This document provides an overview of anthropometry, which involves the quantitative measurement of the human body. It discusses the significance of anthropometry in evaluating nutrition status and differentiating between acute and chronic changes. The key parameters that are measured include weight, height, head circumference, chest circumference, mid-upper arm circumference, and skinfold thickness. The document outlines the techniques for measuring each parameter and provides the normal growth velocities and expected measurements at different ages. It also discusses various formulas and indices used to classify malnutrition based on anthropometric measurements.

1. ANTHROPOMETRY
A.AKHIL ROYAL
KIMS MEDICAL COLLEGE
AMALAPURAM

2. Anthropometry: Introduction
• Anthropos - "man"
• Metron "measurement”
•A branch of anthropology that involves the
quantitative measurement of the human body.
2

3. ANTHROPOMETRY-
significance
• It is used to evaluate both under & over
nutrition.
• The measured values reflects the current
nutritional status & also differentiate between
acute & chronic changes
• It is the singlemost portable, universallyapplicable,
inexpensiveand non-invasive techniquefor assessing the
size, proportions and composition of thehumanbody.
3

4. Parameters of anthropometry
a) Weight
b) Height
c) Head circumference
d) Chest circumference
e) Mid-arm circumference (1-5 years)
f) Skinfold thickness
g) B.M.I
4

5. Weight recording
5

6. Weight
• most reliable criteria of
assessment of nutrition
• periodic recording will help
to detect malnutrition in
under 5 at early age.
 Beam type weighing balance
 Electronic weighing scales
for infants and children
 Salter spring machine (in
field conditions, less
accurate)
6

7. •Growth Velocity :
A. 0-4 months 1.0kg/month(30g/day)
5-8 months 0.75kg/month(20gm/day)
9-12 months 0.50kg/month(15g/day)
1-3 years 2.25kg/yr
4-9 years 2.75 kg/yr
10-18 years 5.0-6.0kg/yr
(0.5kg/month)
B. Weight at 4-5 months 2 x birth weight
Weight at 1 year 3 x birth weight
Weight at 2 years 4 x birth weight
Weight at 7 years 7 x birth weight
7

8. WEECH’S FORMULA
a) 3 – 12 months
Expected weight(kg) = age (months) + 9 / 2
b) 1- 6 years
Expected weight(kg) = age (years) x 2 + 8
c) 7 – 12 years
Expected weight(kg) = age (years) x 7 - 5 / 2
8

9. Classification of Malnutrition by Indian
Academy of Pediatrics
Weight for age * Grade of malnutrition
>80 %
71-80%
61-70%
51-60%
<50%
Normal
Grade 1 (Mild)
Grade 2 (Moderate)
Grade 3 (Severe)
Grade 4 (very severe)
9

10. Length or Height/Stature
Measurement Technique
• Upto 2 years of age-
Infantometer .
• In older children- Standing
Height or Stature- stadiometer
is recorded with an accuracy of
+/- 0.1cm.
• Nutritional deprivation over a
period of time affects the
stature or linear growth of the
child .
10

11. Technique of length
measurement
• The infant is placed supine on the infantometer.
• Assistant or mother is asked to keep the vertex or top
of the head snugly touching the fixed vertically plank.
• The leg are fully extended by pressing over the knee,
and feet are kept vertical at 90⁰ , the movable pedal
plank of infantometer is snuggly apposed against
soles and length is read from scale.
11

12. 12

13. Technique for height
measurement
• In older children who can stand , height can be
measured by the rod attached to the lever type
machine or by stadiometer.
• Child should stand with bare feet on the flat floor
against a wall with fit parallel and with heels
buttocks, shoulders and occiput touching the wall.
• Head should be kept in Frankfurt plane.
• With the help of a wooden spatula or plastic ruler.
The topmost point of the vertex is identified on
the wall.
13

14. 14

15. Height Velocity
At birth 50cms
Gain during 1st year 25cms
Gain during 2nd year 12.5cms
Gain during 3rd year 7.5 to 10cms
Gain during 3 – 12 years 5 to 7.5cms
Adolescence 8cms/year for girls during 12 to 16 years
10cms/year for boys during 14 to 18 years
Birth to 3 months 3.5cm/month
3 – 6 months 2.0cm/month
6 – 9 months 1.5cm/month
9 – 12 months 1.3cm/month
2 – 5 years 6 – 8cm/year
5 – 12 years 5cm/year
AGE Approximate rate of increase in stature
15

16. B] Expected height upto 12 yrs
length or height (in cms) = age in years x 6 +77 ( weech’s formula )
16

17. How to calculate height
• Expected height
Adult male=
father height(cm)+mother height(cm)
2
+6.5cm
Adult female=
father height(cm)+mother height(cm)
2
-6.5cm4/15/2017 17

18. HEAD CIRCUMFERENCE
18

19. HEAD CIRCUMFERENCE:
• Brain growth takes place 70% during fetal life, 15% during infancy and
remaining 10% during pre-school years.
• Head circumference are routinely recorded until 5 years of age.
• If scalp edema or cranial moulding is present , measurement of scalp
edema may be inaccurate until fourth or fifth day of life .
•The head circumference is measured by placing the tape over the
occipital protuberance at the back and just over the supraorbital ridge and
the glabella in front.
19

