolescent patients with ADHD lead to changes in dietary pattern with contribution to the development of obesity and other nutritional disorders.

METHODS

A total of 362 patients with the diagnosis of ADHD and 390 children without any chronic disease were included to the study. We evaluated the anthropometric measurements for all cases.

RESULTS

The overweight/obese cases according to weight for height (WFH) and body mass index scores were more likely in ADHD cases than control group. Malnourished cases according to WFH were more common in ADHD cases. Patients with weight standard deviation scores between <-2 and >2 were significantly higher in ADHD cases than the control group patients.

CONCLUSION

Frequency of malnutrition and overweight/obese patients was found higher in ADHD cases compared with control group, and this situation suggested that ADHD is a risk factor for the development of eating disorders.

Neck Circumference as a Predictor of Adiposity among Healthy and Obese Children

BACKGROUND:

Obesity, particularly in the upper part of body, is a major health problem. Because body mass index (BMI) does not adequately describe regional adiposity, other indices of body fatness are being explored.

OBJECTIVES:

To determine if neck circumference is a valid measure of adiposity (fat distribution) among group of Egyptian children.

SUBJECTS AND METHODS:

This is a cross sectional study, included 50 obese subjects, aged 7 - 12 years recruited from Endocrine, obesity and Metabolism Pediatric Unit at Children Hospital, Cairo University and 50 healthy children, age and sex matched. All children were subjected to blood pressure assessment (systolic SBP and diastolic DBP), and anthropometric assessment (body weight, height, neck circumference (NC), waist (WC) and hip (HC) circumferences, and skin fold thicknesses at three sites: biceps, triceps and sub scapular. BMI [weight (kg)/height (m2)] was calculated.

RESULTS:

In healthy females, significant associations were detected between NC and SBP, DBP and all anthropometric measurements. However, in healthy males NC was not significantly associated with BMI, SBP and DBP. In the obese group; both sexes; insignificant association was found between NC and SBP, DBP, BMI and skinfold thickness.

CONCLUSION:

NC is related to fat distribution among normal healthy female children. However, this relation disappears with increasing adiposity. The results do not support the use of NC as a useful screening tool for childhood obesity.

The utility of bioimpedance analysis for monitoring the children with nutcracker syndrome

We aimed to evaluate anthropometric and bioimpedance analysis (BIA) indices of children with nutcracker syndrome (NCS). Eighteen patients and 20 age-gender matched controls were enrolled. Weight, height, body mass index (BMI), mid-arm circumference (MAC), waist circumference (WC), waist/hip ratio measurements, and BIA results were assessed. Laboratory parameters and Doppler sonographic findings were recorded. The weight, BMI, MAC, WC, body fat z scores, and waist/hip ratio were significantly lower in patients than in controls (p < 0.05). Serum creatinine (Scr), albumin, HDL cholesterol, and urine protein (Up) were significantly increased in NCS patients compared to controls (p < 0.05). On multivariate analysis, body fat z score was independently related to Up and the degree of superior mesenteric artery (SMA) angle (beta = -0.965, p = 0.018 and beta = 0.841, p = 0.04, respectively).

CONCLUSION

NCS might be considered in slim proteinuric patients with unproven etiology. Serial anthropometric measurements and BIA analysis would estimate the severity of entrapment in LRV. Long-term follow-up of Scr might be required in NCS.

WHAT IS KNOWN

• Nutcracker syndrome (NCS) is very rare and characterized by the compression of LRV between aorta and SMA. What is new: • Patients with NCS have a slimmer body feature with lower anthropometric and BIA indices. • Fat percentage indicates the degree of LRV entrapment and amount of proteinuria in NCS.

Use of upper-arm anthropometry as measure of body-composition and nutritional assessment in children and adolescents (6-20 years) of Assam, Northeast India

Background

Upper-arm muscle area (UMA), upper-arm fat area (UFA), arm-fat index (AFI), upper-arm fat estimate (UFE) and upper-arm muscle estimate (UME) was introduced for the assessment of body-composition. This cross-sectional study assessed age-sex specific upper-arm composition and nutritional status among children and adolescents.

Methods

The present cross-sectional study was conducted among 1545 (770 boys; 775 girls) Sonowal Kacharis of Dibrugarh District, Assam, Northeast-India, using multi-stage stratified random sampling method. The anthropometric measurements of height, weight, triceps and mid-upper-arm circumference were recorded. The upper-arm composition was assessed using standard equations. Nutritional status was assessed using standard classification of upper-arm muscle-area by height (UAMAH) and thinness (low BMI-for-age).

Results

Age and sex-specific muscularity were found significantly greater among boys than girls (p<0.01), while adiposity was significantly greater among girls (p<0.01), particularly when they approached to puberty. The overall prevalence of low and below-average UAMAH was found to be 16.38% and 22.65% respectively. The overall prevalence of thinness was 23.69% (26.36% boys, 21.03% girls) (p>0.05).

