Child Anthropometry Research Articles

Food Availability en Route to School and Anthropometric Change in Urban Children

This study examined food availability along children's paths to and from elementary school, and associations with change in body mass index (BMI) and waist circumference over 1year. Secondary data from 319 children aged 8-13years from the "Multiple Opportunities to Reach Excellence" Project was used. Child anthropometry and demographic variables were obtained at baseline (2007) and 1year follow-up. Food outlet locations (n = 1,410) were obtained from the Baltimore City Health Department and validated by ground-truthing. Secondary data on healthy food availability within select food stores in Baltimore City in 2007 were obtained via a validated food environment assessment measure, the Nutrition Environments Measures Study. Multilevel models were used to examine associations between availability of healthy food and number of various food outlets along paths to school and child anthropometric change over 1year. Controlling for individual-, neighborhood-, and school-level characteristics, results indicated that higher healthy food availability within a 100m buffer of paths to school was associated with 0.15kg/m(2) lower BMI gain (p = 0.015) and 0.47cm smaller waist circumference gain (p = 0.037) over 1year. Although prior research has illuminated the importance of healthy food choices within school and home environments, the current study suggests that exposure to the food environment along paths to school should be further explored in relation to child health outcomes.

Household food access and child malnutrition: results from the eight-country MAL-ED study

BackgroundStunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites.MethodsWe administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites.ResultsAverage age of study children was 41 months. Mean food access insecurity score (range: 0–27) was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42%) was much higher than the prevalence of wasting (6%). In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p = 0.008). A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p = 0.17).ConclusionsOur study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and death related to malnutrition.

DNA methylation of the IGF2/H19 imprinting control region and adiposity distribution in young adults

BackgroundThe insulin-like growth factor 2 (IGF2) and H19 imprinted genes control growth and body composition. Adverse in-utero environments have been associated with obesity-related diseases and linked with altered DNA methylation at the IGF2/H19 locus. Postnatally, methylation at the IGF2/H19 imprinting control region (ICR) has been linked with cerebellum weight. We aimed to investigate whether decreased IGF2/H19 ICR methylation is associated with decreased birth and childhood anthropometry and increased contemporaneous adiposity.DNA methylation in peripheral blood (n = 315) at 17 years old was measured at 12 cytosine-phosphate-guanine sites (CpGs), analysed as Sequenom MassARRAY EpiTYPER units within the IGF2/H19 ICR. Birth size, childhood head circumference (HC) at six time-points and anthropometry at age 17 years were measured. DNA methylation was investigated for its association with anthropometry using linear regression.ResultsThe principal component of IGF2/H19 ICR DNA methylation (representing mean methylation across all CpG units) positively correlated with skin fold thickness (at four CpG units) (P-values between 0.04 to 0.001) and subcutaneous adiposity (P = 0.023) at age 17, but not with weight, height, BMI, waist circumference or visceral adiposity. IGF2/H19 methylation did not associate with birth weight, length or HC, but CpG unit 13 to 14 methylation was negatively associated with HC between 1 and 10 years. β-coefficients of four out of five remaining CpG units also estimated lower methylation with increasing childhood HC.ConclusionsAs greater IGF2/H19 methylation was associated with greater subcutaneous fat measures, but not overall, visceral or central adiposity, we hypothesize that obesogenic pressures in youth result in excess fat being preferentially stored in peripheral fat depots via the IGF2/H19 domain. Secondly, as IGF2/H19 methylation was not associated with birth size but negatively with early childhood HC, we hypothesize that the HC may be a more sensitive marker of early life programming of the IGF axis and of fetal physiology than birth size. To verify this, investigations of the dynamics of IGF2/H19 methylation and expression from birth to adolescence are required.

Sibling composition and children's anthropometric indicators of nutritional status: Evidence from native Amazonians in Bolivia

Background: Siblings compete for parental resources. Little is known about how sibling composition (older sisters, older brothers, younger sisters, younger brothers) might affect child anthropometric indicators of nutritional status.Aim: This study evaluates the associations between sibling composition and child anthropometry using panel data from a native Amazonian society (Tsimane').Methods: Anthropometry of ∼168 girls and 169 boys aged 2–9 years were measured annually during 2002–2007 (2360 observations). Children's weight-for-height Z-score (WHZ), mid-upper arm circumference (MUAC), mid-upper arm muscle area (AMA) and triceps skin-fold thickness (TST) were regressed separately against all of the sibling composition variables while controlling for child's age and survey year. Multivariate panel linear regressions were used with individual, village, survey year and village-year fixed-effects, clustering by household.Results: Among girls, an additional older brother was associated with a 1.4% decrease in MUAC (p < 0.01) and a 4.3% decrease in AMA (p < 0.01); an additional younger sister was associated with a 6.3% decrease in TST (p < 0.01). The association between sibling composition and arm anthropometry was robust to various model specifications.Conclusion: Older brothers and younger sisters were negatively associated with arm measures in girls. This finding may help improve policy interventions that aim to address children's nutritional health and long-term well-being.

