11: Evaluation of Anthropometric Data (Chapter 13)
- Page ID
- 116911
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)Anthropometric indices of growth and body composition are compiled from two or more anthropometric measurements. The indices most frequently used for children include weight-for-height, height-for-age, weight-for-age, body mass index (BMI)-for-age, and mid-upper-arm circumference (MUAC)-for age. The methods recommended to evaluate these anthropometric indices use either percentiles or Z‑score calculated in relation to the distribution of the anthropometric indices for a reference population. The World Health Organization (WHO) recommends for international use the prescriptive WHO Child Growth Standards for those age 0–5y and the WHO Growth Reference for those age 5–19y. New international prescriptive growth standards are also available for gestational weight gain, fetal and newborn growth, and postnatal growth for pre-term infants. In clinical settings, serial anthropometric measurements are used to track an individual's growth pattern, and identify abnormal changes in growth and their response to treatment. In public health, screening systems, that include at least one anthropometric measurement or index in combination with one or more reference limits or cutoff points, can be used to identify “at risk” individuals. At the population level, screening can be used to compare and monitor the prevalence and severity of malnutrition within and across countries, and to monitor progress. Examples include use of height-for-age <−2 Z‑score to identify and monitor stunting, weight-for-height <−3 Z‑score or MUAC < 115mm to identify and monitor severe, acute, malnutrition in children 6–60mos, BMI‑for‑age Z‑score or BMI for overweight and obesity in children and adults, respectively, and a composite index of anthropometric failure (CIAF). Public health applications of anthropometry discussed in this chapter include: (a) international comparisons of growth; (b) identifying determinants and consequences of malnutrition; (c) targeting interventions; (d) assessing responses to interventions; and e) nutritional surveillance. Several methods recommended for evaluating anthropometric indicators are also emphasized, the choice depending on the objectives and design of the study.
- 11.1: Introduction (13.0)
- This page emphasizes the importance of standardized methods for evaluating anthropometric indices to assess nutritional status and malnutrition. WHO recommends Child Growth Standards for children aged 0-5, while the INTERGROWTH-21st project provides international standards for fetal growth and gestational weight gain.
- 11.2: Anthropometric indices and their modes of expression (13.1)
- This page provides an overview of standardized procedures for measuring body size and composition in relation to age and sex. It emphasizes anthropometric indices like BMI and growth references from WHO for assessing child growth and identifying malnutrition. Key points include the use of percentiles and Z-scores for interpretation, the importance of data quality, and the implications of using different methods for assessing malnutrition.
- 11.3: Use of anthropometric indices in clinical settings (13.2)
- This page highlights the significance of anthropometry in clinical settings for detecting growth abnormalities and assessing therapy responses in children aged 0-19. Key growth indices include weight-for-age and BMI. Accurate measurements and regular calibrations are vital. The WHO promotes the use of growth velocity charts for early detection of growth changes and provides resources for assessment. Rising rates of childhood obesity are concerning, with 17% obesity prevalence in U.S. children.
- 11.4: Screening systems to identify individuals at risk in a population (13.3)
- This page discusses the use of anthropometry for assessing malnutrition and monitoring progress toward Sustainable Development Goals, focusing on MUAC for children and its correlation with mortality risk. WHO recommends both MUAC cutoffs and weight-for-height Z-scores for accurate classification. It introduces the WHO-modified QUAC stick for malnutrition assessment and emphasizes the need for region-specific BMI cutoffs for Asians due to health risks at lower BMI.
- 11.5: Applications of anthropometry in public health (13.4)
- This page outlines the critical role of anthropometry in public health, particularly in addressing malnutrition and child health outcomes. It covers applications in growth comparisons, intervention targeting, and the evaluation of public health programs. Strategies in Maharashtra emphasize women's nutrition and socio-economic factors affecting child growth. Multiple indicators are essential for assessing nutrition-related mortality risks.