Arm Circumference Research Articles

Validity of non-traditional measures of obesity compared to total body fat across the life course: A systematic review and meta-analysis.

IntroductionTraditional obesity measures including body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio have limitations. The primary objective of this study was to identify and review the validity of non-traditional obesity measures, using measures of total body fat as the reference standard, that have been used across multiple life stages. MethodsWe conducted a systematic review and searched MEDLINE, Embase, and PsycINFO. We included observational studies published from 2013 to October 2023 among "the general population" for any life stage that reported the validity of non-traditional obesity measures compared to total body fat reference standards. Separate meta-analyses were performed to pool correlation coefficients and mean differences for non-traditional obesity measures that were evaluated at multiple life stages. ResultsA total of 123 studies were included, and 55 validated non-traditional obesity measures were identified. Of these, 13 were evaluated at multiple life stages. Two-dimensional (2D) digital imaging technologies, three-dimensional (3D) body scanners, relative fat mass (RFM), and mid-upper arm circumference had high or moderate validity (pooled correlation coefficient >0.70). Pooled mean differences were small (<6%) between total body fat percentage from reference standards and from RFM, 2D digital imaging technologies, 3D body scanners, and the body adiposity index. Heterogeneity (I2) was >75% in most meta-analyses. ConclusionNumerous validated non-traditional obesity measures were identified; relatively few were evaluated at multiple life stages and did not consider health risks associated with adiposity. More research is needed to define valid obesity measures across all life stages that assess health and adiposity.

The performance of upper arm circumference for age in diagnosing severe acute malnutrition in children aged 6 to 59 months in South Kivu, Eastern Democratic Republic of Congo: Lwiro Cohort

BackgroundThe studies on the use and performance of the Mid-Upper Arm Circumference for age (MUACZ) for the diagnosis of severe acute malnutrition (SAM) are still rare. Our study aimed to analyze the performance of MUACZ for diagnosis of SAM in South Kivu, eastern DR Congo.MethodsWe analyzed a database of children admitted from 1987 to 2008 for management of SAM in the east of the DRC. Anthropometric indicators (z-score) were calculated and classified according to the standards of the World Health Organization (WHO). To evaluate the performance of MUACZ using the combination of weight-for-height (WHZ) and Mid-Upper Arm Circumference (MUAC) as the reference, we calculated sensitivity, specificity, positive and negative predictive values (PPV and NPV) overall. Subsequently, we stratified the results by age category, presence or absence of stunting, and presence or absence of edema.ResultsOf the 9969 children aged 6 to 59 months selected, 30.2% had nutritional edema, 70.1% had stunting. Of all cases of SAM (identified by at least one of the WHZ, MUAC, or MUACZ indicators), MUACZ alone identified 85% of them, surpassing other criteria such as MUAC (58%) and WHZ (45%). The MUACZ-WHZ combination identified 97%, surpassing the MUAC-WHZ combination (76%). In the presence of edema, MUACZ-WHZ identified 99%, while MUAC-WHZ identified only 72%. The proportions of SAM cases diagnosed by MUACZ increased according to age groups, with rates of 73% (6–11 months), 85% (12–23 months) and 91% (24–59 months). In the presence of stunting, the detection rates were 58% for MUAC alone, 44% for WHZ alone, 89% for MUACZ alone, 67% for the MUAC-WHZ combination, and 98% for the MUACZ-WHZ combination. MUACZ had a sensitivity of 80.7% (79.9–81.5), a specificity of 92.3% (91.8–92.8), a PPV of 71.5% (70.7–72.4) with a prior prevalence was 19,3% defined by the reference, and an NPV of 95.2% (94.8–95.7). Sensitivity increased in the presence of edema [90.1% (88.9–91.1)], stunting [84.7% (83.8–85.5)] and in children over 12 months [83.6% (82.2–84.9)].ConclusionThe MUACZ was performing well in our region. In a context of high prevalence of stunting and kwashiorkor, MUACZ appears to be a more reliable indicator than MUAC alone. Moreover, the MUACZ-WHZ combination also seems to outperform the MUAC-WHZ combination. These results highlight the MUACZ potential, as well as its combination with WHZ, in enhancing screening of SAM in similar contexts.

Effect of Eight-Week Transcranial Direct-Current Stimulation Combined with Lat Pull-Down Resistance Training on Improving Pull-Up Performance for Male College Students.