Performance analysis of the protective effects of bicycle helmets during impact and crush tests in pediatric skull models

Bicycle accidents are a very important cause of clinically important traumatic brain injury (TBI) in children. One factor that has been shown to mitigate the severity of lesions associated with TBI in such scenarios is the proper use of a helmet. The object of this study was to test and evaluate the protection afforded by a children's bicycle helmet to human cadaver skulls with a child's anthropometry in both "impact" and "crushing" situations. The authors tested human skulls with and without bicycle helmets in drop tests in a monorail-guided free-fall impact apparatus from heights of 6 to 48 in onto a flat steel anvil. Unhelmeted skulls were dropped at 6 in, with progressive height increases until failure (fracture). The maximum resultant acceleration rates experienced by helmeted and unhelmeted skulls on impact were recorded by an accelerometer attached to the skulls. In addition, compressive forces were applied to both helmeted and unhelmeted skulls in progressive amounts. The tolerance in each circumstance was recorded and compared between the two groups. Helmets conferred up to an 87% reduction in so-called mean maximum resultant acceleration over unhelmeted skulls. In compression testing, helmeted skulls were unable to be crushed in the compression fixture up to 470 pound-force (approximately 230 kgf), whereas both skull and helmet alone failed in testing. Children's bicycle helmets provide measurable protection in terms of attenuating the acceleration experienced by a skull on the introduction of an impact force. Moreover, such helmets have the durability to mitigate the effects of a more rare but catastrophic direct compressive force. Therefore, the use of bicycle helmets is an important preventive tool to reduce the incidence of severe associated TBI in children as well as to minimize the morbidity of its neurological consequences.

A Pilot Study of Three-Dimensional Child Anthropometry for Vehicle Safety Analysis

The publicly available anthropometric data for U.S. children were published in 1977, lack body shape data, and do not include measurements in supported sitting postures that are needed for vehicle safety applications. A pilot study was conducted of methods using standard anthropometry, laser scanning, and three-dimensional coordinate measurement to develop the data needed to improve the sizes and shapes of crash dummies and other design tools used to develop and assess child restraints, belt-positioning boosters, and vehicle seat and belt restraint systems. A total of 15 children ages 4 to 11 were measured in this pilot study.

Modified anthropometry in prepubertal Israeli children while excluding the head’s weight and height

A methodological inadequacy in anthropometric measurements of children exists because of an age-dependent decelerating contribution of the head to body weight (Wt) and height (Ht). Hence, we aimed to assess the contribution of head measurements to anthropometry (Ht, Wt and BMI) in healthy prepubertal children. This prospective study was conducted in 300 2- to 9-year-old typically growing children. Head-excluded (HE) Ht was determined by a stadiometer that measured the distance from the foot plate to the lower margin of protuberance occipitalis externa. Head's weight was calculated from the head volume using three different measurements of the head circumference. In the typically growing children, the HE/standard (STD) ratios for Wt and Ht increased significantly with age (p < 0.001 for both), but the HE/STD ratio for BMI did not increase with age. Measurement of body Wt and Ht while excluding the head's Wt and Ht provides a new dimension to standard anthropometry by eliminating the age-dependent head bias with its unique pattern of growth and minimal adipose tissue.

An anthropometric study in children with chronic myeloid leukemia on imatinib.

6554 Background: The long-term adverse effects, especially in children with chronic myeloid leukemia (CML) on imatinib are unknown. There is very little literature addressing the adverse effects on growth in children on imatinib. We analysed the effect of imatinib on anthropometry in children with CML. Methods: The records of children ≤ 18 years with CML diagnosed at our institute between 2003 and 2011 were retrospectively analysed. Children who received imatinib for at least one year and on regular follow up were eligible for growth assessment. The data was analysed using WHO AnthroPlus v1.0.4 and SPSS.v19 software and the Height for age and BMI for age/sex “z” scores were computed. Results: A total of 61 children were started on imatinib. But, only 37 children were eligible for assessment of growth. Of them 3 were further excluded as the WHO AnthroPlus software supported data only till 19 completed years. Median age was 12 years (range: 5 – 17). 17 children were in the prepubertal age (5-11years) at commencement of imatinib. The mean duration of imatinib therapy was 41.24 months (range: 12–91). The overall z- scores for height for age (HAZ) on follow up were significantly (p =0.029) lower, compared to baseline. However when analysed according to age groups, the HAZ was found significantly (p=0.005) lower among 5-11 year age group compared to age group of ≥12 years. No significant differences were observed in BMI for age/sex z scores by age groups, over the period. Conclusions: Imatinib appears to cause growth retardation in prepubertal children. Further follow up may shed more light on the degree of stunting and the deficit in the final adult height.

