Kyle Casadei ; John Kiel. Authors Kyle Casadei 1 ; John Kiel 2. Anthropometric measurements are noninvasive quantitative measurements of the body.
According to the Centers for Disease Control and Prevention CDC , anthropometry provides a valuable assessment of nutritional status in children and adults. Growth measurements and normal growth patterns are the gold standards by which clinicians assess the health and well-being of a child. These measurements can also be used to determine body composition in adults to help determine underlying nutritional status and diagnose obesity. The core elements of anthropometry are height, weight, head circumference, body mass index BMI , body circumferences to assess for adiposity waist, hip, and limbs , and skinfold thickness.
According to the American Academy of Pediatrics and the Child Health and Disability Prevention CHDP Program Health Assessment Guidelines guideline 4 , accurate serial anthropometric measurements can help identify underlying medical, nutritional, or social problems in children.
Abnormal anthropometric measurements, especially in the pediatric population, warrant further evaluation. Anthropometric measurements can also assess body composition in athletes; this has been shown to optimize the competitive performance of athletes and to help identify underlying medical problems, such as eating disorders.
Anthropometry-driven fitness programs in athletes have been shown to improve cardiorespiratory fitness and strength. The Child Health and Disability Prevention CHDP Program Health Assessment Guidelines guideline 4 recommend anthropometric measurements in all children and adolescents at each preventive visit to ensure adequate growth patterns and to assess the risk of obesity.
Accurate serial measurements over time are the most important aspect of anthropometry. Solitary deviations from a growth pattern curve can be a normal variant or due to an acute illness.
However, according to the CHDP guidelines, steady change of the growth curve on serial measurements is a reliable indicator of an abnormal growth pattern and warrants further workup. For infants and toddlers less than two years of age, weight, length, and head circumference are indicated anthropometric measurements at each well-visit.
For children greater than two years of age, indicated measurements include weight and length. Body Mass Index BMI measurement is recommended for all children two years and older to determine adequate nutritional status and risk of obesity.
These measurements should be plotted on World Health Organization WHO charts or the CDC charts, which are gender and age-specific to compare the child to the average population. In adults, anthropometric measurements are recommended at each well-visit to determine nutritional status and the risk of future disease. Anthropometric measurements are noninvasive and, as such, do not have any contraindications for their use. There are situations in which the measurements might give inaccurate results such as acute illness or be impossible to measure such as a limb deformity or casting.
Using anthropometric measurement in such situations can give falsely reassuring or alarming data and should be avoided. Reliable and reproducible measurements are required to obtain meaningful data from anthropometric measurements. As such, clinicians should ensure the use of well-calibrated, quality equipment that is checked regularly for accuracy. Typical equipment list required to obtain anthropometric measurements includes:.
Isolated anthropometric measurements are not useful. The values obtained must be compared to relative standards for the appropriate population. The World Health Organization WHO charts outline the growth of healthy children under optimal nutritional and environmental conditions, providing a 'goal' standard for optimal growth.
On the CDC charts, the normal growth pattern is identified as growth between 5th and 95th percentiles. The 85th to the 95th percentile is considered the overweight category or the at-risk group. The WHO charts are considered applicable to all children from birth to five years of age regardless of ethnicity, socioeconomic status, and type of feeding.
This corresponds to a range between the 2nd and 98th percentiles. A comparison between the two charts showed that the WHO growth standards are less likely to classify a child as undernourished compared to the CDC charts. It is essential to use the correct chart for the patient's age and gender when using growth charts. It is also important to remember that children with disorders that alter the growth pattern need specialized plots to obtain meaningful results.
A number of specialized growth charts have been developed for children with Down syndrome, Turner syndrome, cerebral palsy, Williams syndrome, achondroplasia, Prader-Willi syndrome, and Rett syndrome, and should be used in place of standardized growth charts when indicated. The recommended technique for obtaining anthropometric measurements according to the CHDP Guideline 4 are outlined below. For infants and toddlers less than two years of age, measure the largest circumference of the head using a non-stretchable measuring tape around the most prominent part of the head to the middle of the forehead.
The tape measure should be pulled snug around the head to compress the hair and underlying soft tissue. Repeat the measurement twice to obtain two readings within 0. The average of the two closest measurements should be recorded. For infants and toddlers who cannot stand, the recumbent length should be measured.
Align the infant's head against the top of the headboard of the infantometer. An assistant must straighten the infant's body and legs, ensuring the feet are parallel to the footboard.
