Anthropometric assessment of nutritional status in adolescent populations in humanitarian emergencies

Abstract

Objective: To outline the difficulties and suggest potential solutions in anthropometric assessment of adolescents during humanitarian emergencies. Design: Literature review. Setting: Multiple settings in which the nutritional status of adolescents has been assessed using anthropometric measurements. Subjects: Adolescents in multiple populations. Interventions: None. Results: The use of anthropometry may be more difficult in adolescents than in other age groups because anthropometric indices in normally nourished adolescents change with age and sexual development. Moreover, survey and reference populations may differ in the age at which certain pubertal landmarks are attained, requiring adjustment for differences between survey and reference populations. Adolescent populations may also differ by ethnicity in various body proportions that affect anthropometric indices. Adjustment may be required when the body proportions of adolescents in the reference population differ from those in the population assessed. Conclusions: Although no definitive recommendation can be made regarding which anthropometric indices are the most appropriate for adolescents, some revisions may improve current practices. Weight-for-height could be used for prepubertal adolescents and body mass index could be used for postpubertal adolescents. Because cut-off points are age-specific, age should be collected as accurately as possible for all adolescents measured during screening or survey activities. The WHO-recommended reference population of US adolescents is inappropriate in most populations of adolescents. Adolescents should never undergo nutritional assessment in isolation; other population subgroups should be included, and other health, nutrition and food data should be collected at the same time.

Female gender and wealth are associated to overweight among adolescents in La Paz, Bolivia

“…The present study supports the plea to develop improved references for the assessment of the nutritional status of adolescents in developing countries (Woodruff and Duffield, 2002). The WHO's references have been criticised because of the risk of misclassification of individuals, which can be translated as a combination of over consumption of health resources by individuals at lower health risk and under consumption by those most at risk (Neovius et al, 2004).…”

“…This value triples the reported prevalence of stunting in women of 15-19 y who had had a child in the previous 3 y (INE, 1998); however, applying to our data the single cutoff point of 145 cm for height that is regularly used by the Bolivian National Institute of Statistics, this value is reduced to 3.4% and becomes three times lower than the reported one. These discrepancies support the need to develop further references that may be of more pertinence for adolescents in developing countries (Woodruff and Duffield, 2002;Neovius et al, 2004). The present study found that 4% more boys can be considered as thin when compared with girls.…”

“…Although the use of the IOTF reference may slightly overestimate overweight and underestimate the prevalence of obesity, the differences were not statistically significant, for example, in a Greek sample (Karayiannis et al, 2003). Furthermore, the IOTF reference (Cole et al, 2000) has been suggested to be appropriate for the identification of overweight and obesity since the proposed cutoffs are a result of Overweight in Bolivian adolescents A Pérez-Cueto et al the analysis of international pooled data and therefore constitute the best instrument available to date for epidemiological studies (Woodruff and Duffield, 2002;. One of the characteristics of the nutritional transition is the coexistence of overweight and underweight in the same population (Doak et al, 2002).…”

Nutritional Status of Adolescent Girls from Rural Communities of Tigray, Northern Ethiopia

“…Anthropometric measurements were converted to heightfor-age and BMI-for-age z scores and percentiles. Girls with height-for-age below -2Z scores and BMI-for-age below the 5 th percentile of the 2007 WHO reference population were classified as stunted and undernourished, respectively (12,13,14). Girls with height-for-age z scores (HAZ) < -6 or > 6 were considered outliers.…”

Gender bias in the food insecurity experience of Ethiopian adolescents

“…While direct observation can be used as an alternative to proxy reports of those eating from a common pot (Gittelsohn, Shankar, Pokhrel, & West, 1994), direct observation, like proxy reports, may not provide an accurate assessment of dietary intake for adolescents who typically take more of their meals outside the household. Finally, the use of anthropometric measures to identify adolescent food insecurity resulting from intrahousehold discrimination is hampered by the lack of an agreed upon reference population and the need for sensitive information on maturational stage (Woodruff & Duffield, 2002). Indeed, in a review of eleven studies of nutritional status of adolescence in developing countries, the authors concluded that "nutritional [anthropometric] measures alone should not be used as indicators of wellbeing" (Kurz & Johnson-Welch, 1994:25).…”