The effect of a vaccination program on child anthropometry: evidence from India's Universal Immunization Program

Childhood vaccination may protect children's nutritional status and lead to improved child growth in developing countries. This study evaluates the effect of India's childhood vaccination program Universal Immunization Program (UIP) on the growth of children <4 years of age. Regression models were estimated to examine the effect of UIP on vaccination status and children's anthropometric outcomes, as well as to test whether UIP's effect was uniform across various subpopulations of Indian children. UIP increased height-for-age and weight-for-age among children. This effect constituted a 22-25% reduction in the height-for-age deficit and a 15% reduction in the weight-for-age deficit of the average child. The program appears to have had no effect on other anthropometric indicators or vaccination status. UIP also led to differential changes in anthropometry and vaccination status, based on differences in wealth, maternal education and scheduled-caste status. UIP led to improved child growth. This suggests that vaccination programs-in addition to being a major intervention for reducing child mortality-might be considered a tool for mitigating undernutrition in developing countries. This study also adds to the growing evidence that childhood vaccination programs are high-return investments because they produce long-term health benefits for children.

Pre- and Postnatal Arsenic Exposure and Body Size to 2 Years of Age: A Cohort Study in Rural Bangladesh

Background: Exposure to arsenic via drinking water has been associated with adverse pregnancy outcomes and infant morbidity and mortality. Little is known, however, about the effects of arsenic on child growth.Objective: We assessed potential effects of early-life arsenic exposure on weight and length of children from birth to 2 years of age.Methods: We followed 2,372 infants born in a population-based intervention trial in rural Bangladesh. Exposure was assessed by arsenic concentrations in urine (U-As) of mothers (gestational weeks 8 and 30) and children (18 months old). Child anthropometry was measured monthly in the first year and quarterly in the second. Linear regression models were used to examine associations of U-As (by quintiles) with child weight and length, adjusted for age, maternal body mass index, socioeconomic status, and sex (or stratified by sex).Results: Median (10th–90th percentiles) U-As concentrations were about 80 (25–400) µg/L in the mothers and 34 (12–159) µg/L in the children. Inverse associations of maternal U-As with child’s attained weight and length at 3–24 months were markedly attenuated after adjustment. However, associations of U-As at 18 months with weight and length at 18–24 months were more robust, particularly in girls. Compared with girls in the first quintile of U-As (< 16 µg/L), those in the fourth quintile (26–46 µg/L) were almost 300 g lighter and 0.7 cm shorter, and had adjusted odds ratios (95% confidence interval) for underweight and stunting of 1.57 (1.02–2.40) and 1.58 (1.05–2.37), respectively, at 21 months.Conclusions: Postnatal arsenic exposure was associated with lower body weight and length among girls, but not boys.

Infant and young child feeding (IYCF) practices in Ethiopia and Zambia and their association with child nutrition: Analysis of demographic and health survey data

Data from the 2005 Ethiopia Demographic and Health Survey (EDHS) and the 2007 Zambia Demographic Health Survey (ZDHS) were analyzed to examine the association between World Health Organization (WHO) recommended IYCF indicators and nutritional status among children 0- 23 months of age in Ethiopia and Zambia. A total of 1810 and 2512 children within this age group from Ethiopia and Zambia , respectively , were included in the analysis. Exclusive breast -feeding among children 0- 5.9 months of age is low in both Ethiopia (43 % ) and Zambia (51 % ). Timely introduction of complementary food is lower in Ethiopia (61 %) compared to Zambia (90 %). Only 7 percent of children between 6- 23 months of age consumed diets that met the minimum dietary diversity requirement of four or more food groups consumed per day compared to 37 % in Zambia. Multiple linear and logistic regression analyses using appropriate measures to account for the complex survey design were applied to examine the associations between IYCF practices and child anthropometry. Linear regression results show that exclusive breast -feeding (EBF) is positively associated with weight -for -height z -score (WHZ) (effect size (ES) 0.65; p&lt;0.001) and weight -for- age z -score (W AZ) (ES 0.28; p&lt;0.01) in Zambia. In Ethiopia, EBF under 6 months of age is negatively associated with height -for- age z - score (HAZ) (ES 0.81; p&lt;0.01). Timely introduction of complementary food between 6- 8 months of age was positively associated with HAZ (ES 1.19; p&lt;0.01) in Zambia. Higher dietary diversity score was associated with higher HAZ (ES 0.23, p&lt;0.001 in Ethiopia; ES 0.12, p&lt;0.01 in Zambia) and WAZ (ES 0.17, p&lt;0.001 in Ethiopia; ES 0.04, p&lt;0.10 in Zambia) in both countries. The findings demonstrate the need to reinforce age - appropriate IYCF practices to address child undernutrition. Special attention is needed to improve the complementary feeding practices, particularly diet diversity for children 6 -23 months of age , while sustaining a focus on EBF among children under 6 months of age, in order to improve overall nutrition al status of young children in Ethiopia and Zambia.

