Relationship between nutritional assessments and anthropometric measurements
Nutritional assessments are a prime necessity for the following:
Assess the risk of malnourishment among individuals or a population.
Identify malnourished individuals or populations.
Assess the need and impact of health and nutritional intervention programs undertaken to reverse the malnutrition conditions.
This assessment can be done through the following methods:
Direct method: Individual nutritional status is based on the measurement of specific objective criteria.
The ABCD of nutritional assessments: Anthropomorphic measurements, biochemical, clinical, dietary evaluations.
Indirect method: Based on community indices, anthropometric measurements are as follows:
Based on direct measurement of an individual’s body size and proportion.
Compared against standard reference data in the same gender and age group to assess the individual’s nutritional and health status
Quantitative measurement of muscle, bone, and adipose tissue is done to assess the body composition
Anthropometric measurement parameters and indices
Anthropometric measurement is based on measuring various parameters of an individual’s body, which are as follows:
Mid-upper arm circumference Core indices for nutritional analysis:
Height and weight indices
Weight-for-Height â€“ to locate any muscle wastage or thinning
Height-for-Age-to find stunted growth
Weight-for-Age â€“ to find underweight (undernutrition) or overweight (overnutrition) individual
Body mass index (BMI) is based on the ratio of height and weight, this is determined using the formula: weight (in kilogram)/height (in square meter).
Measurement techniques: These are done using standardized techniques by a measurer and an assistant.
Using an infantometer: The child’s length is measured concerning the child placed supine with legs fully extended to the line perpendicular to the infantometer’s plank.
Children and adults: In children who can stand, height is measured using rod and lever equipment or a stadiometer. The same practice is done for adults. The child should stand using bare feet and with no head accessories. The heels, shoulders, occiput, and buttocks should touch the wall with the head in the Frankfurt plane. The aim is to pinpoint the vertex of the head from the ground level to measure the height.
Weight: It is measured using a calibrated digital balance-beam scale, infant scale, and spring scale.
Head circumference: It is measured using a tape that wraps the head from the occipital protuberance to the supraorbital ridge and glabellar regions.
Chest Circumference: Around the chest at nipple level or xiphisternum
Mid-upper arm circumference (MUAC): It is measured with the arm bent at a right angle, between the acromion and olecranon, using fiberglass or steel tape.
Skin-fold thickness: The skin fold and the subcutaneous fatty layer are picked up using calipers, and the thickness is measured.
Waist circumference: It is measured around the waist at the umbilical level. It is done to analyze the hip or waist ratio and predict obesity.
Hip circumference: It is measured around the hip and buttocks region using non-stretchable tape.
Significance of anthropomorphic measurements in nutritional analysis
Anthropomorphic measurement is the simplest and safest method that can be applied universally to perform nutritional assessments. The advantages of anthropometric analysis are as follows:
Provides measurements based on reliable, precise, and accurate standardized techniques.
Involves only non-invasive methods using very simple, less expensive, and locally available equipment; does not require any highly qualified personnel to perform these tests.
Identifies risk of malnutrition in an individual or any size of a population.
Analyzes the degree and the severity of malnutrition.
Locates the vulnerable populations, under various age groups and gender, who are at risk of malnutrition.
Best indicators to analyze the evolutionary changes in the nutritional status over the generations among various populations.
Assesses the impact of disciplinary measures and intervention programs to alleviate the nutritional issues in a population; and studies its impact on social, economic, political, and cultural factors.
Provides data to monitor any risk of malnutrition during any health or nutritional emergencies
These measurements are baseline markers that define obesity and other metabolic and systemic diseases. MUAC is an indicator of protein-energy malnutrition in children. Head circumference can be used to assess microcephaly. Muscle and fat loss can indicate diabetes. Increased skin fold can indicate hypercholesterolemia, which can trigger heart diseases. Limitations:
Inability to assess specific nutrient deficiencies that can affect an individual’s growth and health.
The exact root cause of malnutrition cannot be identified through anthropomorphic measurements. A decrease in height can indicate stunted growth in a child, but the exact reason for stunted growth cannot be determined.
Relatively insensitive data does not reflect changes happening in a short period and does not differentiate acute or chronic changes in the nutritional status.
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