The aim of this study was to investigate the effects and potential mechanisms of 8-week transcranial direct-current stimulation (tDCS) combined with resistance training (RT) on pull-up performance in male college students. Twenty-five male college students were randomly assigned to either RT combined with anodal tDCS stimulation (RT + tDCS) or RT alone (RT). Participants of both groups engaged in lat pull-down training programs for 8 weeks, with the RT + tDCS group receiving 20 min tDCS before each RT session. Pre- and post-intervention tests included pull-up endurance (number of repetitions), flexed arm circumference (FAC), and lat pull-down maximal voluntary isometric contraction (MVIC) peak force. During the pull-up endurance test, surface electromyography (sEMG) was recorded for the bicep brachii (BB), tricep brachii (TB), brachioradialis (BR), anterior deltoid (AD), middle deltoid (MD), posterior deltoid (PD), pectoralis major (PM), and latissimus dorsi (LD) muscles. Both groups demonstrated significant improvements in pull-up endurance and lat pull-down MVIC peak force after training, but no significant difference between the two groups was observed in the post-training test. Additionally, muscle activation of BR, PD, and PM decreased significantly in both groups, while the RT + tDCS group also demonstrated a significant reduction in TB coactivation after training. These findings suggest that eight weeks of tDCS combined with lat pull-down training and lat pull-down training alone can both significantly improve pull-up performance, which may be attributed to enhanced muscle contraction capacity. Although no significant training gains were found between the two training groups, the RT + tDCS group showed a significant decrease in TB coactivation and the enhancement of elbow flexion muscle contraction efficiency after training.

Readiness to deliver quality curative care for under-five children at health posts in Ethiopia

BackgroundThe institutionalization of village health services with salaried community health workers has been established in Ethiopia for over a decade. However, there are serious concerns about the capacity of health posts to provide quality curative care for children under-five.Understanding the readiness of health posts is crucial for improving the care given to sick children. Therefore, this study aimed to assess the readiness of health posts to deliver quality curative care for children under-five in four regional states in Ethiopia.MethodsA facility-based cross-sectional study was conducted at selected health posts across 10 zones in the Amhara, Oromia, SNNP, and Tigray regions. Study participants, including health posts and health extension workers, were selected using a two-stage stratified cluster sampling strategy. The readiness of health post was assessed in terms of infrastructure, human resources, medicines, medical equipment and supplies and job aids. The variations in health post readiness were analyzed using a One-way analysis of variance (ANOVA).ResultsA survey was conducted on 169 health posts and 276 health extension workers. The majority of health posts had a toilet facility (83%) and water supply (62%). However, less than a quarter had electricity connection (22%) and communication equipment (18%). Over three-fourths of health extension workers were trained (83%) and supervised (78%) on clinical management of sick children. Less than half (44%) had received clinical mentorship. Availability of essential medicines ranged from 81% for zinc tablets to 28% for cotrimoxazole. Similarly, availability of essential medical equipment varied from 57% for blood pressure apparatus to 86% for thermometer and 99% for Mid-Upper Arm Circumference tape. Only a small portion of health posts (8%) had all critical items for infection prevention practices, which are essential for quality care. Overall, the average percentage availability of items to provide quality curative care to children was 66%, with health post preparedness significantly varying across regions (P < 0.0001).ConclusionsThe readiness for delivering quality curative care was below standard and significantly varied among health posts across regions. Serious attention is needed to ensure the sustained availability of critical inputs such as trained health extension workers, medicines, medical equipment, and supplies, which is paramount for delivering quality care.

Alterations in newborn metabolite patterns with preterm birth and diabetes in pregnancy.

This study examines the influence of prematurity and diabetes (DM) in pregnancy on metabolite patterns at birth, and associations with adiposity development in a prospective cohort. Term and preterm (30-36 weeks gestational age [GA]) infants were enrolled and body composition assessments completed through discharge. Targeted metabolomics was used to assess metabolites in cord or infant blood in the first 2 days. Among 91 infants, 62 were preterm and 27 were exposed to DM. In factor analysis, variation in acylcarnitines' and non-essential amino acids differed by GA and DM exposure and were associated with adiposity at term age. DM-group had 1.95-fold increase in t4-OH-pro (p = 0.003) and 2.14-fold increase in taurine (p = 0.004) compared with non-DM group. Preterm infants had 1.77-fold increase in glycerophospholipid PC aa C32:2 versus term group (p < 0.001). Pathway analysis revealed differences across DM and GA groups in pathways associated with citrulline metabolism, amino acid transport/ synthesis, and fatty acid quantity/transport. In this cohort of infants, there are unique metabolite signatures associated with DM exposure, prematurity, and adiposity development after birth. These markers may reflect early metabolism changes in the developing infant which relate to known risks of adverse growth and cardiometabolic outcomes in this group. In this study of term and preterm infants, diabetes in pregnancy was associated with unique metabolic signatures at birth, including increased expression of metabolites related to protein synthesis and lipid metabolism. Metabolites related to lipid and protein metabolism were associated with adiposity development at term age, including estimated body fat percent, skin fold thickness measures, and arm circumference measures. Unique signatures of metabolites associated with prematurity and exposure to diabetes in pregnancy may reflect early metabolism changes in the developing infant which relate to known risks of adverse growth and cardiometabolic outcomes in this group.

