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CSL- 7

-is the process of weighing and measuring children. -is a major determinant of health, and the resolution of many nutritional issues of public health concern, requires survey data. -is to provide information useful for studying the relationship among Diet : Nutritional status : & Health.

Anthropometrics study
Anthropometrics studies are the objective measurements of body muscle and fat. They are used To compare individuals To compare growth in the young To assess weight loss or gain in the mature individual. Weight and height are the most frequently used anthropometric measurements, & Skinfold measurements of several areas of the body are also taken.

Determining frame size is an attempt at attributing weight to specific body compartments. Frame size identifies an individual relative to the bone size, but does not differentiate muscle mass from body fat. It is the muscle mass that is metabolically active and body fat that is associated with disease states. Body Mass Index (BMI) is used to estimate the bodyfat mass. BMI is derived from an equation using weight and height.

Introduction Rapid nutritional surveys are to be carried out for the a. baseline survey

b. mid-term review and the completion c. evaluation of the project.

key indicators
The key indicator of project impact will be: The reduction of chronic malnutrition ('stunting' or 'height for age') among children less than 5 years of age. Other important indicators will be reduction of acute malnutrition ('wasting) underweight ('weight for age').

In addition to dietary intake methodologies, Questionnaire material, Hematological tests, and Nutritional biochemistries,

The assessment of nutritional status requires a series of height, weight, and other anthropometric dimensions.

What is Anthropometry?
Anthropometry is a science which relates to the measurement of body dimensions. These may be : 1. Lengths (e.g. the length of the thigh bone or femur), 2. Breadths (e.g. the width across the shoulders, the biacromial breadth), 3. Girths (e.g. waist circumference) 4. height and weight. 5. Skinfold thickness

Skinfold thickness
Skinfold thickness at various sites on the body (e.g. at the back of the upper arm, tricep skinfold).

a) Bicep, b) Tricep, c) Subscapular, d) Iliac crest

Application of anthropometry in adult

Anthropometry can also be applied for adult. Because: Anthropometry is the study of the measurement of the human body in terms of the dimensions of Bone, Muscle, and

Adipose (fat) tissue.

Measures of subcutaneous adipose tissue are important because individuals with large values of fat are reported to be at increased risks for: Hypertension, Adult-onset diabetes mellitus, Cardiovascular disease, Gallstones, Arthritis, Other diseases, and Forms of cancer.

Uses of Anthropometrics
Actual height, weight, and body measurements including skinfolds, girths, and breadths will be collected for purposes of:1. Assessing growth, 2. Body fat distribution, and for 3. Provision of reference data. 4. Measurements of height and weight will allow for a revision of the child growth charts which are based in part on data collected study. 5. Anthropometric measurements such as skinfolds and circumferences and bioelectrical impedance (a method used to estimate the amount of lean tissue) will allow: cross-sectional analysis of the relationship between obesity and risk of disease.

Anthropometric measurements are taken on a variety of people for a variety of reasons: Monitoring athletes; Tracking growth, (normal or retarded) Development, and Motor performance in children; Linking physical activity and nutrition interventions to changes in body size, shape and composition; Assessing changes in body dimensions in response to disease; Identifying markers for potential sporting performance. Nutritional assessment.

Nutritional assessment A nutritional assessment is an in-depth evaluation of both objective and subjective data related to: an individual's food nutrient intake, lifestyle, medical history.

Once the data on an individual is collected and organized, the practitioner can assess and evaluate the nutritional status of that person.
The assessment leads to: a plan of care, or intervention, designed to help the individual either maintain the assessed status or attain (get) a healthier status.

Elements of Assessment
What are the data? The data for a nutritional assessment falls into four categories: Anthropometric data Biochemical data Clinical data Dietary data.

What are Anthropometrics data?.

Anthropometrics data are the objective measurements of body muscle and fat. They are used to - compare individuals, - compare growth in the young, and - assess weight loss or gain in the mature individual.

Weight and height are the most frequently used Anthropometric measurements, and Skinfold measurements of several areas of the body are also taken.

Type of Body Fat

There are three types of Body Fat: 1. The first is subcutaneous fat, which is stored right below your skin. 2. Second, theres intramuscular fat, which is inside the muscle tissue (picture the fat inside a marbled steak.). 3. Third, you have internal fat, which is located on and around your internal organs for protective cushioning.

Skinfold testing
Skinfold testing is based on the premise that the majority of your body fat is subcutaneous right below your skin where you can see and grab it. By pinching the skin and fat and measuring the thickness of the fold at one or more sites, you can get a fairly accurate estimate of your total body fat percentage and more importantly, a way to consistently measure your progress from week to week.

skin-fold calipers
To estimate body fat skin-fold measurements can be made using skin-fold calipers.
Most frequently, TRICEP and
SUBSCAPULAR (shoulder blade) skin-folds are

measured. Measurements can then be compared to reference dataand to previous measurements of the individual (if available). Accurate measuring takes practice, and comparison measurements are most reliable if done by the same technician each time.

Measuring and Recording Guidelines 1

Body measurements are always taken on the right side of the body. However Some measurements may be taken on the left side of the body because of casts, amputation, or other reasons. When this occurs, the reason is noted in the comments section on the body measurement results screen or hardcopy form by the recorder.