Planning, design and implementation of the enhancing child nutrition through animal source food management (ENAM) project

The Global-Livestock Collaborative Research Support Program’s (GL-CRSP) Child Nutrition Project, a controlled feeding trial in rural Kenya, demonstrated the importance of Animal Source Foods (ASF) for children’s micronutrient status and cognitive development. These findings prompted research efforts to understand the constraints to ASF in children’s diets in Africa so as to design targeted interventions to improve the ASF quality of children’s diets. The Enhancing Child Nutrition through Animal Source Management (ENAM) project (2004-2009) emanated from participatory formative research that identified six principal constraints to the inclusion of Animal Source Foods (ASF) in children’s diets in Ghana, including low income of caregivers, poor producer-consumer linkages, inadequate nutrition knowledge and skills of extension staff and caregivers, cultural beliefs, and inequitable household food distribution. To address these constraints, the ENAM project undertook a multidisciplinary community development, research and capacity building initiative with the goal of augmenting caregivers’ access to and use of ASF in children’s diets. Participatory processes were used to implement an integrated microcredit, entrepreneurship and nutrition education intervention with 181 caregivers of children 2- to5-years old in six rural communities across three agro-ecological zones (Guinea Savannah, Forest-Savannah Transitional and Coastal Savannah) of Ghana. Six matched communities from the same ecological zones served as comparison sites. Quantitative methods that included surveys, child anthropometry, and dietary assessment as well as qualitative case studies were used to assess the effect of the intervention on household, caregiver and child outcomes of interest. This paper presents the key features of the planning, design and implementation of the community intervention and the research processes undertaken to assess the project’s impacts. The ENAM project model presents a unique approach for addressing caregivers’ income and knowledge barriers to improve child nutrition in rural Ghana and may be a promising intervention model for scale-up in Ghana and other African countries.

Cardiorespiratory Fitness, Metabolic Risk, and Inflammation in Children

The aim of this study was to investigate the independent associations among cardiorespiratory fitness, metabolic syndrome (MetS), and C-reactive protein (CRP) in children. The sample consisted of 112 children (11.4 ± 0.4 years). Data was obtained for children's anthropometry, cardiorespiratory fitness, MetS components, and CRP levels. MetS was defined using criteria analogous to the Adult Treatment Panel III definition. A MetS risk score was also computed. Prevalence of the MetS was 5.4%, without gender differences. Subjects with low fitness showed significantly higher MetS risk (P < 0.001) and CRP (P < 0.007), compared to the high-fitness pupils. However, differences in MetS risk, and CRP between fitness groups decreased when adjusted for waist circumference. These data indicate that the mechanisms linking cardiorespiratory fitness, MetS risk and inflammation in children are extensively affected by obesity. Intervention strategies aiming at reducing obesity and improving cardiorespiratory fitness in childhood might contribute to the prevention of the MetS in adulthood.

Breastfeeding duration, age of starting solids and high BMI risk and adiposity in Indian children

This study utilized data from a prospective birth cohort study on 568 Indian children, to determine whether a longer duration of breastfeeding and later introduction of solid feeding were associated with a reduced higher body mass index (BMI) and less adiposity. Main outcomes were high BMI (>90th within-cohort sex-specific BMI percentile) and sum of skinfold thickness (triceps and subscapular) at age 5. Main exposures were breastfeeding (six categories from 1-4 to ≥21 months) and age of starting regular solid feeding (four categories from ≤3 to ≥6 months). Data on infant-feeding practices, socio-economic and maternal factors were collected by questionnaire. