DIFFERENT TYPES OF ANTHROPOMETRIC MEASUREMENT

1. Presented by-
Dr. Ankita Mishra
PhD Scholar
Department of Kaumarbhritya
National Institute of Ayurveda ,
Deemed to be University,
Jaipur, Rajasthan
DIFFERENT TYPES OF ANTHROPOMETRIC
MEASUREMENT

2. INTRODUCTION
 Anthropos means “man” and metron means “measurement”
 A branch of anthropology that involves the quantitative
measurement of human body.
It is use for assessing the
size
proportions and
composition of human
body.
It is single most portable,
universally applicable,
inexpensive and
non-invasive technique.
It is used to evaluate both under and over nutrition

3. ANTHROPOMETERIC PARAMETERS
AGE DEPENDENT FACTORS-
 Height
 Weight
 Head circumference
 Chest circumference
AGE INDEPENDENT FACTORS-
 Mid arm circumference
(1-5 years)
 Thickness of subcutaneous fat
 Weight for height
 Upper segment/lower segment
ratio
 Arm span
 Obesity

4. Assessment of Normal Growth and
Development
Growth:
 Increase in the size of the organ with mass of tissues due to
multiplication of body cell and increase in intracellular
substance is called as growth.
 Growth can be measured by various anthropometric measures.
 It is objective and quantitative.
Development:
 Development is assessed in terms of psychological, social,
spiritual, moral, emotional, and behavioural parameters.
 Development is subjective and more qualitative.

5. Assessment of Growth
Nutritional anthropometry
 Weight
 Height
 Head circumference
 Chest circumference
Assessment of tissue growth
 Measurement of muscle mass
 Skin thickness
 Bone age
 Dental age
 Biochemical and histological measures

6. Growth Chart
 Also called “road to health’’ chart.
 Graphical display of a child’s physical growth and development.
 WHO chart is recognized internationally.
 Chart is different for girls and boys.

9. Uses of growth chart
 Growth monitoring
 Diagnostic tool
 Planning and policy making
 Educational tool
 Tool for action
 Evaluation
 Tool for teaching
 Tool for information

10. Weight
 The measurement of weight is a simple and most reliable
criteria for assessment of health and nutritional status of
children.
 Weight is a measure of total body mass and sensitive to
changes in fluids, fat, muscle mass skeleton and body organ.
 The weight can be recorded using a:-
 Beam type weighing balance
 Electronic weighing scales for infants and children
 Salter spring machine

11. ELECTRONIC WEIGHING MACHINE

12. cont….
 The periodic recording of weight on a growth chart is essential
for monitoring the growth of under-five year children.
 Growth velocity:-
 0-4 month 1.0kg/month (30g/day)
 5-8 month 0.75kg/month (20g/day)
 9-12 month 0.50kg/month (15g/day)
 1-3 years 3.0kg/yr
 4-12 year 2.0kg/yr

13. conti…
 Adolescence
 Girls 12-16 years 3.0-4.0 kg/yr
 Boys 14-18 years 6.0-7.0 kg/yr
 Weight at 4-5 month 2 x birth weight
 Weight at 1 years 3 x birth weight
 Weight at 2 years 4 x birth weight
 Weight at 7 years 7 x birth weight

14. cont…
ADOLESCENCE
Girls 12-16 years 3.0-4.0 kg/yr
Boys 14-18 years 6.0-7.0 kg/yr
Weight at 4-5 month 2 x birth weight
Weight at 1 years 3 x birth weight
Weight at 2 years 4 x birth weight
Weight at 7 years 7 x birth weight

15. WEECH’S FORMULA
3-12 months
 Expected wt. in kg = age (months) + 9/2
1-6 years
 Expected wt. in kg = age (years) x 2 + 8
7-12 years
 expected wt. in kg = age (years) x 7-5/2

16. Classification of malnutrition by
Indian Academy of Pediatrics
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)

17. Length or height
 CHL-It is the distance from the crown of the head to the heel
in embryos fetuses and infants.
 CHL - 47-50 cm.
 Up to 2 years of age recumbent length is measured with the
help of an infantometer.
 In older children standing height is or stature is recorded.
 It is convenient to use an inbuilt Stadiometer affixed on the
wall which provides a direct read out of height with accuracy
of +/- 0.1 cm.
 Nutritional deprivation over a period of time affects the stature
or linear growth.

