Anthropometry measurement

Anthropometric measurement

1. ANTHROPOMETRY Prepared by Group A Roll No. 9- 15 BNS 2 nd Year

2. Introduction Anthropometry = anthropo + metry Anthropo means ‘human’ and metry means ‘measurement’. It is the measurement of physical dimensions such as the fat mass, composition of human body. It is a convenient and reliable technique whereby changes in the nutritional status can be evaluated easily.

3. Introduction (cont’d) Anthropometric measurements are now regarded as important indicators of an individual’s nutritional status which are given below: Height/ length Weight Mid-arm circumference Head circumference

4. Introduction (cont’d) Chest circumference Triceps skin fold thickness Waist-hip ratio Body mass index Abdominal girth

5. Anthropometric Measurements for Infant

6. Head Circumference Routinely measured until 5 years of age. Measured by placing the tape over the occipital protuberance at the back and just over the supraorbital ridge and the glabella in front.

7. Head Circumference (cont’d) Age Head circumference (cm) At birth 33-35 2 months 38 3 months 40 4 months 41 6 months 42-43 1 year 45-46 2 years 47-48 5 years 50-51   Expected Head Circumference in Children

8. Chest Circumference Usually measured at the level of nipples. In children <=5 years: lying down position >5 years: standing position

9. Chest Circumference (cont’d) At birth head circumference is more than chest circumference by up to 3 cm. At around 9 months to 1 year of age head circumference is equal to chest circumference but there after chest grows more rapidly compared to the brain.

10. Chest Circumference (cont’d) The head circumference is greater than chest circumference by more than 3 cm in: preterm small for date and hydrocephalus infants

11. Chest Circumference ( cont’d ) In malnourished children chest size may be significantly smaller than head circumference because growth of brain is less affected by undernutrition. Therefore there will be considerable delay before chest circumference overtakes head circumference.

12. Weight The measurement of weight is most reliable criteria of assessment of health and nutritional status of children. The periodic recording of weight on a growth chart is essential for monitoring the growth of under five children.

13. Weight (cont’d) Birth weight is double at 4-5 months and triple at 1 year of age. Weight measurement help to identify acute malnutrition and it is measured in kilogram Standard calibrated weighing machine (saltier scale) used for weighing the child. Machine can weight one to 25 kg.

14. Weight (cont’d) Weight for Age Grade of Malnutrition >80% Normal 71-80% Grade 1 (Mild) 61-70% Grade 2 (Moderate) 51-60% Grade 3 (severe) <50% Grade 4 (very severe) Classification of Malnutrition by Indian Academy of Pediatrics

15. Length or Height Up to 2 years of age recumbent length is measured with the help of an Infantometer . Normal length of child at birth is 50 cm and 25 cm length is increase during 1 year of age.

16. Length or Height (cont’d) Age Approximate Rate of Increase in Stature Birth to 3 months 3.5 cm/month 3-6 months 2.0 cm/month 6-9 months 1.5 cm/month 9-12 months 1.3 cm/month Height Velocity

17. Anthropometric Measurements for Under 5 Children

18. Height Height is the distance from the bottom of the feet to the top of the head in a human body standing erect which is stable measurement of growth. It is measured in child and adults too in which either a stadiometer or portable anthropometer is used. Measurements are recorded to the nearest millimeter.

19. Height (cont’d) Stadiometer Portable Anthropometer

20. Height (cont’d) Height for age is an index used for assessing stunting (chronic malnutrition in children). Stunting is defined as low height for age of child as compared to the standard child of the same age. Stunting has direct effect in linear growth.

21. Weight Weight for age is most sensitive and best method for assessing physical growth and nutritional status of children. Growth should be monitored every month for up to the age of 24 months using a weighing sling known as “ Saltar Scale ”. For children above 2 years digital weighing machine can be used to assess weight.

22. Weight (cont’d)

23. Weight (cont’d) Weight for age is an index used in growth monitoring for assessing children who may be underweight. Weight for age = *100 Weight for height is an index used for assessing wasting (acute malnutrition). Weight for height = *100  

24. Weight (cont’d)   Mean weight (kg) Mean height( cm)   Boys Girls Boys Girls 1 year 9.5 8.7 73.4 72.1 2 years 11.7 10.6 84.5 82.1 3 years 13.6 12.6 92.7 90.0 4 years 14.9 14.3 98.1 98.0 5 years 17.0 16.0 106.7 104.4

25. Weight (cont’d) Index Cut off value based on SD/ % Indicates Weight for age <-2 to >=-3 Moderate underweight Weight for age <-3 Severe underweight Height for age <-2 to >= -3/70-79.99% of the normal Moderate acute malnutrition Height for age <-3/<70% of the normal or bilateral pitting edema Severe acute malnutrition Indicators of underweight and malnutrition derived from the weight and height of children relative to their age.

