Percentile reference values for anthropometric body composition indices in European children from the IDEFICS study

INTRODUCTION: To characterise the nutritional status in children with obesity or wasting conditions, European anthropometric reference values for body composition measures beyond the body mass index (BMI) are needed. Differentiated assessment of body composition in children has long been hampered by the lack of appropriate references. OBJECTIVES: The aim of our study is to provide percentiles for body composition indices in normal weight European children, based on the IDEFICS cohort (Identification and prevention of Dietary-and lifestyle-induced health Effects in Children and infantS). METHODS: Overall 18 745 2.0-10.9-year-old children from eight countries participated in the study. Children classified as overweight/obese or underweight according to IOTF (N = 5915) were excluded from the analysis. Anthropometric measurements (BMI (N = 12 830); triceps, subscapular, fat mass and fat mass index (N = 11 845-11 901); biceps, suprailiac skinfolds, sum of skinfolds calculated from skinfold thicknesses (N = 8129-8205), neck circumference (N = 12 241); waist circumference and waist-to-height ratio (N = 12 381)) were analysed stratified by sex and smoothed 1st, 3rd, 10th, 25th, 50th, 75th, 90th, 97th and 99th percentile curves were calculated using GAMLSS. RESULTS: Percentile values of the most important anthropometric measures related to the degree of adiposity are depicted for European girls and boys. Age-and sex-specific differences were investigated for all measures. As an example, the 50th and 99th percentile values of waist circumference ranged from 50.7-59.2 cm and from 51.3-58.7 cm in 4.5-to < 5.0-year-old girls and boys, respectively, to 60.6-74.5 cm in girls and to 59.9-76.7 cm in boys at the age of 10.5-10.9 years. CONCLUSION: The presented percentile curves may aid a differentiated assessment of total and abdominal adiposity in European children

Foot anthropometry for shoe design among preschool children in Malaysia

Foot anthropometry provides statistical data on the distribution of foot dimension in the population used to optimize products. Foot anthropometry plays an important role designing good fitting footwear. Changes in life styles, nutrition, and ethnic compositions of the populations have led to the changes in the distribution of foot dimension and thus it requires regular updating of foot anthropometry data collection. This study examined foot anthropometry data of preschool children in Malaysia. The purpose of this study was to develop fit size to shoe design. The data were collected from twelve pre-schools in Selangor, Malaysia. Three-hundred and three pre-school children (129 boys and 174 girls) were randomly selected for this study. Standard anthropometric technique and tools were used. The respondents’ foot lengths (left and right), foot widths (left and right), as well as ankle circumference and foot heights were measured and analyzed using SPSS program. The results showed that there were significant relationships among all the foot anthropometry measurements. The results also revealed there that was no difference between the foot anthropometry among the urban and rural pre-school children. The study found that there was a significant difference between the length of the right and left foot. The study also revealed that there was a significant difference between the width of the right and left foot. The data gathered in this study could be further used to develop footwear sizing system

Age-related gait standards for healthy children and young people: the GOS-ICH paediatric gait centiles

Objective To develop paediatric gait standards in healthy children and young people. Methods This observational study builds on earlier work to address the lack of population standards for gait measurements in children. Analysing gait in children affected by neurological or musculoskeletal conditions is an important component of paediatric assessment but is often confounded by developmental changes. The standards presented here do not require clinician expertise to interpret and offer an alternative to developmental tables of normalised gait data. Healthy children aged 1-19 years were recruited from community settings in London and Hertfordshire, U.K. The GAITRite ® walkway was used to record measurements for each child for velocity, cadence, step length, base of support, and stance, single and double support (as percentage of gait cycle). We fitted generalized linear additive models for location, scale and shape (gamlss). Results We constructed percentile charts for seven gait variables measured on 624 (321 males) contemporary healthy children using gamlss package in R. A clinical application of gait standards was explored. Conclusion Age-related, gender-specific standards for seven gait variables were developed and are presented here. They have a familiar format and can be used clinically to aid diagnoses, and to monitor change over time for both medical therapy and natural history of the condition. The clinical example demonstrates the potential of the GOS-ICH Paediatric Gait Centiles (GOS-ICH PGC) to enable meaningful interpretation of change in an individual’s performance, and describes characteristic features of gait from a specific population throughout childhood.Peer reviewedFinal Accepted Versio

The Growth of Poor Children in China 1991-2000: Why Food Subsidies May Matter

height-for-age; child heath; growth; inequality; poverty; food subsidies; China

Anthropometric measurements of foot length and shape in children 2 to 7 years of age

Background and purpose: A child’s foot changes shape and proportions during growth so that it adapts to function. The purpose of this article is to determine foot length in children aged 2-7 years as a fundamental unit for measuring the growth of the foot, with which it will be able to compare other anthropometric measures of the foot. Determination of the shape of the foot and interpretation of the growth curve of the foot in length are important for standardization of the foot.Materials and methods: The study was conducted on a sample of 2745 children, totalling 5490 feet. Of this, there were 1375 boys and 1370 girls. The population encompassed children aged 2 (1.50-2.49) to 7 (6.50-7.49) years and subjects were divided into 6 age groups. Foot length was measured by measuring tape, while shape was determined clinically.Results: There is no difference in length and shape between the left and right feet of boys and girls across all age and sex groups, and the most common shape was the Egyptian foot shape. The foot grows most rapidly between the 2nd and 3rd year. From the 3rd to 6th years, the foot grows by approximately 1cm yearly, while in girls between the 6th and 7th year the foot grows 5mm.Conclusions: Foot length is the basis for size comparison and determination of foot shape type. The results obtained demonstrate that the foot grows in length equally yearly and that there is no difference between the left and right feet.</p

Estimation of Stature from Different Anthropometric Measurements of Gorkha Soldiers

Stature is one of the most important elements in the identification of a person. Many different anthropometric dimensions can be used in the estimation of stature. Establishing the identity of an individual from body fragments has become an important necessity in recent times due to natural and man-made disasters. This study was performed on 226 Gurung soldiers of Gorkha regiment of Indian Army. The studied soldier’s age range was 18 years - 48 years. Six anthropometric measurements (Stature, Hand length, Arm length, Standing knee height, Foot length and Leg length) were measured and stature is estimated with the help of these measurements.There was no significant difference between actual and estimated stature. All anthropometric measurements were highly correlated with stature at significance level p&lt; 0.001 but leg length had better correlation (r=0.816) compared to other variables. Staturecan be estimated with the help of standing knee height (r=0.686, p&lt;0.001) and arm length (r=0.653, p&lt;0.001). It can be concluded that leg length was a very good predictor of stature estimation for the studied population

Trade-Offs in Relative Limb Length among Peruvian Children: Extending the Thrifty Phenotype Hypothesis to Limb Proportions

Background and Methods Both the concept of ‘brain-sparing’ growth and associations between relative lower limb length, childhood environment and adult disease risk are well established. Furthermore, tibia length is suggested to be particularly plastic under conditions of environmental stress. The mechanisms responsible are uncertain, but three hypotheses may be relevant. The ‘thrifty phenotype’ assumes that some components of growth are selectively sacrificed to preserve more critical outcomes, like the brain. The ‘distal blood flow’ hypothesis assumes that blood nutrients decline with distance from the heart, and hence may affect limbs in relation to basic body geometry. Temperature adaptation predicts a gradient of decreased size along the limbs reflecting decreasing tissue temperature/blood flow. We examined these questions by comparing the size of body segments among Peruvian children born and raised in differentially stressful environments. In a cross-sectional sample of children aged 6 months to 14 years (n = 447) we measured head circumference, head-trunk height, total upper and lower limb lengths, and zeugopod (ulna and tibia) and autopod (hand and foot) lengths. Results Highland children (exposed to greater stress) had significantly shorter limbs and zeugopod and autopod elements than lowland children, while differences in head-trunk height were smaller. Zeugopod elements appeared most sensitive to environmental conditions, as they were relatively shorter among highland children than their respective autopod elements. Discussion The results suggest that functional traits (hand, foot, and head) may be partially protected at the expense of the tibia and ulna. The results do not fit the predictions of the distal blood flow and temperature adaptation models as explanations for relative limb segment growth under stress conditions. Rather, our data support the extension of the thrifty phenotype hypothesis to limb growth, and suggest that certain elements of limb growth may be sacrificed under tough conditions to buffer more functional traits

Neck circumference as screening measure for identifying adolescents with overweight and obesity

Objective: To study the neck circumference (NC) cut-off points for identifying excess body weight levels in adolescents from age between 12-17 years. Methods: Cross-sectional study was conducted using the data from a Brazilian multicentric project called Study of Cardiovascular Risks in Adolescents – ERICA, which included adolescents with age between 12-17 years’ residents in two Brazilian cities from the Northeast part of Brazil. Anthropometric measurements and blood pressure data were collected from the adolescent’s sample. The mean average in between the adolescents’ groups was compared using the Mann-Whitney. The correlation was estimated by Spearman correlation coeffi cient to evaluate the association between the NC and other anthropometric variables like age, waist circumference (WC), body mass index (BMI) and blood pressure. The ROC curve was used to analyze the predictive validation of NC as well as to determine the cut-off point of overweight and obesity identifi cation among the adolescents. Results: This study comprised 1474 adolescents with a mean age of 14.59 ± 1.57 years, in which 55.3% were female. It was found a positive correlation between NC and WC; NC and BMI. The cutoff point for overweight according to the NC for male adolescents aged 12 to 14 years was equivalent to 34.1 cm and for females 32.05 cm. The adolescent male aged 15 to 17 years group the cutoff point was 36.85 cm and for women 32,95 cm. The cutoffs points for obesity according to the NC for male adolescents aged 12 to 14 years was 34.9 cm and for females 33.85 cm. In the age group 15-17 years, the cutoff point for obesity for males was 38.4 cm and for females 35.85 cm. Conclusions: The neck circumference represented significant correlation among waist circumference and body mass index well stablished indicators of adiposity and can identify adolescents with high body mass index