Conclusion

Body-composition and nutritional status of these children and adolescents were found markedly unsatisfactory using upper-arm composition, UAMAH and thinness. The combination of upper-arm composition and conventional anthropometric measures appear to be useful for body-composition and nutritional status assessment.

Determining abdominal obesity cut-offs and relevant risk factors for anthropometric indices in Turkish children and adolescents

AIM

To determine the ≥90th percentile values of waist circumference (WC) to calculate anthropometric measures, indices and relevant risk factors in 5358 Turkish children and adolescents.

METHODS

This cross-sectional study was conducted in Kayseri, Turkey, from February to April 2005. Cut-offs for body weight, height, mid-upper arm circumference (MUAC), triceps skinfold thickness, body mass index (BMI), and fat percentages were calculated for ≥90th percentile of WC.

RESULTS

According to the results of binary multiple logistic regression analysis (the backward stepwise procedure), sleep duration (boys), maternal education (boys), elevator use (boys), and appetite (boys and girls) were revealed as significant predictors of abdominal obesity, adjusted for age. Appetite was the strongest variable to be associated with abdominal obesity for both genders.

CONCLUSIONS

According to receiver operating characteristic analysis, for all age groups within both genders, the best predictors to explain abdominal obesity were BMI and MUAC, respectively.

Arm anthropometry indices in Turkish children and adolescents: changes over a three-year period

OBJECTIVE

Time-related changes and comparisons for mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), arm fat area (AFA) are lacking for Turkish children and adolescents. To determine the arm anthropometry indices (MUAC, TSF, AFA) in children and adolescents and to also assess the changes in these indices over a 3-year time period.

METHODS

The data of the Anthropometry of Turkish Children Aged 0-6 Years (ATCA-06) study and the Second Study of Determination of the Anthropometric Measurements of Turkish Children and Adolescents (DAMTCA-II) were used to calculate the arm anthropometry percentiles in a total group of 6982 children and adolescents aged 28 days to 17 years. The 3rd-97th percentiles were computed by the LMS method.

RESULTS

In girls, 50th percentile MUAC values linearly increased with age. In boys, 50th percentile TSF values linearly increased until 10 years of age and decreased after age 11 years, while in girls, TSF values increased linearly with age. 50th percentile values for AFA showed a linear increase in both genders with age. Significant differences were found between the 5th, 50th and 95th percentile values for MUAC and AFA obtained in the two studies (DAMTCA-II and DAMTCA-I) in both boys and girls.

CONCLUSIONS

The prominent finding was the significant and alarming increase in arm anthropometry indices in both genders within as short period of time as three years.

Upper arm composition and nutritional status of school children and adolescents in Abeokuta, Southwest Nigeria

BACKGROUND

Upper arm composition is a reflection of body protein and calorie reserves. However, there is a paucity of data on upper arm composition of children from African countries, including Nigeria. This study aimed to determine the composition of upper arm and nutritional status of school children in Abeokuta, Nigeria and to compare with international reference standards. The sensitivity and specificity of upper arm muscle area by height (UAMAH) as a nutritional assessment tool was also determined.

METHODS

Five hundred and seventy children aged 5 to 19 years were selected from seven schools using multistage random sampling. Weight, height, mid-upper arm circumference (MUAC) and triceps skin fold thickness (TSF) were measured. Body mass index, upper arm muscle area (UAMA), upper arm fat area (UAFA), fat percentage and UAMAH were derived.

RESULTS

The TSF, UAFA and fat percentage were significantly higher in females than males at each age group. MUAC and UAMA were significantly higher in female children aged 10-14 years, whereas UAMA was significantly higher in male children aged 15-19 years. UAMA and UAFA of the children were lower than those of Americans but similar to those of Zimbabweans, and higher than those of Indians. The sensitivity and specificity of UAMAH for detecting wasting were 80.8% and 63.9%, respectively, whereas the corresponding values for stunting were 32.2% and 58.2%, respectively.

CONCLUSIONS

The school children studied have a combination of poor calorie and protein reserve. UAMAH may be a valuable tool for complete evaluation of the nutritional status of school children.

Anthropometric studies on the Turkish population--a historical review

A historical review of anthropometric studies conducted on Turkish children and adults is presented. In view of observed differences in growth status between children of different societies, the need for local reference standards and the methodology to be used for such studies have been stressed. The importance of local studies in reflecting the state of health and nutrition both in children and adults has also been mentioned. While a number of studies in children cited in this paper are designed to compare the growth of children from different socioeconomic levels, other studies aim to establish local reference data for Turkish children. While the historical studies in adults aim to define racial characteristics, the more recent studies aim to bring out nutritional characteristics with emphasis on increasing frequency of obesity.

