Nutritional status among young adolescents attending primary school in Tanzania: contributions of mid-upper arm circumference (MUAC) for adolescent assessment

Margaret Lillie,Sylvia Kaaya,Isaac Lema,Joy Noel Baumgartner,Dori Steinberg

doi:10.1186/s12889-019-7897-4

Abstract

BackgroundAdolescence is a critical time of development and nutritional status in adolescence influences both current and future adult health outcomes. However, data on adolescent nutritional status is limited in low-resource settings. Mid-upper arm circumference (MUAC) has the potential to offer a simple, low-resource alternative or supplement to body mass index (BMI) in assessing nutrition in adolescent populations.MethodsThis is secondary data analysis, from a cross-sectional pilot study, which analyses anthropometric data from a sample of young adolescents attending their last year of primary school in Pwani Region and Dar es Salaam Region, Tanzania (n = 154; 92 girls & 62 boys; mean age 13.2 years).ResultsThe majority of adolescents (75%) were of normal nutritional status defined by BMI. Significantly more males were stunted than females, while significantly more females were overweight than males. Among those identified as outside the normal nutrition ranges, there was inconsistency between MUAC and BMI cut-offs. Bivariate analyses indicate that BMI and MUAC show a positive correlation for both female and male participants, and the relationship between BMI and MUAC was more strongly correlated among adolescent females.ConclusionsFurther studies are needed with more nutritionally and demographically diverse populations to better understand the nutritional status of adolescents and the practical contribution of MUAC cut-offs to measure adolescent nutrition.

Highlights

Adolescence is a critical time of development and nutritional status in adolescence influences both current and future adult health outcomes
Apart from reproductive health risk assessments, comprehensive adolescent health assessments are frequently neglected in clinical encounters, research, and programming in low and middle income countries (LMIC) [1, 2]
Relationship between body mass index (BMI) and Mid-upper arm circumference (MUAC) Bivariate analyses indicate that BMI and MUAC measurements show a positive correlation for both female and male participants, though the relationship between BMI and MUAC was more strongly correlated among adolescent females (R = 0.846, p = < 0.001) compared to adolescent males (R = 0.459, p-value< 0.001) (Fig. 1)

Summary

Introduction

Adolescence is a critical time of development and nutritional status in adolescence influences both current and future adult health outcomes. Mid-upper arm circumference (MUAC) has the potential to offer a simple, low-resource alternative or supplement to body mass index (BMI) in assessing nutrition in adolescent populations. While undernutrition continues to be a concern, with increasing globalization and development, LMICs are experiencing an increase in overnutrition, creating a “dual burden” of under- and overnutrition [8] Anthropometric measurements and their corresponding referent curves are positioned as important indicators for assessing nutritional status for adolescents due to their comparability across sex and age [11,12,13]. In addition to height-for-age and BMI-for-age, mid-upper arm circumference (MUAC), or the measurement of the circumference of the arm halfway between the tip of the elbow and the tip of the shoulder, has the potential to offer a simple alternative or supplement to BMI in assessing nutrition in adolescent populations. MUAC has the advantages of simple equipment (a standardized tape in millimetres created for MUAC measurements) and can be used by clinicians and nonclinicians alike in clinical and non-clinical settings, allowing for more efficiency in clinical practice and programs in low-resource settings [12, 16, 17]

Methods

Results

Conclusion