20. Expected head circumference in
children
Age Head circumference (cm)
At birth 34 – 35
2 months 38
3 months 40
4 months 41
6 months 42 - 43
1 year 45 - 46
2 years 47 - 48
5 years 50 - 51
20

21. Head Circumference Growth Velocity
•Head circumference approximately
• 40cm-3month
• 43cm-6month
• 46-74cm-1year
• 48cm-2year
• 52cm-12 year
Till 3 months 2 cm/month
3 months – 6 months 1 cm/month
6 months -12 months 0.5 cm/ month
21

22. 4/15/2017 Anthropometry – AKHIL ROYAL 22
•During first year there is 12 cm increase in head circumference ,
while 1 – 5 year age , only 5 cm gain occur in head size.
•Adult head size is achieved between 5 to 6 years .
the following formula (Dine’s formula) is used for estimating the head
circumference in the first year of life : -
( length in cm + 9.5 ) ± 2.59
2

23. The term Macrocephaly refers to OFC(OCCIPUTO FRONTAL
CIRCUMFERENCE) of more than 2SD above the mean while
Microcephaly refers to OFC more than 3SD below the mean for
age , sex , height and weight.
15/04/2017 23

24. Chest circumference
• It is usually measured at the level of nipples,
preferably in mid inspiration.
• Xiphisternum
• In children
<= 5years - lying down position
> 5 years - standing position
24

25. Relationship between head size
with Chest Circumference:
• At birth: head circumference > chest
circumference by upto 3 cms.
• At around 9 months to 1 year of age: head
circumference = chest circumference,
• but thereafter chest grows more rapidly
compared to the brain.
25

26. • The head circumference is greater than chest
circumference by more than 3 cm in :
a) pre terms
b) small-for-date , &
c) hydrocephalic infants
• In malnourished children, chest size may be
significantly smaller than head circumference
because growth of brain is less affected by
under nutrition.
Therefore there will be considerable delay
before chest circumference overtakes head
circumference.
26

27. AGE INDEPENDENT CRITERIA FOR
ASSESSMENT OF NUTRITIONAL STATUS
• Mid-upper arm circumference
• Thickness of subcutaneous fat
• Body ratios
• Weight for height
• Body mass index
• Upper segment/ lower segment ratio
• Arm span
• Obesity
27

28. MID ARM CIRCUMFERENCE
28

29. MID-UPPER ARM
CIRCUMFERENCE
• During 1-5 Yrs of age it remains reasonably static between 15-17cms
among healthy children .
• It is conventionally measured over the left upper arm , at a point marked
midway between acromion (shoulder) and olecranon (elbow) with arm
bent at right angle.
• The child is asked to stand or sit with the arm hanging loose at the side.
• MUAC is measured with a fiber glass or steel tape.
• If it is less than 12.5 cm it is suggestive of severe malnutrition.
• If it is between 12.5 -13.5 cm it is indicative of moderate malnutrition.
29

30. • Bangle test – quick assessment of arm circumference. A
fiber glass ring of internal diameter of 4 cm is slipped up the
arm, if it passes above the elbow, it suggests that upper arm is
less than 12.5 cm and child is malnourished.
• Shakir tape – is a fiber-glass tape with
red – less than 12.5 cm
yellow – 12.5- 13.5 cm
green – greater than 13.5 cm
shading so that paramedical workers can assess nutritional
status without having to remember the normal limits of mid
arm circumference.
30

31. SKIN FOLD THICKNESS
31

32. Skinfold thickness
• Measured with Herpenden’s caliper
• Triceps or subscapular region
• The skinfold with subcutaneous fat is picked up with
thumb and index finger, and caliper is applied beyond
the pinch.
• Fat thickness
>10mm - healthy children 1-6 years
<6mm - is indicative of moderate to
severe degree of malnutrition
32

33. 33

34. BODY MASS INDEX (BMI)
•A BMI-for-age of > 85th percentile is suggestive of Overweight.
•A BMI-for-age of > 95th percentile is or when it is associated
with triceps or skinfold thickness-for-age of > 90th percentile, it
is diagnostic of Obesity.
34

35. Body ratios
• Rao & Singh’s weight-height index:
= [weight (kg) / (height)2 cms ] * 100
normal index is more than 0.15
PEM=0.12-0.14
• Kanawati index: (during 3m to 4 years)
= Mid-arm circumference / Head circumference
Normal 0.331
Mild 0.310 – 0.280
Modreate 0.279 – 0.250
Severe < 0.250
35

36. ADVANTAGES OF
ANTHROPOMETRY
• Less expensive & need minimal training
• Readings are reproducible.
• Objective with high specificity & sensitivity
• Measures many variables of nutritional significance
(Ht, Wt, MAC, HC, skin fold thickness, waist & hip
ratio & BMI).
• Readings are numerical & gradable on standard
growth charts

37. LIMITATIONS
• Cannot identify specific deficiencies.
• Fairly slow to respond to recent changes in
nutritional status.

38. Thank you
38