Population-based centile curves for triceps, subscapular, and abdominal skinfold thicknesses in Polish children and adolescents--the OLAF study

Skinfold thicknesses are used as valid anthropometric indicators of regional body fatness. Actual population-based values for skinfold thicknesses for Polish children are not available. The purpose of this study was to provide population-based values for triceps, subscapular, and abdominal skinfold thicknesses in healthy children and adolescents. A total number of 17,416 boys and girls aged 6.5-18.5 years, randomly selected from whole Polish population of children and adolescents, were enrolled in the study. Skinfold thicknesses (triceps, subscapular, and abdominal) were measured using Harpenden skinfold caliper. All measurements were taken after the training of participating investigators. The LMS method was used to fit percentile curves across age for each skinfold. Q tests for fit were used to assess the global goodness of fit of our final models. The study shows for the first time smoothed population-based values of body fat distribution indices for Polish children and adolescents 7-18 years of age. Reported skinfold centiles are higher compared to previously established for Warsaw children and very close to the actual US data.

CONCLUSION

Our study provided for the first time population-based values for skinfold thicknesses evaluation in a way allowing to calculate reliable Z scores. The early detection of abnormal fat stores, using our population-based values and respective Z scores, may be now implemented for practice.

Is urolithiasis in children associated with obesity or malnutrition?

BACKGROUND

Although it is known that obesity predisposes to urolithiasis, a tendency for malnutrition in children with urolithiasis owing to recurrent urinary infections and abdominal pain also makes sense.

AIMS

In this study, we aimed to determine the nutritional status of infants and children with urolithiasis, and to observe whether obesity or malnutrition is more prevalent in that population.

METHODS

One hundred eighty-seven children aged 4 months to 17 years (mean, 4.9 ± 4.4 years) with urolithiasis, and 278 age- and sex-matched children without any chronic diseases were included. Anthropometric evaluations, including weight and height standard deviation score (SDS), body mass index, and triceps and subscapular skinfold thickness (SFT), were performed.

RESULTS

Mean weight SDSs of the patients was statistically lower than that of the control subjects (P < .0001). Malnutrition rate was statistically higher in the patients with urolithiasis when evaluated according to weight SDS and percentiles of body mass index and SFT. When the age factor was taken into account, the percentage of malnutrition, determined by the percentiles of triceps and subscapular SFT measurements, was found to be higher in children younger than 2 years. Short stature was more prevalent in older children.

CONCLUSION

Malnutrition among children with urolithiasis is not as rare as thought previously. A careful anthropometric evaluation should be included in the clinical assessment of those children.

Assessment of the nutritional status of children aged 5-12 years using upper arm composition

BACKGROUND

Upper arm muscle area (UMA) and upper arm fat area (UFA) were introduced for assessment of child nutritional status.

AIM

This cross-sectional study assesses child nutritional status using UMA and UFA. It also evaluates the suitability of upper arm muscle area by height (UAMAH) for assessing child under-nutrition with respect to stunting and wasting.

SUBJECTS AND METHODS

The study was conducted among 1248 children (619 boys; 629 girls) aged 5-12 years belonging to the Bengalee Muslim Population of West Bengal, India. Anthropometric measurements of height, weight, mid-upper arm circumference and triceps skin-fold were recorded. Nutritional status was assessed using UMA, UFA and UAMAH. Percentile curves were derived using the least median square method.

RESULTS

Mean age specific values of UMA, UFA and UAMAH of boys and girls were markedly below the 5th percentile. Using UAMAH, a very high proportion of children (boys, 91.28%; girls, 88.55%) were found to be under-nourished. Prevalence of stunting (boys, 39.74%; girls, 41.49%) and wasting (boys, 19.55%; girls, 15.74%) were also found to be high.

CONCLUSION

The combination of UMA, UFA, UAMAH and conventional nutritional indices appear to be useful for assessment of child under-nutrition.

UAE population reference standard charts for body mass index and skinfold thickness, at ages 0-18 years

AIMS

To determine a range of anthropometric measurements including skinfold thickness measurements in four different areas of the body, to construct population growth charts for body mass index (BMI), skinfolds, and to compare these with growth charts from other countries. One aim was also to validate body fat charts derived from skinfold thickness.

METHODS

A national cross-sectional growth survey of children, 0-18 years old, was conducted using multistage stratified random sampling. The sample size included at least 200 children in each age-sex group. Height, weight, biceps skinfold, triceps skinfold, subscapular skinfold, suprailiac skinfold, and mid-upper-arm circumference were measured in each child. We describe correlation, standard deviation scores relative to the other standards, and calculation of body density in the United Arab Emirates population. We determined whether any of the above is a good indicator of fatness in children.

RESULTS

BMI, upper-arm circumference, sum of four skinfolds, and percentage body fat charts were constructed using the LMS method of smoothing. BMI was very significantly correlated with sum of skinfold thicknesses, and mid-upper-arm circumference. Prevalence of obesity and overweight in ages 13-17 years was respectively 9.94% and 15.16% in females and 6.08% and 14.16% in males. Derived body fat charts were found not to be accurate.

CONCLUSION

A national BMI, upper-arm circumference, and sum of four skinfolds chart has been constructed that can be used as a reference standard for the United Arab Emirates. Sum of four skinfold thickness charts can be used as crude determinants of adiposity in children, but derived body fat charts were shown to be inaccurate.