Validation of the Hanvon FY730 upper-arm blood pressure monitor according to the AAMI/ESH/ISO universal standard (ISO 81060-2:2018).

This study evaluates the measurement accuracy of the Hanvon FY730 upper-arm blood pressure (BP) monitor, which uses the Korotkoff sound method, in compliance with the AAMI/ESH/ISO universal standard (ISO 81060-2:2018). A clinical trial involving 86 eligible adults was conducted, and data were analyzed based on standardized protocols. The mean differences between the device and reference measurements for systolic blood pressure (SBP) and diastolic blood pressure (DBP) were -0.37 mmHg (SD: 2.25 mmHg) and -0.17 mmHg (SD: 2.02 mmHg), respectively. Standard deviations for SBP (≤6.93 mmHg) and DBP (≤6.95 mmHg) met the required thresholds. A total of 258 effective paired measurements demonstrated that the Hanvon FY730 provides highly consistent results compared with reference methods, with all deviations falling within acceptable limits. The study also confirmed the device's reliability across a wide range of arm circumferences (22-36 cm) and BP levels (SBP: 90-188 mmHg, DBP: 53-107 mmHg). These findings confirm that the Hanvon FY730 complies with ISO 81060-2:2018 standards, demonstrating its suitability for accurate BP monitoring in clinical, personal, and home settings.

Validation of the A&D BP UA-1100NFC/UA-1100NFC-W, hoseless upper arm-type home blood pressure devices, according to the ISO81060-2:2018/Amd 1:2020 protocol.

The aim of this study was to validate the performance of the A&D UA-1100NFC hoseless devices of two cuff sizes in monitoring blood pressure (BP) in the upper arm according to the International Organization for Standardization (ISO) 81060-2:2018/amendment (Amd) 1:2020 protocol. The accuracy of the UA-1100NFC (for arm circumferences of 22.0-32.0 cm) and the UA-1100NFC-W (for arm circumferences of 22.0-42.0 cm) was assessed using the same-arm sequence protocol as per the ISO 81060-2:2018/Amd 1:2020 standard. Individuals aged >12 years were recruited from the outpatients and volunteers of Jichi Medical University (Tochigi, Japan); 85 participants were included in the final analyses for each device. Both devices performed well against the standard; mean and SD values for the differences between the device-measured and observer-measured SBP and DBP values met both criterion 1 and criterion 2 of the standard [(UA-1100NFC) criterion 1: -3.71 ± 6.82 mmHg and 0.86 ± 6.33 mmHg, respectively; criterion 2: 5.65 mmHg and 5.87 mmHg, respectively; (UA-1100NFC-W) criterion 1: 0.73 ± 7.84 mmHg and 1.72 ± 6.44 mmHg, respectively; criterion 2: 6.49 mmHg and 5.86 mmHg, respectively]. The Bland-Altman plots did not show any systematic variation in the error. Both the UA-1100NFC and UA-1100NFC-W hoseless devices had a high level of accuracy and fulfilled the requirements of the ISO81060-2:2018/Amd 1:2020 validation standard. They are therefore suitable as home BP monitoring tools in patients with hypertension.

Incorporating the Malnutrition Screening Tool and the Malnutrition Universal Screening Tool in Rehabilitation Practice: Comparison With the Nutrition Risk Screening 2002.

