Human Nutrition 3(3+0)

Lesson 47 : Assessment of Nutritional Status

Nutritional Indices in Adults

• BMI is computed using the following formula:

BMI = Weight (kg)/ Height (m²)

Nutritional status	BMI
Severe energy deficiency	? 16
Moderate energy deficiency	16-17
Marginal energy deficiency	17-18.4
Normal	18.5-24.5
Overweight (grade 1 obesity)	25-30
Obese (grade 2 obesity)	>30-40
Very obese (morbid or grade 3 obesity)	>40

• Mid-arm circumference (MAC)

Level of severity/Nutritional status	MAC cut off points
severe malnutrition	<110 mm
moderate malnutrition	110 -120 mm
serious risk of malnutrition	120 -125 mm
moderate risk of malnutrition	125 -135 mm
satisfactory nutritional status	? 135 mm

• Skin fold thickness
  Skin fold thickness is usually measured on the back of the arm, over the triceps muscle midway between the tip of shoulder and the elbow.

Various types of skin-fold calipers are available. The caliper should have standard contact surface or pinch area of 20-40mm, should read to 0.1mm accuracy and exert a constant pressure of 10gm/mm2 throughout the whole range of skin fold thickness at all distances of separation of the jaws.

• Head circumference (HC)
• Head/chest ratio
• <1 ----------- Mal nutrition
• >1 ------------ Normal

Waist/Hip Ratio (WHR)

• High risk WHR= >0.80 for females & >0.95 for males. Waist measurement >80% of hip measurement for women and >95% for men indicates central (upper body) obesity and is considered high risk for diabetes & CVS disorders.

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

	Males	Female
Level 1	> 94cm	> 80cm- maximum acceptable
Level 2	> 102cm	> 88cm- obesity and requires weight management