Guideline 2
1. All measurements, except skinfolds, should be taken to the nearest tenth of a centimeter 1.0 cm or 10.0 mm (millimeter). 2. Skinfold measurements are taken to the nearest 0.1 mm (millimeter) 3. Measures that exceed specific limits on the computer will be repeated by each technician. 4. All skinfold measurements will be done in duplicate (i.e., by two different technicians or twice by the same technician) SINCE THESE MEASURES HAVE THE MOST VARIABILITY.

Instruction for measuring Skinfold thickness

Measurement should be taken on healthy, undamaged, uninfected skin. To keep the muscle relaxed. All measurements must be taken on the right side of the body. Using Tape to find the accurate mid points & mark the skinfold sites. Skinfold should be firmly grasped by THUMB & INDEX finger, gently pull the skinfold away from the body. Place the Caliper perpendicular to the fold. A Minimum of two measurements should be taken at the same site. Record each skinfold measured. Must get consistent results; must not have high variations.

PROTOCOL for site selection

Two protocols 1st protocol :- Four sites system i). Biceps : Vertical fold Midway between anterior auxiliary fold & anterior cubital fossa. ii). Triceps : Vertical fold on posterior mid- line of arm, halfway between acromium process (bony process on top of shoulder) & olecranon process (bony process of elbow) iii). Subscapular : The fold taken on Diagonal line 1-2 cm below the point of shoulder blade. iv). Suprailiac : a diagonal fold above the iliac crest of at the spot where an imaginary line come down from anterior auxiliary line just above the hipbone.

Four sites
Site 1 - Biceps The anterior surface of the biceps midway between the anterior fold and the antecubital fossa. Site 2 - Triceps A Vertical fold on the posterior midline of the upper arm, over the triceps muscle, halfway between the acrosion process (bony process on top of the shoulder) and olecranon process (bony process on elbow). The elbow should be extended and the arm relaxed. Site 3 - Subscapular The fold is taken on the diagonal line coming from the vertebral border to between 1 and 2cm from the inferior angle of the scapulae. (A diagonal fold about 1 to 2cm below the point of the shoulder blade and 1-2cm toward the arm). Site 4 - Suprailiac A diagonal fold above the crest of the ilium at the spot where an imaginary line would come down from the anterior auxiliary line just above the hipbone and 2-3cm forward.

4 sites protocol

2nd protocol
Three sites system
1. Chest 2. Abdomen 3. Thigh.

Location of TRICEP Skinfold

Location of Subscapular skinfold

Skinfold should be firmly grasped by THUMB & INDEX finger, gently pull the skinfold away from the body.

Place the Caliper perpendicular to the fold

Skinfold thickness in mm & Total adipose tissue in KG

Skinfold thickness in mm & subcutaneous fat in KG

Clinical data.
Clinical data provides information about the individual's medical history, including acute and chronic illness and diagnostic procedures, therapies, or treatments that may increase nutrient needs or induce malabsorption. Current medications need to be documented, and both prescription drugs and over-the-counter drugs, such as laxatives or analgesics, must be included in the analysis. Vitamins, minerals, and herbal preparations also need to be reviewed. Physical signs of malnutrition can be documented during the nutrition interview and are an important part of the assessment process.

Different body fat averages in male & female

Body fat averages and ideals are different for men and women. The female hormone estrogen causes women to carry at least 5% more body fat than men. The average woman has about 23% body fat and the average man about 17%. Body fat average and ideals also vary with age. In both sexes, body fat increases while lean body mass decreases with age.

How much body fat is unhealthy?

High body fat levels have been linked to over 30 health problems including: Diabetes, High blood pressure, Cardiovascular disease, Cancer and Osteoarthritis.

Being categorized as clinically obese means that body fat is at such a level that health problems become more of a concern. Men are considered borderline at 25% body fat and clinically obese at 30% women are borderline at 30% and clinically obese at 35% body fat.

How low should you go?

Its impossible for your body fat levels to drop to zero since some fat is located internally and is necessary for normal body functioning. This is called essential fat. Essential fat is necessary for energy storage, protection of internal organs, and insulation against heat loss. Essential fat is found in the nerves, brain, bone marrow, liver, heart, and in nearly all the other glands and organs of the body. In women, this fat also includes sex-related fat deposits including the breast tissue and uterus.

Essential body fat at least 2-3% for men and 7-8% for women.

Maximum preferred or desirable fatness levels for ages

The average fat content for females is between 24 and 26%, dependent upon country of residence, although from a health point of view, a maximum desirable level of 30% (young) and 35%(older), may pose no threat. This level of moderate obesity would not satisfy the desirable shape or quirks of contemporary fashion. The fashion model type of body composition reflects a fat percentage of 15% or less, female gymnasts as low as 8% and distance runners down to 6%. The maximum desirable level suggested is based on the work of Katch & McArdle (1973), Pollock et al (1975) and Brown & Jones (1977) and is 25% for women of 30 years and over, but starts at 20% for those less than 20 years old. Again there is a sliding scale reflecting advancing years and a reduction in health risk. Contemporary fashion would indicate a preferred female level of perhaps 3% lower than these values.

Body Fat % of Men & Women

Body Fat Categories for Women

10-12% - Essential Fat 14-20% - Athletic Fat Levels 21-24% - Fitness Fat Levels 25-31% - Acceptable Fat Levels >32% - Obese

Body Fat Categories for Men

2-4% - Essential Fat 6-13% - Athletic Fat Levels 14-17% - Fitness Fat Levels 18-25% - Acceptable Fat levels >26% - Obese