To demonstrate the prevalence of malnutrition risk in a specific rehabilitation setting. The secondary aim of the study was to compare Malnutrition Screening Tool (MST) and Malnutrition Universal Screening Tool (MUST) with Nutritional Risk Screening-2002 (NRS-2002). Patients diagnosed with stroke, anoxic brain injury, spinal cord injury, multiple sclerosis, arthritis, neuromuscular diseases, Parkinson's disease, and lymphedema who were admitted to a rehabilitation hospital were included. NRS-2002, MST, and MUST were used to assess malnutrition risk. Body weight (kg), height (cm), and mid upper arm circumference (cm) were measured. Twenty-four hours dietary records were obtained. Routine blood test results were recorded from patient files. Five hundred sixteen patients with a mean age of 54.3 ± 18.0 years were included. The most prominent diagnoses were stroke and spinal cord injury. According to NRS-2002, 71.7% (n = 370) of the patients were at low risk, but 28.3% (n = 146) of the patients were at high risk. Comparisons between NRS-2002 and MST showed that these two scales have similar results at classifying patients for malnutrition risk (p = 0.154). Comparison between NRS-2002 and MUST showed significant differences (p < 0.001). Both sensitivity and specificity of MST were above 80.0%. Sensitivity of MUST was 78.1% and specificity was 88.1%. Approximately one-third of the patients were at risk of malnutrition. Specificity and sensitivity of MST and MUST were as high as routinely used scale NRS-2002, and therefore it can be supposed that, considering the diagnostic groups of the patients, MST and MUST are useful in rehabilitation practice.

Perceptions of stakeholders on the use of a simplified, combined protocol for treatment of acute malnutrition in Central African Republic.

Treatment of acute malnutrition requires novel approaches to improve coverage, reduce costs and improve the efficiency of standard protocols that separate the management of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM). The use of simplified, combined protocols to treat both MAM and SAM has drawn research and policy interest among global, regional and national stakeholders. However, the perspectives of local communities and health care workers regarding the use of protocols to treat acute malnutrition in a routine health care system are generally lacking. This was a cross-sectional mixed-methods study aimed at assessing the perceptions of different stakeholders on the use of a simplified, combined protocol in two districts in the Central African Republic. Most of the respondents preferred the simplified, combined protocol over the standard protocol. They generally agreed that the protocol was easy to understand, allowed more children to receive treatment and was effective in treating acute malnutrition. The protocol modifications were well received, including the expanded admission criteria, use of mid-upper arm circumference (MUAC) only for admission and discharge criteria and reduced and simplified ready-to-use therapeutic food quantity to treat MAM and SAM. Some caregivers expressed concern with the use of MUAC only to declare recovery, flagging that underlying illnesses could still be present. The caregivers recommended the provision of other food basket interventions to improve the treatment. The support by caregivers and health care workers on the idea of training community health volunteers to treat acute malnutrition points to the potential of scaling up decentralized treatment to increase coverage in remote areas.

Baseline Nutritional Status of Mother-Child Dyads in Urban Slums: Pre-Intervention Analysis for a Nutrition Informatics Intervention

Background: Urban slums are critical for public health intervention due to high population density, poor living conditions, and limited healthcare access. This study examines baseline nutritional and lifestyle patterns among mother-child dyads in the urban slums of Uttar Pradesh. The dyads were recruited for Nutritional Assessment and Intervention Kiosk (NAIK), a Population Health Informatics platform to address double burden of malnutrition. Methodology: This cross-sectional, pre-intervention study involved 406 mother-child dyads with children aged 2-5 years. Data on socio-demographic variables, anthropometric measurements, nutrient intake and lifestyle patterns were collected. Descriptive statistics summarized baseline characteristics. Results: The demographic profile showed predominantly low-income mothers with 43.34% without primary education. The mean ages of mothers and children were 33.98 ± 5.9 years and 46.91 ± 10.89 months, respectively. The waist-to-hip ratio was 0.92 ± 0.76 indicating cardiovascular risk factors with significant maternal obesity (47.78%). Education of the mother was found to be significantly associated with Mid Upper Arm Circumference (MUAC) of the child. The findings highlight the overnutrition in mothers and nutrient inadequacy in children, influenced by inadequate dietary intake and unhealthy lifestyle. Conclusions: This paper will comprehensively overview baseline population status, setting the stage for further analysis and evaluation of the intervention.

Rates and risk factors for relapse among children recovered from severe acute malnutrition in Mali, South Sudan, and Somalia: a prospective cohort study.