26. Mid Upper Arm Circumference The mid-upper arm circumference( MUAC) is the circumference of the upper arm at the midway between the shoulder tip and the elbow tip on the left arm. It cannot be used before the age of one year. Used for screening target children for moderate and severe acute malnutrition. A special tape “ Shakir’s tape ” is used for measuring the MUAC.

27. Mid Upper Arm Circumference (cont’d) Results are interpreted as: MUAC (in cm) Colour Code Interpretation <11.5 Red Severe malnutrition 11.6-12.4 Yellow Mild moderate malnutrition >12.5 Green Normal nutritional status

28. Mid Upper Arm Circumference (cont’d)

29. Head Circumference It is useful in assessing chronic nutritional problems in children under 2 years old as the brain grows faster during the first 2 years of life. But after 2 years the growth of brain is more sluggish and head circumference is not useful.

30. Current Status of Malnutrition in Nepal (NDHS 2016) Underweight 27% Wasting 10% Stunting 36%

31. Anthropometric Measurements for Pregnancy

32. Pregnancy During pregnancy following measurements are made at the time of woman’s first contact with health care system Height Weight Mid upper arm circumference Weight for height

33. Pregnancy (cont’d) Body mass index (BMI) Preeclampsia is a major cause of maternal death and morbidity. Body mass index (BMI) predicts an increased risk of developing hypertensive disorders and preeclampsia.

34. Pregnancy (cont’d) Waist circumference

35. Pregnancy (cont’d) Hip circumference

36. Pregnancy (cont’d) The waist-hip ratio  or  waist-to-hip ratio  ( WHR ) is the dimensionless ratio of the circumference of the waist to that of the hips. This is calculated as waist measurement divided by hip measurement ( W  ÷  H ).

37. Anthropometric Measurements for Adolescence

38. Adolescence Anthropometric measurements are very important in adolescents as maximum increase in height and weight occur in this period. The growth spurt begins earlier in girls usually between age 9.5 to 14.5 years and in boys at 10.5 to 16.5 year.

39. Adolescence (cont’d) Common anthropometric measurements in adolescents are: Height Average height a boy gains during this period is 10-30 cm and average height gained by girls is 5-20 cm. The diagnostic criteria for defining stunting in adolescence is height for age less than third percentile of NCHS/WHO reference data.

40. Adolescence (cont’d) Weight The average weight gain in boys is 7-30 kg in boys and 7-25 kg in girls. Under nutrition is characterized by low weight and obesity is characterized by over weight in this period.

41. Adolescence (cont’d) BMI (Basal Metabolic Index) A BMI lesser than 5th percentile indicates under nutrition or thinness and more than 85th percentile indicates obesity.

42. Anthropometric Measurements for Elderly

43. Elderly Anthropometric measurement is an important component of nutritional assessment in the elderly. The anthropometric standards derived from adult populations may not be appropriate for the elderly because of body composition changes that occurs during ageing. Specific anthropometric reference data for the elderly are necessary.

44. Elderly (cont’d) Weight and height significantly decreased with age. BMI is significantly higher in women than in men but lower in the elderly than in the young people According to BMI values, the prevalence of malnutrition is lower than 5 % in both genders, whereas obesity is shown to have a higher prevalence in women than in men.

45. Elderly (cont’d) Waist circumference and waist hip ratio It decreases with age in men, but increases higher in old women, suggesting that visceral redistribution in old age predominantly affects females. Elderly people show a thinner body frame than the young people of both genders There is a more marked fat redistribution in women than in men.

46. References Adhikari,T .(2015).Essentials of Pediatric Nursing(2 nd edition). Bhotahity , Kathmandu: Vidhyarthi Pustak Bhandar Park,K .(2007).Park’s Textbook of Preventive and Social Medicine(18 th edition). Jabalpur, India: M/S Banarsidas Bhanot Ministry of Health - MOH/Nepal, New ERA/Nepal, and ICF. 2017. Nepal Demographic and Health Survey 2016. Kathmandu, Nepal: MOH/Nepal, New ERA, and ICF. Retrieved from http://dhsprogram.com/pubs/pdf/FR336/FR336.pd on 2020/07/22. NEPAL Integrated Management of Acute Malnutrition (IMAM) Guideline Retrieved from https://km.mohp.gov.np/document/nepal-integrated-management-of-acute-malnutrition-imam-guideline on 2020/07/22 . (1995) Physical Status: The Use and Interpretation of Anthropometry - Report of a WHO Expert Committee. WHO Retrieved from http://helid.digicollection.org/en/d/Jh0211e/5.2.2.html on 2020/07/22 Perissinotto,E ., Pisent , C., Sergi , G., Grigoletto , F.,& ILSA Working Group (Italian Longitudinal Study on Ageing) (2002).Anthropometry measurements in the elderly: age and gender differences. The British Journal of Nutrition,87(2), 177186.https://doi.org/10.1079/bjn2001487 Retrieved from https://pubmed.ncbi.nlm.nih.gov/11895170/ on 2020/07/22 .

47. Thank You