For children who can stand, a stadiometer should be used. The child should stand up straight, with buttocks, shoulder blades, and heels together touching the back of the stadiometer. The feet should face outward at a degree angle. If the patient has genu valgum, separate the feet enough to avoid overlapping the knees while maintaining contact between the knees.
Arms should be loosely hanging at the sides with palms facing the thighs. The horizontal bar of the stadiometer should be lowered until the hair is compressed to the crown of the head.
Remove any objects on the head and hair that may obstruct the bar from compressing the hair to the crown of the head. The measurement should be read to the nearest 0. For children less than two years of age, use a calibrated beam or a digital infant scale. Ensure the infant is not wearing any clothes and remove the diaper before measuring the weight. The weight should be measured to the nearest 0. For children older than 24 months, a balanced floor scale or electronic floor scale can be used.
BMI is a calculation based on the height and weight of the child and is recommended by the CHDP guidelines for all children older than two years of age. The formulas for the calculation of BMI in children are as follows:. In adults, BMI is used to diagnose obesity as it correlates with body fat. However, it does not directly measure body fat and has its limitations when used in isolation. Percent body fat varies with age, gender, and ethnicity. Percent body fat increases with age even if the weight stays the same, making it a less accurate measure of obesity in adults.
Also, in athletes, increased muscle mass for a given height and age will increase their BMI, even though they have a very low percentage of total body fat. The American Academy of Pediatrics recommends the use of Z-scores to define malnutrition in children. This measurement uses standard deviations to determine the nutritional and developmental pattern of a child as compared to the average population.
Currently, z-score levels for classifying obesity in children are not well established. Consequently, they were not included in the CHDP guideline.
To measure upper leg length, have the patient seated with legs at a degree angle. Then, run the measuring tape from the inguinal crease to the proximal aspect of the patella.
To measure the upper arm length, find the superior edge of the spine of the scapula. Then, run the measuring tape down the center of the triceps to the olecranon. Immediately after measuring the upper arm length, the mid-point of the arm should be marked in preparation to measure the mid-upper arm circumference. The patient stands upright with the arm hanging freely at the side. The patient should not flex the arm muscles. Measuring tape should be placed snugly around the mid-point of the arm without compressing the skin.
To measure waist circumference, patients should stand with their arms crossed on the contralateral shoulders. The placement of the measuring tape should be snugly around the lateral aspect of each ilium at the mid-axillary line.
It is an essential measure of anthropometry in adults and children as it directly measures central adiposity. Increasing central adiposity is associated with an increased risk of morbidity and mortality due to an increased risk of diabetes and heart disease. Common sites for skinfold measurements include the biceps, triceps, iliac crest, thigh, calf, subscapular, abdomen, and chest.
The exact technique can vary, but we will discuss one method using the triceps as an example. For the triceps skinfold, grab the skin 2 cm above the midpoint of the right upper arm with the thumb and index finger to create a skinfold.
Then, place the calipers at the midpoint to obtain the measurement. Similarly, at other sites, the skinfold measurement is obtained by grabbing the skin 2 cm away from the measuring site. Despite standard measuring techniques, skinfold testing has high variability and has limited use thus far in the clinical setting.
Errors in measurements are the only complications of anthropometric measurements. Evidence suggests that errors in weight and abdominal obesity measurements occur in higher proportions in the obese population.
Another common cause of measurement error is obtaining measurements in a non-uniform manner. Research shows that classical anthropometric measurements, including weight, height, and BMI calculation, are less prone to measurement error.
Sebo et al. Anthropometric measurements have utility in assessing physical fitness data for a wide variety of the population, from children to elite athletes to the elderly. One study of Australian volleyball players revealed that anthropometric data improves with increases in playing level. They found that pilates combined with hydro-gymnastics decreased BMI, weight, and hip-to-waist measurements. I think this is interesting, because it gives us the idea that only women who are extremely thin can wear these clothes.
I also included a picture of a "Japanese Barbie" that I found on the internet. The article quoted above explains the transformation of the "fashion barbie" to all the other forms of modern Barbies that have developed over the past fifty years. However, this Japanese Barbie does not really look Japanese. In fact, it looks very similar to the original Barbie.
The ad above is a mac makeup advertisement; it is interesting to me how she looks exactly like a Barbie doll. Sources: Urla, Jacqueline, and Alan C. Terry, Jennifer, and Jacqueline Urla, eds. Posted by Andrea Smith at PM. Labels: Our Barbies , Our Selves. No comments:. Newer Post Older Post Home.
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