18. 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 snuggly touching the fixed vertically plank.
 The leg are fully extended by pressing over the knee,
and feet are kept vertical at 90 degree the movable
pedal plank of infantometer is snuggly apposed against
the soles and the length is read from the scale.

19. INFANTOMETER

21. TECHNIQUE OF HEIGHT
MEASURMENT
 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.
 Head should be held erect with eyes aligned
horizontally and ears vertically without any tilt.

22. conti…
 With the help of wooden spatula or plastic ruler
the topmost point of vertex is identified on the
wall.
 The linear growth cease after fusion of epiphyses
when puberty or sexual maturation is achieved.
 Nutritional deprivation over a period of time
generally over 6 month affects the stature or linear
growth of the child .

23. Technique of Height Measurement

24. Length or height velocity
 At birth 20 inches (50 cm)
 Gain during 1st year 10 inches(25 cm)
 Gain during 2nd year 5 inches (12.5 cm)
 Gain during 3rd year 3-4 inches (7.5-10 cm)
 Gain during 3-12 year 2-3 inches/year (5-7.5 cm)
 Adolescence
 Girls 12-16 years 8 cm/year
 Boys 14-18 years 10 cm/year

25. Calculation of Expected Height Up to 12
Year
 Length or height (inches) = Age in years x 2.5 + 30
 Length or height (cm) = Age in years x 6 +77
 Prediction of adult height
 Boy’s = Mother's height in cm + Father's height in cm/ 2 + 6.5
cm
 Girls = Mother's height in cm + Father's height in cm / 2 – 6.5
cm
 Tanner,s formula
Adult height = height at 2 yr x 2

26. Head Circumference
 During fetal life almost 60 to 70 % of brain growth takes place.
 During infancy 15% of brain growth occurs while remaining 10%
of brain growth takes place during pre school year.
 Head circumference is are routinely recorded until 5 year of age.
 If scalp edema or cranial moulding is present measurement of
scalp edema may be inaccurate until fourth or fifth day of life.
 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.

27. Technique of Head Measurement

28. Head Circumference in under Five Children
AGE HEAD CIRCUMFERENCE
Birth (40 weeks) 32 - 35.5 cm
1 month 34 - 37.5 cm
2 month 36 – 39.5 cm
3 month 38 -41.5 cm
6 month 40 – 43.5 cm
9 month 42 – 45 cm
1 year 43.5 – 46.5 cm
1.5 year 44.5- 48.0 cm
2 year 45.5 – 49 cm
2.5 year 46.5-50 cm
3 year 46.8- 50 cm
3.5 year 47.1- 50.6 cm
4 year 47.5 – 50.9 cm
5 year 48.1 – 51.5 cm

29. Head Circumference Growth Velocity
 First 3 months 2 cm/ month
 3 months -1 year 2 cm/ 3 months
 1 - 3 years 1 cm/ 6 months
 3 – 5 years 1 cm/ year
 During first year there is 12 cm increases in head
circumference while 1- 5 year age only 5 cm gain in head size.
 Clinical Significance: The marasmic children are seen to have
relatively large head for their body size because brain growth
is minimally affected by malnutrition.

30. Conti…..
 The term macrocephaly refers to OFC of more than 2SD above
the mean while microcephaly refers to OFC more than 3 SD
below the mean for age, sex, height, and weight

31. Chest Circumference
 It is usually measured at the level of nipples, preferably in mid
inspiration
 Xiphisternum
 In children
< = 5 years – lying down position
> 5 years – standing position

32. Relationship Between Head & Chest
Circumference
 At birth : head circumference > chest circumference by upto
3cms
 At around 9 months to 1 year of age : head circumference =
chest circumference .
 But there after chest grows more rapidly compared to the brain.

