Comparison of anthropometric measures of nutritional status in preschool children in five developing countries

Abstract

Weight, height, and arm circumference were measured in 7304 children 1 to 5 years old in Columbia, Costa Rica, the Dominican Republic, India, and Pakistan. Previously developed indices using these measures were applied to assess nutritional status, and the agreement between measures was compared. Weight for age and height for age deficits increased with age while weight for height deficits diminished. Many children diagnosed as mildly malnourished by weight for age were found to have normal weights for their actual heights. Deviations from weight for age norms were frequently due to height limitations. Highest positive correlation was found between weight and height, and between weight for age and height for age. Good agreement in malnutrition diagnoses was found between a weight for height limit of 90% of standard and a weight for age limit of 75% of standard. A cut-off point of 80% of standard weight for height was too low to detect most malnourished children. An age-constant arm circumference limit of 13.5 cm identified nearly all children with severe or acute malnutrition by weight for age or weight for height.

PIP: Age, sex, weight, length or height, and arm circumference data were collected by CARE in 1976 on 7304 children ages 9 to 66 months in Colombia, Costa Rica, the Dominican Republic, India, and Pakistan in an effort to further clarify the various nutrition status indices. Previously developed indices using these measures were applied to assess nutritional status, and the agreement between measures was compared. Weight for age and height for age deficits increased with age; weight for height deficits diminished. Many children diagnosed as mildly malnourished by weight for age were found to have normal weights for their actual heights. Deviations from weight for age norms were often because of height limitations. The highest positive correlation was found between weight and height and between weight for age and height for age. There was good agreement in malnutrition diagnoses between a weight for height limit of 90% of standard and a weight for age limit of 75% of standard. A cut-off point of 80% of standard weight for height was too low to detect most malnourished children. An age-constant arm circumference limit of 13.5 cm identified almost all children suffering with severe or acute malnutrition by weight for age or weight for height. In sum, weight for height appears to be the best single anthropometric indicator of current nutritional status of preschool children over 1 year of age.