Community-based management of acute malnutrition is an effective treatment model for severe acute malnutrition. However, sparse evidence exists on post-discharge outcomes and the sustainability of recovery. This study aimed to evaluate the risk and determinants of relapse following severe acute malnutrition recovery in high-burden settings. This multi-country prospective cohort study followed children who had recovered from severe acute malnutrition and their non-malnourished peers in parallel for 6 months in Mali (nine sites), South Sudan (six sites), and Somalia (one site). Nutritional status was assessed by research staff at nutrition clinics monthly to obtain the proportion of children exposed to severe acute malnutrition who relapsed to acute malnutrition and the relative risk of developing acute malnutrition for exposed versus non-exposed (ie, previously non-malnourished) children. Exposed children were eligible if they had been discharged from community-based management of acute malnutrition programmes while aged 6-47 months. Non-exposed children were eligible if they had not had an episode of acute malnutrition in the previous year; non-exposed children were matched to exposed children by age, sex, and community. Acute malnutrition was defined as having a mid-upper arm circumference of less than 125 mm, a weight-for-height Z score of less than -2, or nutritional oedema. The primary outcome was the cumulative incidence of acute malnutrition at 6 months in the exposed and non-exposed cohorts. Relapse was defined as an episode of acute malnutrition among exposed children during the 6-month follow-up period. Between April 9, 2021, and June 2, 2022, 2749 children were enrolled (1689 exposed and 1060 non-exposed). After 6 months, 30% (95% CI 25-34) of children previously exposed to severe acute malnutrition relapsed in Mali, 63% (95% CI 59-67) in South Sudan, and 22% (95% CI 19-25) in Somalia. Depending on the context, exposed children were 1·2-6·2 times more likely to have acute malnutrition compared with non-exposed children. Higher anthropometric measurements at discharge were protective against relapse; however, few other child-level or household-level factors at the time of discharge were associated with subsequent relapse. After discharge, children experiencing food insecurity or morbidity at time of follow-up were more likely to relapse than those who were not experiencing these factors. Following severe acute malnutrition recovery, children have a significant risk of relapsing within 6 months, highlighting the particular vulnerability of this population. Although the community-based management of acute malnutrition model proves highly effective in saving lives, high relapse indicates the need for additional services during and following treatment to better sustain recovery. The United States Agency for International Development.

Enhancing anthropometric proficiency: Effect of a structured training program on skills of Anganwadi workers in rural areas of Raebareli District, Uttar Pradesh

ABSTRACT Context: Anganwadi workers (AWWs) require technical skills for growth monitoring of under-five children. Anthropometric skills help Anganwadi workers assess any changes or deterioration in the normal growth of children. Aims: To determine the effect of a structured training program on the anthropometric skills of Anganwadi workers in rural areas of Raebareli district in Uttar Pradesh. Settings and Design: A community-based interventional study, was conducted among 162 AWWs, 73 from Salon and 89 from Rahi development blocks of Raebareli district. Methods and Material: The skills of AWWs in anthropometric measurement domains (weight, height/length, and mid-upper arm circumference) were assessed using a pre-tested observatory checklist both before and after the training sessions. The skills for each domain were assessed on four points i.e. standard procedure applied to the child, assurance of safety precautions, observer protocol during anthropometry, and precision and accuracy in recording measurement. Statistical Analysis Used: The McNemar Chi-square test was used for paired categorical data analysis. P &lt; 0.05 was considered to be statistically significant. Results: The mean age of the study population was 43.30 ± 9.68 years. The mean years of their job was 16.68 + 7.38 years. About one-fourth (26.5%) of AWWs had received training within the last three years. Inadequate/non-functional equipment (9.8%), low honorarium (29.4%), interruption in timely supply of supplementary food (6.3%), non-cooperation of the community (84.6%), insufficient space (58.0%), and availability of periodic job aids (16.8%) were the major challenges that were faced by ICDS workers. The anthropometric skills of the AWWs were found to improve significantly in almost all the domains. The proportion of AWWs following standard procedure, assurance of safety precautions, observer protocol during anthropometry, precision, and accuracy on recording measurement were found to increase significantly after a structured training program. (P &lt; 0.05). Conclusions: A structured training programme focusing anthropometric skills on play an important role in increasing the skills of AWWs in growth monitoring. AWWs’ capacity to monitor child growth must be refreshed regularly through separate focussed training programs rather than during comprehensive sessions.

