Menu ENN Search

Assessing nutritional status using armspan measurement

Summary of published paper1

In older people, the use of body mass index (BMI) to determine nutritional status is often unreliable. In particular, the accuracy of height measurement may be impeded by age-related spinal deformities, such as kyphosis (curvature of the spine), alterations in height and shape of the vertebral discs, and vertebral compression. A number of studies have demonstrated that other skeletal measurements might be employed as alternatives to height when assessing the older age groups. Arm-span has been shown to approximate to height at maturity in Caucasian populations and is relatively independent of ageing, suggesting that it may offer an alternative to height in calculating BMI in older populations. Also, it is an inexpensive and simple measurement to obtain in a field setting. However, there are few equations developed for determining height from arm-span in African populations and these are often based on small samples.

A recent study set out to examine the differences in the relationship between height and arm-span in four ethnic groups in Ethiopia. In addition, the study determined BMI using arm-span cut-off values (BMIas) equivalent to conventional BMI which uses height cut-off values (BMI-ht), for chronic energy deficiency.

The study took place in four regions in Ethiopia, namely Oromo, Amhara, Tigray and Somali regions. A total of 706 Ethiopians aged 18-50 years from four different ethnic groups were measured. Anthropometric measurements (weight, height and armspan)2were obtained using standard techniques. BMIs using arm-span (BMI-as) and height (BMI-ht) were calculated. T-tests were performed to compare means, and linear regression employed to investigate the relationship between BMI-ht and BMI-as.

Results

Both ethnic and sex differences in the relationships between height and armspan and their derived variables (BMI-as and BMI-ht) were found. Armspan measurements exceeded height measurements in all the ethnic groups and in both sexes. Armspan and height and their corresponding BMI-as and BMI-ht were highly correlated in all ethnic groups. BMI-as cut-offs equivalent to the conventional BMI-ht classification of chronic energy deficiency were similar in the Oromo, Amhara and Tigre groups, but substantially higher in the Somalis.

Conclusion

Armspan can be used as a proxy for height to estimate BMI, however the relationship between the two measures varies considerably with ethnicity and sex. Unless sex and ethnicity specific cut-offs are applied, the use of BMI-as using conventional cut-off points will over-estimate the prevalence of underweight in these populations.

In order to estimate true height from arm-span in elderly people, it is necessary first to establish the relationship between these two measurements in a younger population of the same ethnicity. The authors propose that this study has achieved this for Ethiopia, since the four ethnic groups studied together make up more than 85% of the Ethiopian population. It is therefore possible to use the relationships identified to estimate height from arm-span in older Ethiopians in whom height cannot be measured accurately. However, additional research is needed to determine similar anthropometric differences in other groups, in Africa and in other regions of the world.

Show footnotes

1De Lucia.E, Lemma.F, Tesfaye.F, Demisse.T and Ismail.S (2002): The use of armspan measurement to assess the nutritional status of adults in four Ethiopian ethnic groups. European Journal of Clinical Nutrition: vol 56, pp 91-93

2A 3 m long steel tape measure was used for the armspan measurement. Armspan was measured while the subject was standing erect and looking straight ahead, with their back against the wall to provide support. The arms were outstretched at right angles to the body with palms facing forwards. The measurements were taken from one middle fingertip to the other middle fingertip, with the tape passing in front of the clavicles. Two field workers supported the elbows.

More like this

en-net: Ebola and Anthropometry: Height measurement of adult patients

Ebola and Anthropometry: Height measurement of adult patients Dear colleagues I am in DRC working on Ebola Virus Disease (EVD) and nutritional care. I have an urgent...

FEX: Older people, nutrition and emergencies in Ethiopia

By Vanessa Tilstone Vanessa Tilstone has worked for HelpAge International in Ethiopia for the last 3 years as the Country Programme Director and has worked previously in...

FEX: Methods for Assessing Malnutrition in Older People

A Summary of Initial Findings In the first edition of Field Exchange we reported on an ongoing research project by Helpage and the LSHTM which was developing methods for...