33. Conti….
 The head circumference is greater than chest circumference by
more than 3 cm in :
 Preterm
 Small for date
 Hydrocephalic infants
 Clinical Significances: 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 considerably delay before chest
circumference overtakes head circumference.

34. Age Independent Criteria for Assessment of
Nutritional Status
 Mid upper arm circumference
 Thickness of subcutaneous fat
 Body ratio
 Body mass index
 Upper segment/lower segment
 Arm span
 Obesity

35. Mid Upper Arm Circumference
 At birth - 9-11cm.
 1 – 5 yrs - 15 - 17 cm 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.
 MUAC< 12.5 cm - severe malnutrition.
 MUAC 12.5 – 13.5 –cm. - moderate malnutrition.

36.  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 arms is less than 12.5
cm and child is malnourished.
 SHAKIR TAPE:-
It is a fiber glass tape with
 red – less than 12.5 cm
 yellow- 12.5-13.5 cm
 green > 13.5 cm

37. Quac stick
 It is developed on the principle that acute starvation
severely affects mid upper arms circumference while
height is unaffected.
 Quac stick is meter rod with two sets of marking .
 It is a height measuring rod calibrated in MAC
 The malnourished child would be taller than the anticipated
height derived from the mid-arm circumference.

38. Arm Circumference for different Height
Mid upper arm
circumference (cm)
Height (cm)
16.50 133
16 129
15.50 125
15 121
14.50 116
14 110
13 90

39. Thickness of Subcutaneous Fat
 Measured with herpenden’s or lange caliper over the triceps,
subscapular or suprailiac region.
 The skin folds with subcutaneous fat is picked with left thumb and
index finger, and caliper is applied beyond the pinch.
 fat thickness
 > 10 mm or more - healthy children between 1 and 6 year of
age.
 < 6mm is indicative of moderate to severe malnutriton.

40. Technique of measurement of skin
fold thickness

41. Body Ratio
 Rao and singh’s weight - height index
weight in kg/( height in cm)2 x100
 Normal index is more than 0.15
 Kanawati and McLaren index (during 3month to 4 year)
Mid – upper arm circumference / head circumference
Clinical Significance: The normal ratio is more than 0.31 while
a ratio of less than 0.25 suggests severe malnutrition.

42. NORMAL 0.331
MILD 0.310-0.280
MODERATE 0.279-0.250
SEVERE <0.250
Grading of kanawati scale

43. Weight for Height
weight of the patient (kg) x 100
weight of normal child of same height
weight for height nutritional status
> 90% normal
85-90% borderline malnutrition
75-80% moderate malnutrition
<75% sever malnutrition

44. Weight for Height and Height for Age
Classification
 When malnutrition has been chronic the child is “stunted”
weight for age is low
height for age are low.
weight for height is usually normal.
 In acute malnutrition child is “wasted”
weight for age is low
height for age is normal
weight for height is low

45. Body Mass Index [BMI]
 Body mass index is considered as a better criterion for the
diagnosis of overweight and obesity because it expresses body
weight in relation to height.
 BMI = Weight in kg x100
height in meter2
 A BMI for age of > 85th percentile is suggestive of overweight
 A BMI for age >95th percentile is or when it is associated with
triceps or skinfolds thickness for age of > 90th percentile it
diagnostic of obesity.

46. PONDERAL INDEX
 It is another parameter which is similar to BMI and is used for
defining newborn babies with intrauterine growth retardation
Body weight in grams
 PI = x 100
length in (cm)3
 In malnourished small for date babies (asymmetric IUGR) PI
is <2 while it is usually more than 2.5 in term appropriate for
gestation babies and hypo plastic small for date babies

47. Proportional Trunk and Limb Growth
 The mid point of the body in newborn is at umbilicus where as in an
adult the mid point shift to the symphysis pubis due to greater
growth of limb than trunk
 The upper segment (vertex to the upper edge of symphysis pubis) to
lower segment (symphysis pubis to heel) ratio at birth is 1.8 to 1.0
 The ratio is around 1:0 to 1:0 at 10 – 12 year of age
 This gradually becomes 1.0 to 1.1 in healthy adult
 In infant upper segment (crown to symphysis pubis) can be
measured by using infantometer.
 The lower segment is obtained by subtracting the upper segment
from total length

