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

Development of adiposity among Ju/'Hoansi Hunter-Gatherers

OBJECTIVES

To characterize the development of childhood adiposity among the Ju'/Hoansi, a well-known hunter-gather group, to compare our results to U.S. references and to recently published results from Savanna Pume' foragers of Venezuela, with the goal of expanding our understanding of adipose development among human hunter-gatherers.

METHODS

Triceps, subscapular, and abdominal skinfolds, along with height and weight from ~120 Ju'/Hoansi girls and ~103 boys, ages 0 to 24 years, collected in 1967-1969 were analyzed using best-fit polynomial models and penalized spines to characterize age-specific patterns of adiposity and their relationship to changes in height and weight.

RESULTS

Overall, Ju/'Hoansi boys and girls exhibit small skinfolds with a decline in adiposity from 3 to 10 years, with no consistent differences among the three skinfolds. Increases in adiposity during adolescence precede peak height and weight velocities. Adiposity declines during young adulthood for girls and remains largely constant for boys.

DISCUSSION

Compared to U.S. standards, the Ju/'Hoansi show a strikingly different pattern of adipose development, including the lack of an adiposity rebound at the onset of middle childhood, and clear increases in adiposity only at adolescence. These findings are consistent with published results from the Savanna Pumé hunter-gatherers of Venezuela, a group with a very different selective history, suggesting that the adiposity rebound does not characterize hunter-gathering populations more generally. Similar analyses in other subsistence populations are called for to confirm our results, and help distinguish the impact of specific environmental and dietary factors on adipose development.

Maternal and child FUT2 and FUT3 status demonstrate relationship with gut health, body composition and growth of children in Bangladesh

Fucosyltransferase 2 (FUT2) and 3 (FUT3) may influence host biological functions. We aim to assess the relationship between maternal and child FUT2 (Secretor) and FUT3 (Lewis) status with growth, body composition, gut health and histologic features in Bangladeshi children. We conducted a case-control study where secretor and Lewis status were ascertained from saliva samples of 408 mother-child dyads. Upper-arm fat area estimate (UFE) and total upper arm area (TUA) were found higher among children of Lewis negative mothers (p = 0.01 and p = 0.07, respectively). Changes in UFE after nutrition intervention were significantly greater among Lewis positive children than those of negative for Lewis (p = 0.05). Significant differences were observed for child UFE based on secretor and Lewis status of the mothers (p = 0.04). Lewis positive children had greater changes in WAZ (p = 0.07) and WLZ (p = 0.02) than Lewis negative children at the end of nutrition intervention. Fecal Reg1B was elevated in secretor positive children compared to their counterparts (p = 0.03). Lewis negative children had higher concentrations of MPO compared to Lewis positive children (p = 0.08). We also observed a higher frequency of subtotal villous atrophy among secretor negative and Lewis positive children (p = 0.09 and p = 0.01, respectively) than those of their counterparts. The findings provide insights for further studies to elucidate causal influences.

Sex differences in adipose development in a hunter-gatherer population

OBJECTIVE

Humans are unusually sexually dimorphic in body composition, with adult females having on average nearly twice the fat mass as males. The development of adipose sex differences has been well characterized for children growing up in food-abundant environments, with less known about cross-cultural variation, particularly in populations without exposure to market foods, mechanized technologies, schooling, vaccination, or other medical interventions.

METHODS

To add to the existing cross-cultural data, we fit multiple growth curves to body composition and anthropometric data to describe adipose development for the Savanna Pumé, South American hunter-gatherers.

RESULTS

(1) Little evidence is found for an adiposity 'rebound' at the end of early childhood among either Savanna Pumé girls or boys. (2) Rather, fat deposition fluctuates during childhood, from age ~4 to ~9 years, with no appreciable accumulation until the onset of puberty, a pattern also observed among Congo Baka hunter-gatherers. (3) Body fat fluctuations are more pronounced for girls than boys. (4) The age of peak skeletal, weight, and adipose gains are staggered to a much greater extent among the Savanna Pumé compared to the National Health and Nutrition Examination Survey (NHANES III) reference, suggesting this is an important developmental strategy in lean populations.

CONCLUSION

Documenting growth patterns under diverse preindustrial energetic conditions provides an important baseline for understanding sex differences in body fat emerging today under food abundance.

