Anthropometry involves measuring the physical dimensions of the human body, such as weight and body circumference. Such measurements are important indicators of nutritional status. For infants and children, key measurements include head circumference, chest circumference, weight, length/height, mid-upper arm circumference, and weight-for-age. These measurements are used to identify undernutrition. During pregnancy and adolescence, weight, BMI, and waist circumference are important. For the elderly, weight, height, BMI, waist circumference, and waist-hip ratio are measured but special standards are needed due to changes in body composition with aging.

1. ANTHROPOMETRY
Prepared by
Group A
Roll No. 9- 15
BNS 2nd Year

2. Introduction
Anthropometry = anthropo + metry
 Anthropo means ‘human’ and metry means ‘measurement’.
It is the measurement of physical dimensions such as the fat
mass, composition of human body.
It is a convenient and reliable technique whereby changes in
the nutritional status can be evaluated easily.

3. Introduction (cont’d)
Anthropometric measurements are now regarded as
important indicators of an individual’s nutritional status which
are given below:
• Height/ length
• Weight
• Mid-arm circumference
• Head circumference

4. Introduction (cont’d)
• Chest circumference
• Triceps skin fold thickness
• Waist-hip ratio
• Body mass index
• Abdominal girth

5. Anthropometric Measurements
for Infant

6. Head Circumference
 Routinely measured until 5 years of
age.
 Measured by placing the tape over
the occipital protuberance at the
back and just over the supraorbital
ridge and the glabella in front.

7. Head Circumference (cont’d)
Age Head circumference (cm)
At birth 33-35
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
Expected Head Circumference in Children

8. Chest Circumference
Usually measured at the level
of nipples.
In children
•<=5 years: lying down
position
•>5 years: standing position

9. Chest Circumference (cont’d)
At birth head circumference is more than chest
circumference by up to 3 cm.
At around 9 months to 1 year of age head circumference is
equal to chest circumference but there after chest grows
more rapidly compared to the brain.

10. Chest Circumference (cont’d)
The head circumference is greater than chest
circumference by more than 3 cm in:
• preterm
• small for date and
• hydrocephalus infants

11. Chest Circumference (cont’d)
In malnourished children chest size may be
significantly smaller than head circumference because
growth of brain is less affected by undernutrition.
Therefore there will be considerable delay before
chest circumference overtakes head circumference.

12. Weight
The measurement of weight is most
reliable criteria of assessment of
health and nutritional status of
children.
The periodic recording of weight on a
growth chart is essential for
monitoring the growth of under five
children.

13. Weight (cont’d)
Birth weight is double at 4-5 months and triple at 1 year of age.
Weight measurement help to identify acute malnutrition and it is
measured in kilogram
Standard calibrated weighing machine (saltier scale) used for
weighing the child. Machine can weight one to 25 kg.

14. Weight (cont’d)
Weight for Age Grade of Malnutrition
>80% Normal
71-80% Grade 1 (Mild)
61-70% Grade 2 (Moderate)
51-60% Grade 3 (severe)
<50% Grade 4 (very severe)
Classification of Malnutrition by Indian Academy of
Pediatrics

15. Length or Height
 Up to 2 years of age recumbent length
is measured with the help of an
Infantometer.
 Normal length of child at birth is 50 cm
and 25 cm length is increase during 1
year of age.

16. Length or Height (cont’d)
Age Approximate Rate of Increase in
Stature
Birth to 3 months 3.5 cm/month
3-6 months 2.0 cm/month
6-9 months 1.5 cm/month
9-12 months 1.3 cm/month
Height Velocity

17. Anthropometric Measurements
for
Under 5 Children

18. Height
 Height is the distance from the bottom of the feet to the top of
the head in a human body standing erect which is stable
measurement of growth.
It is measured in child and adults too in which either a
stadiometer or portable anthropometer is used.
Measurements are recorded to the nearest millimeter.

19. Height (cont’d)
Stadiometer Portable Anthropometer

20. Height (cont’d)
Height for age is an index used for assessing stunting (chronic
malnutrition in children).
Stunting is defined as low height for age of child as
compared to the standard child of the same age.
Stunting has direct effect in linear growth.

21. Weight
Weight for age is most sensitive and best method for assessing
physical growth and nutritional status of children.
Growth should be monitored every month for up to the age of
24 months using a weighing sling known as “Saltar Scale”.
For children above 2 years digital weighing machine can be used
to assess weight.

22. Weight (cont’d)

23. Weight (cont’d)
 Weight for age is an index used in growth monitoring for assessing
children who may be underweight.
 Weight for age =
weight of the child
weight of the reference child of same age
*100
 Weight for height is an index used for assessing wasting (acute
malnutrition).
 Weight for height =
weight of the child
weight of the normal child at same height
*100

24. Weight (cont’d)
Mean weight (kg) Mean height( cm)
Boys Girls Boys Girls
1 year 9.5 8.7 73.4 72.1
2 years 11.7 10.6 84.5 82.1
3 years 13.6 12.6 92.7 90.0
4 years 14.9 14.3 98.1 98.0
5 years 17.0 16.0 106.7 104.4

25. Weight (cont’d)
Index Cut off value based on SD/ % Indicates
Weight for age <-2 to >=-3 Moderate underweight
Weight for age <-3 Severe underweight
Height for age <-2 to >= -3/70-79.99% of the normal Moderate acute malnutrition
Height for age <-3/<70% of the normal or bilateral pitting
edema
Severe acute malnutrition
Indicators of underweight and malnutrition derived from the
weight and height of children relative to their age.