48. Arm Span
 It is the distance between the tip of middle fingers of both
arms outstretched at right angle to the body with palms
facing forward.
 In under- 5 children span is 1 to 2 cm smaller than body
length
 During 10-12 year of age span is equal to the height
 In adult span is more than height by 2 cm

49. Technique of measurement of
Arm Span

50. Arm Span
 It is the distance between the tips of middle fingers of
both arms outstretched at right angles to the body
measured acrossed the back of the child .
 <5 year children , arm span is 1-2 cm. smaller than body
length.
 10-12 year ,arm span= height

51. conti…
 Abnormally larger span is seen in patient with –
 Arachnodactyly (Marfan syndrom)
 Eunuchnodactyly
 Klinefelter syndrome
 Coarctation of aorta
 Arm span is short as compared to height in patient
with -
 Short limbed dwarfism
 Cretinism
 Achondroplasia

52. Anthropometery in ayurveda
 Different Pramanas are explained in Ayurveda.
 Anguli Praman and Anjali Pramana are the two important
elements.
 According to Charak total length of Purush in terms of his own
Anguli is 84 angulas.
 According to Sushruta total length of the body is 120 angula
 According to Vagbhat total length of body is 3 1/2 hasta

53. अंगुल प्रमाण
 शरीर अंगुल प्रमाण- ८४ अंगुल
(च वि. ८)
 पाद- ४ अंगुल
 जंघा- १८ अंगुल
 जानु- ४ अंगुल
 उरु- १८ अंगुल
 उदर- १२ अंगुल
 उर- १२ अंगुल
 ग्रीिा- ४ अंगुल
 मुख- १२ अंगुल

54. सु.सू ३५
 मद् यामा- ४ अंगुल
 प्रदेशनी, अनावमका- ४/२, ३/२ अंगुल
 हस्त तल- ६ x ४ अंगुल
 प्रपानी- १६ अंगुल
 प्रबाहू- १६ अंगुल
 हृदय से ग्रीिा मूल-१२ अंगुल
 नावि से हृदय-१२ अंगुल
 उरु- १८ x ३२ अंगुल
 जनु- ४ x १४ अंगुल
 जंघा- १८ x १४ अंगुल

55. Conti…
 पाद- १४ अंगुल
 प्रपाद- ४ x ५ अंगुल
 पशशनी- ५ x ४
 िृषण,वचबुक,दशन,नासापुट,कणशमूल,नयनअंतर- २ अंगुल
 मेहन,िदनअंतर,नासा,कणश,ललाट,ग्रीिा,दृष्टीअंतर-४ अंगुल
 िगविस्तार,वशश्न नाविविस्तार.स्तानांतर-१२ अंगुल
 इंद्रबस्ती पररनाह,अंसपीठ कपुशरअंतर- १६ अंगुल
 दोनों िुजा- ३२ अंगुल
 मवणबंध कपुशरअंतर- १६ अंगुल

56. दीघाशयु लक्षण
 वशर- प्रक
ृ त्या,अवतसम्पनम,इस्तप्रमाण.अवतिृतमनुरुपमातपन्नोपम
 ललाट- व्यूढ,दृढ़,सम,उर्ध्शव्यंजन,अधशचन्द्रकार
 त्वचा- स्थिर,बहल
 उर- व्यूढम,उपवचतम
 बाहू,स्थिक्त- िृत्त,पररपुन्र्नायतो
 कटी- समा,समुपवचतमांसा
 स्िच- िृत्त,स्थिर,उपवचतमांस,नाअवतउन्नत,नाअवतअिनत
 उरु- अनुपूिश,िृता,उपचययुक्त
 जंघा- प्रगूदवसरा,अस्थिसंवध
 गुल्फ- नाअवतउपवचत,नाअवतअपवचत