Assessment of Nutritional Status and Body Composition in Tibetan Adolescent girls of Kangra district, Himachal Pradesh

Malnutrition among adolescents is an important public health issue in India. The aim of the present study was to assess nutritional status and body composition characteristics of adolescent girls and their interrelationships with physical activity and socioeconomic status (SES). Nutritional status and body composition characteristics were assessed in terms of body mass index (BMI), upper arm muscle area by height (UAMAH) and percent body fat (PBF) among 276 Tibetan adolescent girls from Kangra district, Himachal Pradesh. Overall, 12.7% of the girls were in the wasting category (using Z-score based classification for UAMAH) and 9.8% were thin. About 16.3% girls were obese. Significant variabilities of PBF have been observed with respect to age and levels of physical activity and wasting. Adolescent girls were observed to have higher lean body mass than body fat.

The Relationship between Under-Nutrition and Hypertension among Ellisras Children and Adolescents Aged 9 to 17 Years

Background: Globally, under-nutrition and hypertension in children has been associated with the risk of developing cardiovascular disease (CVD) in adulthood. The main objective of this study was to investigate the relationship between under-nutrition and hypertension, furthermore, to determine the risk of developing hypertension due to under-nutrition. Methods: The study comprised of 1701 participants (874 boys and 827 girls) between the ages of 9 and 17 years old. All anthropometric and blood pressure measurements were taken according to standard procedures. Mid-upper arm circumference (MUAC), body mass index (BMI), upper arm fat area (UFA), total upper arm area (TUAA) and upper arm muscle area (UMA) of Ellisras children were compared with the National Health and Nutrition Examination Survey III reference population. The linear regression models were used to determine the relationship between under-nutrition with hypertension for unadjusted and then adjusted for age and gender. The logistic regression model was used to determine the risk of under-nutrition on developing hypertension for unadjusted and adjusted for age and gender. Results: There was a positive significant (p < 0.0001) association between all under-nutrition variables (MUAC, BMI, UFA, TUAA and UMA) and systolic blood pressure (SBP; beta ranges between 0.84 and 2.78), and diastolic blood pressure (DBP; beta ranges between 0.3 and 1.08 before adjusting and after adjusting for age and gender (SBP, beta ranges between 0.59 and 2.00 and DBP (beta ranges between 0.24 and 0.80. Conclusion: The prevalence of under-nutrition was high while the prevalence of hypertension was low in this study. The mean under-nutrition variables (BMI, UFA, UMA and MUAC) of Ellisras children were far lower compared to the NHANES III reference population. Hypertension was significantly associated with under-nutrition in this study.

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.

Osteosarcopenic obesity, the coexistence of osteoporosis, sarcopenia and obesity and consequences in the quality of life in older adults ≥65 years-old in Greece

OBJECTIVE

We investigated the coexistence of sarcopenia and obesity in older adults≥65 years diagnosed with osteoporosis and the association with Quality of Life (QoL).

METHODS

A Cross-sectional survey has been performed on a randomized sample of 50 diagnosed osteoporotic elderly people from both sexes (Men=16; Women=34).

MEASUREMENTS

Quantitative ultrasound was conducted to identify osteoporosis and defined with a T score ≤2.5. Validated anthropometric equations were used in order to estimate body fat percentage and skeletal muscle mass so as to detect the reallocation of body fat and lean muscle. 10m gait speed and hand grip strength was measured in order to diagnose sarcopenia according to European Society for Clinical Nutrition and Metabolism (ESPEN) algorithm. The evaluation of QoL was conducted using a QoL questionnaire specific to osteoporosis. The data were analyzed with descriptive statistics and a chi-square test was performed to examine if Osteosarcopenic Obesity (OSO) is sex related and the correlation between OSO and QoL.

RESULTS

From the 50 participants, 40%(n=19) were classified as people with OSO and 60%(n=31) without OSO. From n=19 people that experienced OSO women represent 20% (n=9) and men 18% (n=9); with the latter had a greater decline in muscle mass than women, while women had lower BMD than men according to the z score. OSO is not related with sex (p>.05) and there is no significant association between OSO and QoL (p> .05 for all the domains of QoL questionnaire).

CONCLUSION

Osteoporosis in the elderly often coexists with reduced muscle mass and muscle strength as well as an increase in adiposity and was independently associated with QoL. People that experience OSO presenting lower functionality that increases the risk for falls and bone fractures originated from the decline in bone and muscle mass, and increased adiposity. Increased awareness of OSO may help develop efficient interventions and public health policies for healthier and more active elderly people.