FEX: Assessing malnutrition in older people

During emergencies the elderly are often identified as a vulnerable group who appear susceptible to malnutrition and disease. At the moment there are no standards for assessing...

FEX: Nutritional status and handgrip strength in older refugees

Summary of research1 Handgrip strength measurement in the Chabilissa II camp, Tanzania 1995 A recent study set out to demonstrate the relationship between nutritional status...

en-net: Estimating weight from height and MUAC

Here is an article on using MUAC and height to estimate weight. This is nutritional anthropometry but the application is first response emergency medicine. If follows on a...

en-net: W/h in rickets

is W/H criteria applicable to children with rickets?? I will do a "toy example" with only a few data points. Is is a "toy example" in the sense that I will use only 10 pairs...

en-net: Nutritional status and vulnerability of older adults/older people (aged 50 +)

Happy New Year to En-net colleagues, I have recently been contracted by HelpAge International (in partnership with NutritionWorks) to write a module on nutrition in older...

FEX: Nutrition and baseline survey of older people in three refugee camps in Dadaab

Summary of research1 An older man in Dadaab camps during the HOA crisis in 2011 This short summary of the findings of a nutrition survey conducted by HelpAge International in...

FEX: Can height-adjusted cut-offs improve MUAC’s utility as an assessment tool?

By Michel Van Herp, An Verwulgen, Bérengère Leurquin, and Pascale Delchevalerie Michael Ven Herp, Bérengère Leurquin, An Verwulgen & Pascale Delchevalerie Michael Ven Herp is...

FEX: Implementation of a field study of body composition among infants and young children in sub-Saharan Africa

View this article as a pdf By Ezekiel Mupere, John Mukisa, Lynnth Turyagyenda, Peace Aber, Luke S Uebelhoer, Celine Bourdon, Robert Bandsma, Emmanuel Chimwezi, Jonathan C...

FEX: MUAC versus weight-for-height debate in the Philippines

By Bernardette Cichon Bernardette is a Public Health Nutritionist who at the time of the work described in this article, worked with Action Contre la Faim (ACF). She is...

en-net: Assessment of Adult Malnutrition in "Long-legged" populations

Dear ENN, I was wondering if there was any information or experience available in the use or adjustment of BMIs in adult populations in populations that are skewed from the...

FEX: Improved surveillance prevents excess mortality: the Gode experience

Summary of published paper1 A study on the epidemiology of the famine in Gode district of Ethiopia has just been published. The primary objectives of the study (which was...

FEX: Comparison of Weight-for-Height Based Indices for Assessing the Risk of Death

Summary of Published Paper Mortality rates among children with severe malnutrition vary considerably between different treatment centres. This variation is due to differences...

FEX: Postscript on older people, nutrition in emergencies in Ethiopia

Bradley A.Woodruff, MD MPH, Medical Epidemiologist International Emergency and Refugee Health Branch U.S. Centers for Disease Control and Prevention This field article from...

FEX: New WHO Growth Standards for 0-5 years

The WHO Multicentre Growth Reference Study (MGRS) was undertaken between 1997 and 2003 to generate new growth curves for assessing the growth and development of infants and...

FEX: Adults and adolescents: assessment of nutritional status in emergency-affected populations

New publications1,2 In July last year the ACC/Sub-committee on nutrition published two reports on the assessment of nutritional status in emergencies. One report deals with...

en-net: When can we use BMI for lactating women again?

Lactating women and Anthropometry Dear colleagues There is no agreed anthropometric indicator for lactating women to classify them as malnourished . I want to measure,...

FEX: Anthropometry in infants under 6 months in rural Kenya

Summary of research1 Reliability study participants It is currently estimated that worldwide 8.5 million infants under 6 months are wasted. In poor communities, low rates of...

Close

Reference this page

Assessing nutritional status using armspan measurement. Field Exchange 17, November 2002. p6. www.ennonline.net/fex/17/assessing

(ENN_3623)

Close

Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.