Education and Implementation in Handling and Preventing Stunting

Various educational programs are being conducted among children and youth in South Alalak, Indonesia to improve health and hygiene. Key initiatives include education on proper handwashing, reproductive health awareness, risks of free association, and stunting prevention. awareness, risks of free association, and stunting prevention. Stunting is a condition where children under five have poor nutrition, resulting in stunted development and resulting in stunted growth and development and making the child too short, underweight, and lacking upper arm circumference. Stunting, which results from chronic malnutrition, has serious long-term consequences, including cognitive decline and increased vulnerability to disease. increased susceptibility to disease. Through interventions that include nutrition counseling, health education sessions, and promotion of hygiene practices, results show that education efforts and nutritious food programs can effectively reduce stunting rates and improve child health. This concludes with a call for continued efforts in health education and prevention strategies to improve well-being. health education and prevention strategies to improve the region's well-being of children and adolescents. This journal aims to reduce stunting rates and improve the well-being of children and adolescents in the region through health education and prevention strategies.

The Relationship Between Upper Extremity Anthropometric Measurements and Bioimpedance Analysis With Grip Strength in Female Elite Handball Players

Handball players need to have upper extremity power and sufficient grip strength to be successful. In this context, it was aimed to determine the relationship between upper extremity anthropometric measurements and bioelectrical impedance analysis with grip strength in elite handball players. The study was conducted on 95 female elite handball players aged 18-24. Athletes with any trauma, musculoskeletal system problems, metabolic or systemic diseases that could affect the upper extremity were not included in the study. Stadiometer, electronic scale, digital caliper, inflexible tape measure, hand dynamometer, pinchmeter and skinfold caliper were used for anthropometric measurements, while Tanita MC-780 was used for bioelectrical impedance analysis. Upper extremity length, arm circumference, arm span, forearm length, forearm circumference, hand length, hand width, hand span, wrist medio-lateral diameter, wrist dorso-volar diameter, wrist circumference, tip pinch, key pinch, palmar pinch were found to be statistically significantly positively correlated with grip strength. A positive significant correlation was identified between grip strength and weight, body mass index, basal metabolic rate, waist/hip ratio from bioelectrical impedance analysis. The positive correlation between grip strength and athletes' anthropometric variables demonstrated the effect of hand anthropometry on grip strength in athletes who use their hands to grip a ball or an opponent. The results of this study can be useful for optimizing training programs as well as providing practical applications for talent selection of handball players.

Evaluation of Nutritional Interventions in Overcoming Chronic Energy Deficiency in Pregnant Women: A Case Study

Introduction: Chronic Energy Deficiency in pregnant women is one of the public health problems that can hurt the health of the mother and fetus. This study aims to evaluate the effectiveness of nutritional interventions in overcoming Chronic Energy Deficiency in pregnant women through a case study in one of the health centers in the Padangsidimpuan City area. Methods: A qualitative study with a case study design involving pregnant women with nutritional status with Chronic Energy Deficiency who received nutritional interventions over three months. This data was collected at the Padangmatinggi Health Center through in-depth interviews involving four primary informants and seven triangulation informants, which included document analysis and data analysis. Results: This study proves that the input aspects, namely sources of funds, infrastructure, forms of services, and supplementary feeding materials, are by the instructions, while the goals and human resources are not by the Supplementary Feeding Guidelines. It is appropriate for the planning, implementation, and recording process, but there are obstacles due to the uncertain dropping from the center. The increase in the size of the upper arm circumference is an output of the supplementary feeding program for pregnant women, but in reality, the cases of Chronic Energy Deficiency are still high. Conclusion: It can be concluded that the administration of supplementary feeding can only be monitored until distribution to pregnant women with Chronic Energy Deficiency, but consumption monitoring has not been carried out. This study suggests the importance of nutrition intervention programs integrated with health services at the health center level to reduce the prevalence of chronic energy deficiency in pregnant women and encourage healthier diets.

Nutritional Status, Frailty, Oral Health, and Oral Motor Functions in Long-Term Care Residents with Swallowing Dysfunction.