Composite Index of Anthropometric Failure (CIAF) among Sonowal Kachari tribal preschool children of flood effected region of Assam, India

Undernutrition is considered to be a serious public health problem in most of the developing countries. Globally, the anthropometric measures are widely used to estimate the magnitude of undernutrition in children. The Composite Index of Anthropometric Failure (CIAF) provides the overall magnitude of undernutrition as an aggregate single measure over the conventional anthropometric indices and helps in identification of single or double or multiple anthropometric failures in preschool children. The present investigation assesses the age-sex specific prevalence of undernutrition using both conventional anthropometric measures and CIAF among Sonowal Kachari tribal preschool children of Assam, India. This cross-sectional investigation was carried out among 362 (162 boys and 190 girls) Sonowal Kachari tribal children younger than 5 years of flood affected regions of Lakhimpur district of Assam, India. Anthropometric measurements of height and weight were measured using standard procedures. Age-sex specific Z-score value of weight-for-age, height-for-age and weight-for-height were calculated by using WHO-Anthro, v. 3.2.2. A child Z-score <−2.00 of any anthropometric indices was considered to be undernourished and the standard CIAF classification was used to calculate the prevalence of undernutrition. The overall prevalence of wasting, underweight, stunting and CIAF was observed to be 11.6%, 22.9%, 36.2%, and 48.6%, respectively. The sex-specific prevalence of wasting (15.8% vs. 6.9%), underweight (30.5% vs. 14.5%) and stunting (42.1% vs. 29.6%) observed to be significantly higher among girls than boys (p<0.05). The girls (61.05%) were found to be more affected than boys (34.9%) by CIAF (p<0.01). The present investigation reported higher magnitude of undernutrition using CIAF over conventional anthropometric measures, hence the CIAF is relatively better indicator that reflects higher magnitude of undernourishment as compared to any conventional anthropometric indices in children. This research investigation has also reinforced the importance of appropriate intervention programme and strategies needed to reduce the prevalence of undernutrition in childhood and in population as a whole.

Nutritional status of the student nurses of a tertiary health-care center - A mixed-method study

Context:

Nursing students are the future role model of health; so critical evaluation of their nutritional status is imperative for effective functioning of health sector.

Aims:

The aim is to assess the nutritional status of nursing students using basal metabolic index and exploring the causes of malnutrition along with uncovering the causes behind these causes of malnutrition.

Setting and Design:

Nutritional status of student's nurses was assessed by mixed-method study design in tertiary care center of Mumbai, India.

Materials and Methods:

The method is to use the census method for sampling 280 nursing students of a tertiary care center interviewed using a semistructured interview schedule. Focus group discussions were held with student nurses, which were selected through purposive sampling technique to interpret the instigator causes behind causes of malnutrition.

Statistical Analysis:

Descriptive statistics was applied on qualitative data. Conceptual model framed on themes and subthemes based upon the codes from qualitative data.

Results:

Students having BMI less than 18 and more than 24.9 were 189 and 11, respectively, out of 280 students. About 64.20% had acidity and 11.07% performed regular exercises evolving major themes: challenges, stress, attitude, knowledge, social barriers, and motivators.

Conclusion:

About 67.5% of nursing students had BMI less than 18. Inappropriate dietary pattern, frequent ailments, and improper personal habits ensued their malnourished status. Lack of proper knowledge on balanced diet, work place stress, and challenges such as financial constrain, peer pressure, and health ailments along with improper perception of body image of the student nurses are major triggering factors behind the causes of malnutrition.

Soy protein supplement intake for 12 months has no effect on sexual maturation and may improve nutritional status in pre-pubertal children

AIM

To evaluate the intake of a soy protein-based supplement (SPS) and its effects on the sexual maturation and nutritional status of prepubertal children who consumed it for a year.

METHODS

Healthy children (n = 51) were recruited and randomly assigned to consume the lunch fruit juice with (n = 29) or without (n = 22) addition of 45 g of a commercial soy protein-based supplement (SPS) over 12 months. Nutritional assessment including anthropometry (bodyweight, height, triceps skinfold thickness, mid-upper arm circumference), body mass index (BMI), upper arm muscle area, arm muscle circumference, upper arm area, upper arm fat area data were derived from measures using usual procedures; age and gender-specific percentiles were used as reference. Sexual maturation was measured by Tanner stage. Isoflavones were quantified using liquid chromatography and tandem mass spectrometry.

