Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-23T16:20:45.685Z Has data issue: false hasContentIssue false

Adult malnutrition: simple assessment techniques for use in emergencies

Published online by Cambridge University Press:  09 March 2007

Anna Ferro-Luzzi
Affiliation:
Istituto Nazionale della Nutrizione, Via Ardeatina 546, 00178 Roma, Italy
W.P.T. James
Affiliation:
Rowett Research Institute, Greenburn Road, Bucksburn, Aberdeen AB2 9SB
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The recent recognition of the problem of adult malnutrition requires methods for specifying the severity of undernutrition. The measurement of mid upper arm circumference (MUAC) can now be used as a screening method for underweight (normally assessed from the BMI) or as an additional criterion with the BMI to identify the preferential loss of peripheral tissue stores of fat and protein. By analysing and extrapolating anthropometric data from nine detailed adult surveys from Asia, Africa and the Pacific a series of MUAC cut-off points have now been identified to allow the screening of individual adults under extreme conditions, e.g. during famine. Grade 4 malnutrition is now specified for those with a MUAC <200 mm for men and <190 mm for women since these MUAC values correspond to the loss of fat stores at BMI of <13. Food supplementation is clearly needed in these individuals. Extreme wasting (grade 5 malnutrition) corresponds to MUAC values of <170 and <160 mm for men and women respectively. These adults have extremely low BMI, i.e. about 10, have lost mast, if not all, of their protein stores and are at a high risk of imminent death. These individuals will need immediate special feeding regimens to ensure their sumval. The sex-specific MUAC values corresponding to BMI of 16, 13 and 10 can now therefore be used for rapid screening and the choice of remedial action.

Type
Malnutrition assessment in emergencies
Copyright
Copyright © The Nutrition Society 1996

References

REFERENCES

Agarwal, K. N., Agarwal, D. K., Benakappa, D. G., Gupter, S. M., Kanduja, P. C., Khatua, S. P., Ramachandran, K., Udani, P. M. & Gopalan, C. (1991). Growth Performance ofAffluent Indian Children (Under Fives). Nutrition Foundation of India. Scientific Report no. 11.Google Scholar
Bistrian, B. R. (1984). Nutritional assessment of the hospitalized patient: a practical approach. In Nutritional Assessment, pp. 183205 [ Wright, R. A. and Heymsfield, S., editors ]. Oxford: Blackwell Scientific Publications.Google Scholar
Ferro-Luzzi, A. (1990). Seasonality studies in three developing countries: introduction and background. European Journal of Clinical Nutrition 44, 37.Google ScholarPubMed
Ferro-Luzzi, A., Sette, S., Franklin, M. &James, W. P. T. (1992). A simplified approach of assessing adult chronic energy deficiency. European Journal of Clinical Nutrition 46, 173186.Google ScholarPubMed
Forbes, G. B. (1987). Lean body mass-body fat interrelationships in humans. Nutrition Reviews 45, 225231.CrossRefGoogle ScholarPubMed
Golden, M. H. N. (1995). Severe malnutrition. In The Oxford Textbook of Medicine, Vol 1, 3rd Ed, pp. 12781296. [Weatherall, D. J., Ledingham, J. G. G. and Warrell, D. A. editors] Oxford: Oxford University Press.Google Scholar
Henry, C. J. K. (1990). Body mass index and the limits of human survival. European Journal of Clinical Nutrition 44, 329335.Google ScholarPubMed
Heymsfield, S. B., McManus, C. B. III, Seitz, S. B., Nixon, D. W. & Smith, Andrews J. (1984). Anthropometric assessment of adult protein-energy malnutrition. In Nutritional Assessment, pp. 2782 [Wright, R. A. and Heymsfield, S., editors]. Oxford: Blackwell Scientific Publications, Inc.Google Scholar
James, W. P. T., Ferro-Luzzi, A. & Waterlow, J. C. (1988). Definition of chronic energy deficiency in adults. Report of a Working Party of the International Dietary Energy Consultative Group. European Journal of Clinical Nutrition 42, 969981.Google ScholarPubMed
James, W. P. T., Mascie-Taylor, C. G. N., Norgan, N. G., Bistrian, B. R., Shetty, P. S. & Ferro-Luzzi, A. (1994). The value of arm circumference measurements in assessing chronic energy deficiency in Third World adults. European Journal of Clinical Nutrition 48, 883894.Google ScholarPubMed
Keys, A., Brozek, J., Henschel, A., Michelson, O. & Taylor, H. L. (1950). The Biology of Human Starvation. Minneapolis: University of Minnesota Press.CrossRefGoogle Scholar
Lwanga, S. K. & Lemeshow, S. (1991). Sample Size Determination in Health Studies. A Practical Manual. Geneva: World Health Organization.Google Scholar
Montgomery, R. D. (1962). Muscle morphology in infantile malnutrition. Journal of Clinical Pathology 13, 511519.CrossRefGoogle Scholar
Norgan, N. G. (1994). Relative sitting height and the interpretation of the body mass index. Annals of Human 21, 7982.CrossRefGoogle ScholarPubMed
Picou, D., Halliday, D. & Garrow, J. S. (1966). Total body protein, collagen and non-collagen protein in infantile protein malnutrition. Clinical Science 30, 345351.Google ScholarPubMed
Shetty, P. S. (1993). Chronic undernutrition and metabolic adaptation. Proceedings of the Nutrition Society 52, 267284.CrossRefGoogle ScholarPubMed
Shetty, P. S. & James, W. P. T. (1994). Body Mass Index: A Measure of Chronic Energy Defciency in Adults. Rome: Food and Agriculture Organization.Google Scholar
Weiner, J. S. & Lourie, J. A. (1981). Practical Human Biology. London: Academic Press.Google Scholar
World Health Organization (1995). Physical Status: The Use and Interpretation of Anthropometry. Chapter 5: Infants and Children. Technical Report Series 854. Geneva: World Health Organization.Google Scholar