Indicators of Nutritional status

COMMUNITY NUTRITION 3 (1+2)
Lesson 3 : Analysis and Interpretation of Anthropometric data

Indicators of Nutritional status

  1. Classifications based on weight for Age:

    • Gomez Classification
      ≤ 60% weight for age: Grade III malnutrition
      61-75% weight for age: Grade II malnutrition
      76-90% weight for age: Grade I malnutrition
      >90% weight for age : Normal.

    • Indian Academy of Pediatrics (IAP) Classification
      ≤50% weight for age: Grade IV
      51-60% weight for age: Grade III malnutrition
      61-70% weight for age: Grade II malnutrition
      71-80% weight for age: Grade I malnutrition
      >80% weight for age : Normal

    • Jellief classification
      < 60% of weight for age: Grade III
      60-80% of weight for age: Grade II
      80-90% of weight for age: Grade I
      90-110 % of weight for age: Normal

  2. Classifications based on Height for Age:

    • Mclaren’s classification
      < 80%: dwarf
      80-93%: Short
      93-105%: Normal

    • Water low’s classification
      <85% expected height for age: Severe retardation
      85-90% expected height for age: Moderate retardation
      90-95% expected height for age: Mild retardation
      >95% expected height for age: Normal

  3. Classifications based on Weight for Height: Water low’s classification based on height for age and weight for height.

    Normal
    Weight for height ≥ 80% standard
    Height for age ≥ 90% standard
    Stunted
    : Weight for height ≥ 80% standard
    Height for age < 90% standard
    Wasted
    : Weight for height < 80% standard
    Height for age ≥ 90% standard
    Wasted and stunted
    : Weight for height < 80% standard
    Height for age < 90% standard

  4. Body Mass Index (BMI): The ratio of weight in kg/Height2 mts is referred to as Body Mass Index.
    BMI has good correlation with fitness. It also can be used as an indicator of health risk.

    1. BMI in relation to energy status
      Presumptive diagnosis

      BMI

      Chronic energy deficiency Grade-III severe
      Chronic energy deficiency Grade-II
      Moderate
      Chronic energy deficiency Grade-I Mild
      Low weight –Normal
      Normal
      Obese grade-I
      Obese grade-II

      < 16.0

      16.0-17.0

      17.0-18.50

      18.5-20.0
      20.0-25.0
      25.0-30.0
      >30


      BMI classification, as suggested by WHO (for Asian Population)
      20.0-23.0-Normal
      23-30-over weight
      30-35-obesity I
      35-40-obesity II
      ≥40- obesity II

      Broka’s Index
      Height in cms -100=Ideal weight (kg)
      Broka’s Index correlates with BMI and weight/height

  5. Weight/Height ratios
  6. These ratios are generally termed as body mass indices/obesity indices as those ratios are highly correlated with obesity.
    Advantages of Weight/Height ratios
    • It is an age independent parameter
    • Weight/height can be measured easily.
    • It is quick method
    • More precise than skin fold thickness measurement.
    • Hence widely used as indirect measures of obesity.


    There are two types of Weight/Height ratios

    Relative Weight/Height indices-Expressed weight of a person as percent of average weight of persons of the same height.
    Power type indices
    -Weight relative to some power function of height or height relative to some power function of weight

    jhk

    vb

    chn

    b

    P is derived from weight/height ratio and the regression coefficient of weight or height for age, sex and population.

  7. Waist and Hip Circumference Ratio: A waist hip ratio >1.0 in men and >0.8 in women is indication of android obesity and increases the risk of atherosclerosis.
  8. Waist circumference
    Waist circumference predicts mortality better than any other anthropometric measurement. It has been proposed that waist measurement alone can be used to assess obesity and two levels of risk have been identified.


    Male

    Female

    Level 1

    >94cm

    >80cm: max acceptable

    Level 2

    >102 cm

    >88cm: Obesity


    Best set of measurements/Indices found useful for nutritional status.

    Details

    Measurements/Indices

    • Newborns

    Weight, height, weight for height (%) or weight/height 2

    • Infants

    Weight, height, weight for height (%) or weight/height 2 , head circumference, chest circumference.

    • Preschool children

    Weight, height, weight for height (%) or weight/height 2 , arm circumference and calf circumference

    • School age children adolescents

    Weight, height, weight for height (%) or weight/height 2

    • Adults

    Weight, height, weight for height (%) or weight/height 2
    Weight/height, weight/height3 of Broka’s index.


  9. Mid-upper Arm circumference (MUAC)
  10. < 12.5 cm: Severe malnutrition
    12.5-13.5cm: Moderate malnutrition
    > 13.5cm: Normal

  11. Head/chest circumference ratio (for children above 6 months of age)
    <1 normal
    >1 malnourished
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Last modified: Tuesday, 29 November 2011, 1:16 PM