26. Mid Upper Arm Circumference
The mid-upper arm circumference( MUAC) is the circumference
of the upper arm at the midway between the shoulder tip and
the elbow tip on the left arm.
It cannot be used before the age of one year.
Used for screening target children for moderate and severe acute
malnutrition.
A special tape “Shakir’s tape” is used for measuring the MUAC.

27. Mid Upper Arm Circumference (cont’d)
Results are interpreted as:
MUAC (in cm) Colour Code Interpretation
<11.5 Red Severe malnutrition
11.6-12.4 Yellow Mild moderate
malnutrition
>12.5 Green Normal nutritional status

28. Mid Upper Arm Circumference (cont’d)

29. Head Circumference
It is useful in assessing chronic nutritional problems in
children under 2 years old as the brain grows faster during
the first 2 years of life.
But after 2 years the growth of brain is more sluggish and
head circumference is not useful.

30. Current Status of Malnutrition in Nepal
(NDHS 2016)
Underweight 27%
Wasting 10%
Stunting 36%

31. Anthropometric Measurements
for
Pregnancy

32. Pregnancy
During pregnancy following measurements are made at the
time of woman’s first contact with health care system
Height
Weight
Mid upper arm circumference
Weight for height

33. Pregnancy (cont’d)
Body mass index (BMI)
Preeclampsia is a major cause of maternal death and
morbidity. Body mass index (BMI) predicts an increased risk of
developing hypertensive disorders and preeclampsia.

34. Pregnancy (cont’d)
Waist circumference

35. Pregnancy (cont’d)
Hip circumference

36. Pregnancy (cont’d)
The waist-hip ratio or waist-to-hip ratio (WHR) is the
dimensionless ratio of the circumference of the waist to that
of the hips. This is calculated as waist measurement divided
by hip measurement (W ÷ H).

37. Anthropometric Measurements
for
Adolescence

38. Adolescence
Anthropometric measurements are very important in
adolescents as maximum increase in height and weight occur
in this period.
The growth spurt begins earlier in girls usually between age
9.5 to 14.5 years and in boys at 10.5 to 16.5 year.

39. Adolescence (cont’d)
Common anthropometric measurements in adolescents are:
Height
• Average height a boy gains during this period is 10-30 cm
and average height gained by girls is 5-20 cm.
• The diagnostic criteria for defining stunting in adolescence is
height for age less than third percentile of NCHS/WHO
reference data.

40. Adolescence (cont’d)
Weight
• The average weight gain in boys is 7-30 kg in boys and 7-25
kg in girls.
• Under nutrition is characterized by low weight and obesity is
characterized by over weight in this period.

41. Adolescence (cont’d)
BMI (Basal Metabolic Index)
• A BMI lesser than 5th percentile indicates under nutrition or
thinness and more than 85th percentile indicates obesity.

42. Anthropometric Measurements
for
Elderly

43. Elderly
Anthropometric measurement is an important component of
nutritional assessment in the elderly.
The anthropometric standards derived from adult
populations may not be appropriate for the elderly because
of body composition changes that occurs during ageing.
Specific anthropometric reference data for the elderly are
necessary.

44. Elderly (cont’d)
Weight and height significantly decreased with age.
BMI is significantly higher in women than in men but lower
in the elderly than in the young people
According to BMI values, the prevalence of malnutrition is
lower than 5 % in both genders, whereas obesity is shown to
have a higher prevalence in women than in men.

45. Elderly (cont’d)
 Waist circumference and waist hip ratio
• It decreases with age in men, but increases higher in old
women, suggesting that visceral redistribution in old age
predominantly affects females.
• Elderly people show a thinner body frame than the young
people of both genders
• There is a more marked fat redistribution in women than in
men.

46. References
Adhikari,T.(2015).Essentials of Pediatric Nursing(2nd edition). Bhotahity, Kathmandu: Vidhyarthi
Pustak Bhandar
Park,K.(2007).Park’s Textbook of Preventive and Social Medicine(18th edition). Jabalpur, India: M/S
Banarsidas Bhanot
Ministry of Health - MOH/Nepal, New ERA/Nepal, and ICF. 2017. Nepal Demographic and Health
Survey 2016. Kathmandu, Nepal: MOH/Nepal, New ERA, and ICF. Retrieved from
http://dhsprogram.com/pubs/pdf/FR336/FR336.pd on 2020/07/22.
NEPAL Integrated Management of Acute Malnutrition (IMAM) Guideline Retrieved from
https://km.mohp.gov.np/document/nepal-integrated-management-of-acute-malnutrition-imam-
guideline on 2020/07/22.
(1995) Physical Status: The Use and Interpretation of Anthropometry - Report of a WHO Expert
Committee. WHO Retrieved from http://helid.digicollection.org/en/d/Jh0211e/5.2.2.html on
2020/07/22
Perissinotto,E., Pisent, C., Sergi, G., Grigoletto, F.,& ILSA Working Group (Italian Longitudinal Study
on Ageing) (2002).Anthropometry measurements in the elderly: age and gender differences. The
British Journal of Nutrition,87(2), 177186.https://doi.org/10.1079/bjn2001487 Retrieved from
https://pubmed.ncbi.nlm.nih.gov/11895170/ on 2020/07/22.

47. Thank You