Mid-Upper-Arm Circumference (MUAC) as a Simple Measure to Assess the Nutritional Status of Adolescent Girls as Compared With BMI

Jeyakumar, Angeline; Ghugre, Padmini; Gadhave, Swapnil

doi:10.1177/1941406412471848

Cited by 21 publications

(23 citation statements)

References 5 publications

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“…A total of 851 adolescents, 456 males and 395 females, participated in this study. The median and interquartile range of age, MUAC and BMI Z-score of the total participants were 17 (16)(17)(18) (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Mid-upper arm circumference (MUAC) can be an invaluable alternative to BMI Z-score and overcome some of its practical limitations. MUAC is simple, easy to perform, relatively inexpensive and more convenient than using BMI Z-score (17) . However, MUAC also requires training and standardisation for accurate measurement (22) .…”

mentioning

confidence: 99%

“…Few studies have explored the performance of MUAC as a screening tool for thinness among the adolescent population in India (Asian). These studies have proposed an optimal MUAC cut-off point range between ≤17•7 cm and 21•6 cm depending on the age of adolescents (17,21,29,30) . However, little is known about the diagnostic performance of MUAC to detect thinness among 15-19-year-old adolescents, in our context.…”

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confidence: 99%

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Mid-upper arm circumference as a screening tool for identifying adolescents with thinness

Sisay

Haile

Hassen

et al. 2020

Public Health Nutr.

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Objective: To evaluate the performance of mid-upper arm circumference (MUAC) to identify thinness in the late adolescence period (aged 15–19 years) in Ethiopia. Design: We conducted a school-based cross-sectional study. The receiver operating characteristics curve was used to examine the validity of MUAC compared with BMI Z-score to identify adolescents with thinness (BMI Z-score <−2 sd). Settings: Fifteen high schools (grade 9–12) located in Addis Ababa, Ethiopia. Participants: A total of 851 adolescent (456 males and 395 females) were included in the study. Results: The prevalence of thinness and severe thinness among high-school adolescents in Addis Ababa was 9·5 % (95 % CI 7·7, 11·7 %). The overall AUC for MUAC against BMI Z-score <−2 SD was 0·91 (95 % CI 0·88, 0·93). The optimal MUAC cut-offs to identify thinness were 23·3 cm for males and 22·6 cm for females. These cut-off points give high sensitivity and specificity for both males (a sensitivity of 87·9 % and a specificity of 75·9 %) and females (a sensitivity of 100 % and a specificity 88·2 %). Conclusions: MUAC has a comparable level of accuracy with BMI Z-score to identify thinness in adolescents aged 15–19 years. Hence, MUAC could be used as an alternative tool for surveillance and screening of thinness among adolescents aged 15–19 years. The optimum cut-off proposed by this study may incorrectly include a large number of adolescents when used in a relatively well-nourished population. In this situation, it would be necessary to choose a cut-off with greater positive predictive value.

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Section: Resultsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Mid-upper arm circumference as a screening tool for identifying adolescents with thinness

Sisay

Haile

Hassen

et al. 2020

Public Health Nutr.

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“…Methods of assessing nutritional status (malnutrition/undernutrition/overnutrition) include the measurement of arm circumference (Jeyakumar et al, 2013). The current opinion is that children living in families with better living conditions are characterized by greater arm circumferences.…”

Section: Discussionmentioning

confidence: 99%

Body structure, muscular strength and living conditions of primary school children in Warsaw