Anthropometric indices as novel markers of risk in type 2 diabetes mellitus (T2DM) among Nigerian adults in Zamfara State

Body mass index (BMI) has traditionally been used as an indicator of body size measure and composition. Although, other measures of adiposity of the abdomen such as waist circumference (WC), waist-hip ratio (WHR), neck circumference (NC) have been suggested as being superior to BMI in predicting disease outcome. This study was designed to compare different anthropometric variables in term of their ability to predict type 2 diabetes mellitus (T2DM). This was a case-control study in 240 participants involving 120 verified T2DM cases and 120 non-diabetics as control. Age, gender and anthropometric data were collected from each participant. Logistic regression models were used with areas under the receiver operating characteristic (AROC) curve to compare the variables predictive statistics. The AROC of WHR to identify T2DM patients was 0.678 (P&lt;0.05), with sensitivity 62.5% of and specificity of 60.8%. The AROC for average arm circumference (AAC) model is 0.649 with sensitivity of 55.8% followed by BMI model (AROC 0.635) and WC model (AROC 0.600) (P&lt;0.05). Hip circumference (HC) (AROC 0.508) and NC (AROC 0.492) models were not significant predictors of T2DM. Subjects of ≥60 years, AAC value ≥32.6 cm, BMI value ≥ 30 kg/m2, and WHR value ≥ 0.93 were at significantly (P&lt;0.05) higher odds of developing T2DM than lower subjects with lower values. There were no significant differences (P&gt;0.05) in the mean HC and NC values between the diabetic and non-diabetic subjects. The non-diabetic subjects have significantly (P&gt;0.05) higher mean height value than the diabetic subjects. Measures of generalized and central obesity were significantly associated with increased risk of developing T2DM. This study revealed that WHR can predict type 2 diabetes mellitus risk more accurately than other anthropometric measures and can thus be helpful in predicting patients with future occurrence of diabetes and providing necessary intervention

Association of general and central adiposity with blood pressure among Chinese adults: results from the China National Stroke Prevention Project

Background: The American Heart Association concluded that waist circumference was a better predictor of blood pressure risk than BMI in Asians. However, data are inconsistent and information in Chinese, the largest global population group, is limited.  Methods: Data was obtained from the Chinese National Stroke Prevention Project Survey of a nationally representative sample of middle-aged and older Chinese adults. A total of 135 825 individuals not taking any antihypertensive drugs were included in this study. Multiple linear regression analyses were conducted to examine the association between blood pressure and parameters of general adiposity, including BMI, height-adjusted weight, and parameters of central adiposity, including waist circumference, hip circumference, waist–hip ratio, and waist–height ratio. Results were shown as mean difference in blood pressure associated with one standard deviation higher level of adiposity.  Results: The overall means ± standard deviation of BMI and waist circumference were 24.3 ± 3.18 kg/m2 and 84.0 ± 8.88 cm, respectively. BMI seemed more strongly associated with SBP/DBP (4.22 mmHg/SD; 2.60 mmHg/SD) than central adiposity markers. In addition, there were sex differences. For men, waist circumference showed a stronger association with SBP/DBP than BMI (4.04 vs. 3.79, P < 0.05; 2.26 vs. 2.13, P < 0.05). For women, BMI was more closely related to SBP/DBP than central adiposity parameters, such as waist circumference (4.59 vs. 3.41, P < 0.05; 2.98 vs. 2.24, P < 0.05). Additionally, in both urban and rural areas, waist circumference was mostly associated with SBP/DBP among men, whereas it was BMI among women.  Conclusion: Compared with central adiposity, blood pressure is more strongly associated with general adiposity in Chinese adults. Interestingly, there are significant sex differences in the relationship of blood pressure with general and central adiposity. Waist circumference is the strongest predictor for men but suboptimal for women, and BMI tend to a better predictor of blood pressure for women. In addition, our results for men are consistent with the recommendation of the American Heart Association in 2015 that waist circumference could be used for assessing the risk of blood pressure