RESULTS

Height, BMI/age, weight/age and height/age were significantly different (P < 0.05) at 12 months between girls in the control and intervention groups. Statistically significant differences between groups by gender (P < 0.05) were found in boys in the control group for the triceps skinfold thickness and fat area. Nutritional status was adequate according to the World Health Organization parameters. On average, 0.130 mg/kg body weight/day of isoflavones were consumed by children, which did not show significant differences in their sexual maturation.

CONCLUSION

Consumption of SPS for 12 months did not affect sexual maturation or the onset of puberty in prepubertal boys and girls; however, it may have induced an increase in height, BMI/age, height/age and weight/age of the girls, associated with variations in fat-free mass.

Percent of body fat, fat-mass, fat-free mass and assessment of body composition among rural school-going children of Eastern-India

Percent of body fat (PBF), fat mass (FM) and fat free mass (FFM) are useful indicators for the assessment of body composition. The present study was conducted among 1351 children (boys: 660; girls: 691) aged 5–12 years residing in West Bengal, Eastern-India. The children were selected using a stratified random sampling method. Anthropometric measurements of height, weight, triceps skinfold (TSF) and sub-scapular skinfold (SSF) were recorded using standard procedures. The PBF, PBF-for-age z-score (PBFZ) and body mass index (BMI) were subsequently calculated. Body composition was assessed using FM, FFM, fat mass index (FMI) and fat free mass index (FFMI). Age-specific mean values of FM ranged from 2.12–4.00 kg (boys) and 2.16–4.40 kg (girls). Age-specific mean values of FFM ranged from 14.45–23.93 kg (boys) and 14.01–23.03 kg (girls). Sex-specific mean differences between sexes were statistically significant in weight, height, TSF, SSF, PBF, PBFAZ, FM, FFM, FMI and FFMI (p<0.05), except in BMI (p>0.05). These results are important for future investigations in clinical and epidemiological settings so as to accurately identify the risk of lower or higher adiposity and body composition using PBF, FM and FFM.

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.

Serum adiponectin in HIV-1 and hepatitis C virus mono- and co-infected Kenyan injection drug users

Adiponectin is an important marker of anthropometric profiles of adipose tissue. However, association of adiponectin and adiposity in HIV mono- and co-infected and hepatitis (HCV) injection drug users (IDUs) has not been elucidated. Therefore, the relationship of total adiponectin levels with anthropometric indices of adiposity was examined in HIV mono-infected (anti-retroviral treatment, ART-naive, n=16 and -experienced, n=34); HCV mono-infected, n=36; HIV and HCV co-infected (ART-naive, n=5 and -experienced, n=13); uninfected, n=19 IDUs; and healthy controls, n=16 from coastal Kenya. Anthropometric indices of adiposity were recorded and total circulating adiponectin levels were measured in serum samples using enzyme-linked immunosorbent assay. Adiponectin levels differed significantly amongst the study groups (P<0.0001). Post-hoc analyses revealed decreased levels in HIV mono-infected ART-naive IDUs in comparison to uninfected IDUs (P<0.05) and healthy controls (P<0.05). However, adiponectin levels were elevated in HCV mono-infected IDUs relative to HIV mono-infected ART-naive (P<0.001) and -experienced (P<0.001) as well as HIV and HCV co-infected ART-naive (P<0.05) IDUs. Furthermore, adiponectin correlated with weight (ρ=0.687; P=0.003) and BMI (ρ=0.598; P=0.014) in HIV mono-infected ART-naive IDUs; waist circumference (ρ=-0.626; P<0.0001), hip (ρ=-0.561; P=0.001) circumference, and bust-to-waist ratio (ρ=0.561; P=0.001) in HIV mono-infected ART-experienced IDUs; waist girth (ρ=0.375; P=0.024) in HCV mono-infected IDUs; and waist-to-hip ratio (ρ=-0.872; P=0.048) in HIV and HCV co-infected ART-naive IDUs. Altogether, these results suggest suppression of adiponectin production in treatment-naive HIV mono-infected IDUs and that circulating adiponectin is a useful surrogate marker of altered adiposity in treatment-naive and -experienced HIV and HCV mono- and co-infected IDUs.