et al. 2020

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The aim of this study was to determine whether the living conditions of school children affects their body structure and muscular strength. Data were taken from 400 girls and 341 boys aged 7–15 years attending nine primary schools in Warsaw in 1997. A questionnaire was completed, anthropological measurements made and two muscular strength tests conducted. The questionnaire asked questions on the children’s level of education, their parents’ professions and monthly incomes, the number of persons in the family and the number of rooms in the family’s apartment/home. Body height, body weight, chest and arm circumferences, grip strength and vertical jump height were measured and used to calculate body mass index, Marty’s Index and the Sargent Vertical Jump Index. Statistical tests included Student’s t-test, Principal Component Analysis (PCA) and multiple regression analysis. Body height, chest circumference, Sargent Vertical Jump Index and grip strength were significantly greater in the boys than the girls. Two factors, namely ‘socioeconomic status’ (F1) and ‘family size’ (F2), describing living conditions, were isolated after PCA. Boys from bigger families (F2) were shorter, with lower weights and BMIs, smaller chest and arm circumferences and greater grip strengths than those from smaller families, whereas girls from families of lower socioeconomic status (F1) weighed less and had greater BMIs and arm circumferences than those from higher socioeconomic status families. The results suggest that boys seem to be more ‘ecosensitive’ than girls.

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“…MUAC has been validated in adults for diagnosing malnutrition and shown to be highly correlated with the body mass index while predicting outcomes better [19][20][21]. MUAC is in general highly specific (up to 96 %), but can be poorly sensitive depending on the chosen cut-offs [22]. We used a non-stretchable MUAC tape to obtain MUAC as the circumference of either of the patient's arm at the midpoint between the olecranon and the acromion, with the patient seated or lying supine, and the rested arm flexed at 90 0 at the elbow.…”

Section: Measurement Of Malnutritionmentioning

confidence: 99%

Causal impact of malnutrition on mortality among adults hospitalized for medical illness in sub-Saharan Africa: what is the role of severe sepsis?

et al. 2015

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Background: In sub-Saharan Africa, malnutrition is associated with mortality in adults hospitalized for medical illness. However, it remains unclear whether this association is causal, and if causal, what the potential mediators are. We assessed whether malnutrition is causally related to mortality among hospitalized adults, and whether severe sepsis plays a mediating role. Methods: We analyzed data from a cohort study of adults hospitalized for any medical illness in Uganda. We measured malnutrition using mid-upper arm circumference (MUAC). We used a directed acyclic graph to identify a minimum sufficient adjustment set of confounders in order to estimate the overall effects of malnutrition on mortality. We then used recently developed statistical methods to determine whether mortality in malnourished patients is mediated by severe sepsis. Results: We analyzed data of 318 adults. Median age was 37 (interquartile range [IQR] 27 to 56), and 25 % (n = 80) were malnourished according to MUAC. Malnourished patients were more likely to be HIV positive (64 % versus 39 %, p < 0.001), more severely ill (median MEWS 5, IQR 3 to 7 versus 4, IQR 2 to 6, P = 0.003), and to have both any sepsis (66 % versus 39 %, p < 0.001) and severe sepsis (51 % versus 20 %, P < 0.001) compared to normally nourished patients. After adjusting for the modified early warning score at admission, tuberculosis, HIV status, education status, age, and sex, malnourished patients remained at 3.0-fold (95 % CI: 1.5, 6.1, P = 0.002) increased odds of having severe sepsis at admission, and at 2.1-fold (95 % confidence interval [CI]: 1.2, 3.7, P = 0.008) increased odds of dying by 30 days post-admission. Only a small proportion of the effects of malnutrition on mortality were mediated by severe sepsis; overall, malnutrition increased the risk of death by 16.8 percentage points (95 % CI: 4.1, 29.4), but only 1.1 percentage points (95 % CI: −2.1, 4.4) absolute risk difference was mediated by severe sepsis. Conclusion: Our data suggest that malnutrition increases mortality in adults hospitalized for medical illness; thus, interventions against malnutrition in this population may reduce mortality. As severe sepsis did not mediate a large proportion of the effects of malnutrition on mortality, future studies are recommended to investigate other potential mediators.

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Mid-Upper-Arm Circumference (MUAC) as a Simple Measure to Assess the Nutritional Status of Adolescent Girls as Compared With BMI

Cited by 21 publications

References 5 publications

Mid-upper arm circumference as a screening tool for identifying adolescents with thinness

Mid-upper arm circumference as a screening tool for identifying adolescents with thinness

Body structure, muscular strength and living conditions of primary school children in Warsaw

Causal impact of malnutrition on mortality among adults hospitalized for medical illness in sub-Saharan Africa: what is the role of severe sepsis?

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