Background: Swallowing dysfunction is a prevalent but often overlooked problem in long-term care facilities. This study investigated the relationships between nutritional deficits, frailty, oral health, and swallowing dysfunction. Additionally, we explored the associations between oral muscle weakness, frailty markers, and swallowing dysfunction. Methods: We recruited 373 participants from seven long-term care facilities across Taiwan. Swallowing function, frailty, nutrition status, and oral health were assessed by research staff. Oral muscle function was evaluated through tongue strength measurements, cheek bulging function tests, the Repetitive Saliva Swallowing Test (RSST), and a diadochokinetic task. Frailty was assessed through grip strength as well as mid-upper arm and calf circumference measurements. Results: The Functional Oral Intake Scale revealed that 97 participants (26%) had swallowing dysfunction. Participants with swallowing dysfunction had poorer nutritional status, higher frailty levels, and worsened oral health. Frailty was the factor most strongly associated with swallowing dysfunction. Participants with swallowing dysfunction also exhibited lower tongue pressure, decreased cheek-bulging ability, fewer repetitions in the diadochokinetic task, lower scores on the RSST, lower calf circumferences, and lower grip strength. Logistic regression demonstrated that cheek bulging was most strongly associated with swallowing dysfunction. Furthermore, lower grip strength was significantly associated with swallowing dysfunction. Conclusions: Frailty was most strongly associated with swallowing dysfunction, followed by poorer nutritional status and worsened oral health. These factors should be thoroughly assessed in long-term care residents. Participants with swallowing dysfunction also experienced oral muscle weakness, particularly in cheek bulging. Grip strength, which represents frailty, was directly associated with swallowing dysfunction and could serve as a crucial indicator of swallowing dysfunction.

Anthropometric measurements as predictors of nutritional status in black South African women during pregnancy.

Nutritional risk assessment is an essential component of primary health care screening, especially for pregnant women. The aim of this study was to investigate the relationship between maternal body mass index (BMI) and maternal anthropometric measurements in black South African pregnant women, both with and without human immunodeficiency virus (HIV). A cross-sectional observational study design was used. Two hundred black South African pregnant women were recruited of which 90 were HIV-infected and 110 were HIV-uninfected. The anthropometric measurements assessed included mid-upper arm circumference (MUAC), tricep skinfold (TSF), subscapular skinfold (SSF), mid-arm muscle circumference (MAMC), wrist circumference (WC), frame size, and BMI. Maternal age was significantly associated with changes in maternal anthropometric measurements. Maternal BMI was significantly correlated with other maternal anthropometric measurements including MUAC, TSF, SSF, MAMC, WC, and frame size. The anthropometric measurements that were found to be accurate for assessing obesity in pregnancy included TSF (≥20.75 mm), SSF (≥21.75 mm), MAMC (≥25.23 cm), and WC (≥16.25 cm). Additionally, SSF (≥15.75 mm) and MAMC (≥23.35 cm) could be used to assess for overweight nutritional status. Lastly, frame size could be used to assess for underweight (≥10.05) and normal (≥9.95) nutritional status. No significant anthropometric differences were observed between the HIV-infected pregnant women and the HIV-uninfected pregnant women in this study. Surrogate anthropometric measurements offer a simple solution for assessing nutritional status in pregnant women. MUAC was the most accurate method for identifying overweight and obesity. Furthermore, maternal HIV status did not affect the anthropometric measurements.

Validation of the Uscom BP+ automated oscillometric blood pressure monitor for professional office use in children and adolescents according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018).

To (1) assess the accuracy of the Uscom BP+ oscillometric upper-arm professional blood pressure (BP) monitor in children and adolescents as per the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018); (2) assess the suitability of a non-standard cuff; and (3) assess the impact of motion artefact on device accuracy and precision. Children and adolescents were recruited to fulfil the sex/cuff distribution criteria of the Universal Standard. Single arm sequential BP measurements were used, the test device measured on deflate with an altered child/adolescent algorithm, using three standard (Extra Small, Small Adult, Adult) and, as exploratory analysis, additionally in one non-standard cuff (Wide Range; WR) (arm circumferences: 12-17, 16-24, 22-32, 22-42 cm, respectively). The presence of motion artefact was determined and its impact on BP assessed. One-hundred-forty participants were recruited with 123 included for analysis. When using the Extra Small, Small Adult and Adult cuffs only, the BP+ passed both criteria (95 participants, 321 pairs, -0.1 ± 7.3/ - 1.6 ± 7.6 and 5.72/6.50 mmHg systolic/diastolic) (reference thresholds: ≤5 ± 8, ≤6.95/6.76, respectively). The inclusion of the WR cuff showed unacceptable imprecision, and motion artefact had a substantial influence on test device precision. The Uscom BP+ fulfilled the requirements of the Universal Standard in children and adolescents when using the altered algorithm with the three standard cuffs and can be recommended for clinical use. The WR cuff cannot be recommended in this population in measure-on-deflate mode due to its imprecision. Additionally, BP measurement accuracy in children and adolescents can be improved through inclusion of a motion artefact detection system.

