Anthropometry

Anthropometry What is anthropometry? Anthropometry is the measurement of body parameters to indicate nutritional status.

Anthropometry Why is anthropometry important? Anthropometry is the easiest way to measure nutritional status.

Anthropometric measurements Height Weight Mid-upper arm circumference (MUAC) Demi-span or arm span Knee height Sitting height Skin fold thickness Head circumference

Anthropometric index Combination of different measurements or combination of a measurement with other data Weight-for-height Height-for-age Weight-for-age MUAC-for-height MUAC-for-age BMI-for-age Etc.

Building blocks of anthropometric indices Sex Age Height/ Length Weight 1 2 3 4

Use of building blocks Height Using this information we can find out if the child is “stunted” or short for his age Weight Using this information we can find out if the child is “wasted” or thin for his height and and Age Height

Which anthropometric index to use? Depends on target group Depends on what you want to measure For children <5 years of age: Nutritional problem Index Chronic malnutrition (stunting) Height-for-age Acute malnutrition (wasting) Weight-for-height Any protein-energy malnutrition (underweight) Weight-for-age

Classification of malnutrition in children Protein-energy Malnutrition (Underweight) Acute (wasting) Chronic (stunting) Marasmus Kwashiorkor

Acute and chronic protein-energy malnutrition What are the characteristics of acute malnutrition? Chronic What are the characteristics of chronic malnutrition?

Acute and chronic protein-energy malnutrition Acute shortage of food Produces recent rapid weight loss Results in wasting Is reversible Measured by weight-for-height Adults can become wasted Is most important type in emergencies Chronic Chronic shortage of nutrients or presence of multiple infections Occurs over a long period Results in stunting In kids > 2 years, may be irreversible Measured by height-for-age Adults cannot become stunted Is very common in stable populations

Acute and chronic protein-energy malnutrition Both type of malnutrition can have serious consequences.

Anthropometry in adults Body mass index (BMI) Is ratio of weight and height: Weight (kgs) (Height [m]) 2 Single cut-off points for all ages: BMI Category of Nutritional Status < 16.0 16.0 - 16.9 17.0 - 18.4 Severe Malnutrition Moderate Malnutrition Mild Malnutrition 18.5 – 24.9 Normal Nutrition Status > 25 Overweight

Why is it important how well we measure? Accurate data is needed to correctly classify nutritional status of individuals Need correct classification of individuals to measure nutritional status in populations We use population assessments to make important program decisions

Measuring height (children 24 months or older) 1. Measure height for children 24 months and older if they can stand unassisted. 2. Measure child without shoes and wearing light clothing. 3. Remove hair accessories that interfere with measurement. 4. Position child with feet flat and together on the base of the board. 5. Heels, back of knees, buttocks, shoulder blades and back of head touch back of board while child is maintaining a normal stance. For some children this is not possible and only the heels and buttocks will touch the board. 6 Shoulders level and eyes looking straight ahead. 7. Headpiece firmly against top of the child’s head and firmly against the board. 8. Read measurement to the nearest 0.1 cm.

Child Height

Correct positions for measuring height

Child height - assistant’s hand position Left hand on knees; knees together against board Right hand on shins; heels against back and base of board

Feet flat, heels against board

Position of head

Problem?

Problem?

How to measure length 1. Measure length for children less than 24 months of age. 2. Measure infant without shoes and wearing light underclothing or clean diaper. 3. Remove hair accessories that interfere with measurement 4. Lay child on his back in the center of the measuring surface. 5. Assistant cups the ears to hold the infant’s head so the infant is looking upward and the crown of the head is against the headpiece. 6. Bring knees together, extend both legs and bring movable foot piece to rest against heels. 7. Read measurement to the nearest 0.1 cm.

Correct positions for length measurement

Child flat on board

Position of head 90o

Correct hand and head position

Child and assistant positions

Problem?

Problem?

Feet flat, heels against board TIP Sometimes tickling the soles of the baby’s feet can cause them to turn up their toes and you can get the foot piece flat against the feet

Correct position of feet and measurer

Problem?

Supervisor observing child length procedure

How to use the UNISCALE - display and switch window Kg SECA Switch Window Turns the scale on and makes the scale work in different ways. When the window is covered up for a short time, the scale is switched on or the way in which it works is changed. Display Window Is where the weight is shown in Kg and one tenth of a Kg

How to use the UNISCALE - using the switch window The best way to cover the switch window is to use your foot: Pass one foot close over the top of the switch window from one side to the other. DO NOT step on or touch the window. It is not a push button switch.

How to use the UNISCALE 188.8 0.0 kg 1. Put the scale on the floor. Choose the flattest, most level surface you have. Do not stand on the scale yet. 2. Look at the display window. It should be blank. kg 3. Move your foot quickly across the switch. The scale will switch on and you will see: 188.8 4. In 5 seconds, the scale will adjust itself to zero. You are ready to weigh a person. 0.0

How to use the UNISCALE 1 . .1 1 . 58.3 kg 5. Stand on the scale. Stand still. Make sure that feet or clothes do not cover the switch window. You should see: 1 . and then: .1 and then: 1 . 6. The 1 will move back and forth from side to side to show you the scale is working. Then you should see the weight in the display , for example: 58.3 kg

UNISCALE: weighing adults and children who can stand on their own 1. Turn on the scale. Move your foot across switch window. 2. Ask the person to step on the scale. Wait until the display shows weight. 3. Ask the person to get off the scale. Wait until the display shows 0.0 before weighing the next person.

UNISCALE: Weighing children who are held by their mothers Make sure her feet or clothes do not cover the switch window. You will see the mother’s weight in the display, for example: 52.4 1. Turn on the scale. Move your foot across switch window. 2. Ask the mother to step on the scale by herself. She can give her child to you or another person to hold.

UNISCALE: Weighing children who are held by their mothers 3. With the mother on the scale pass your foot slowly across the switch window. Then wait a couple seconds. 4. Ask the mother to step off the scale. You should see: 0.0 --.-

UNISCALE: Weighing children who are held by their mothers 5. Ask the mother to step back on the scale with her child. You should see the child’s weight. 6. Ask the mother to step off the scale. You should see: 5.4 --.-

UNISCALE: Weighing children who are held by their mothers 7. Pass your foot across the switch window to reset the scale before weighing the next mother. You should see: 0.0

Summary It is crucial to follow these procedures as closely as possible to get accurate measurements of children, women, and men.