Association of anthropometric parameters with intelligence quotient in early school-aged children: a cross-sectional study in Iran

BackgroundWhile the link between body growth indices in the first three years of life and neurodevelopment is well established, the relationship between these indicators and intelligence levels in later stages is not well understood. This study aimed to investigate the association between various anthropometric indices and Intelligence Quotient in early school-aged children.MethodsThis cross-sectional study recruited healthy students aged 7 to 8 years from four primary schools in Tehran, Iran. Measurements included body weight, height, body mass index, arm circumference, waist circumference, and hip circumference. Intelligence Quotient was assessed using the Raven's Standard Progressive Matrices Test, with scores standardized by age according to the Raven's manual. Separate univariate linear regression analyses evaluated the association between each anthropometric index and children’s Intelligence Quotient scores. Multivariate linear regression analyses were then performed to adjust for potential confounding factors, including the child's sex, age, and parental education levels.ResultsA cohort of 160 children (80 females), with a mean age of 7.5 ± 0.6 years, was included in the study. The participants exhibited the following mean anthropometric values: weight 27.7 ± 6.5 kg, height 1.2 ± 0.1 m, body mass index 17.9 ± 3.4 kg/m2, arm circumference 20.7 ± 2.8 cm, waist circumference 56.4 ± 6.4 cm, and hip circumference 68.1 ± 6.6 cm. Their mean Intelligence Quotient score was 106 ± 16.6. In the univariate analysis, children's weight was not significantly associated with Intelligence Quotient score (P-value = 0.153, β = 0.288 [-0.108, 0.684]), while height was negatively associated (P-value = 0.048, β = -31.685 [-63.142, -0.228]) and body mass index showed a positive association (P-value = 0.001, β = 1.265 [0.524, 2.006]). Abdominal circumference was not significantly associated with Intelligence Quotient (P-value = 0.913, β = 0.051 [-0.870, 0.972]), but both waist circumference (P-value = 0.007, β = 0.542 [0.147, 0.937]) and hip circumference (P-value = 0.013, β = 0.484 [0.102, 0.866]) demonstrated significant positive associations with Intelligence Quotient. However, none of the anthropometric indices maintained statistically significant associations with Intelligence Quotient after adjusting for potential confounders (P-values > 0.05).ConclusionsThis study indicated no strong relationship between various body measurements and intelligence levels in school-aged children after adjusting the analyses for confounders. This suggests that intelligence in these children may be largely shaped by genetic and sociodemographic factors, with minimal influence from physical growth patterns.

Assessment of the Diagnostic Performance of MUAC in Malnutrition Screening and Its Correlation with Other Anthropometric Indicators in Healthy Children and Adolescents

Background/Objectives: This study aimed to evaluate the correlation of mid-upper arm circumference (MUAC) z-scores with body mass index (BMI) and weight-for-height (WFH) z-scores to determine its reliability in identifying malnutrition and its potential in clinical practice in healthy children and adolescents. Methods: Our study included 906 healthy children and adolescents aged between 2 months and 18 years who were admitted to University Hospital’s General Pediatrics Clinic and attended 12 primary schools in 6 additional Izmir provinces. Anthropometric measurements (weight, length/standing height, MUAC, BMI, WFH) were performed. The relationship between MUAC z-scores, BMI, and WFH z-scores of cases with malnutrition were evaluated. Results: According to the WHO BMI z-score classification, 6 (0.7%) of the children were defined as having severe undernutrition, 43 (4.7%) as moderate undernutrition, 146 (16.1%) as mild undernutrition, 486 (53.6%) as normal, 142 (15.7%) as overweight, and 83 (9.2%) as obese. At any age over two years, fair agreement was observed between MUAC z-scores and WHO BMI z-scores in defining malnutrition alone compared to other growth measures (weighted kappa = 0.371). Under two years of age, the correlation between MUAC z-scores and BMI z-scores showed moderate agreement in detecting overweight and obesity (weighted kappa = 0.479), and between MUAC and WHO WFH z-scores showed moderate agreement (kappa = 0.252). Conclusions: The study found a moderate and fair connection between MUAC z-scores and other criteria. However, further MUAC z-score screening and diagnostic power testing in larger pediatric populations are needed to validate its use alongside other key anthropometric indicators in malnutrition diagnosis. MUAC measurement should be popularized in routine pediatric outpatient clinics to detect malnutrition quickly.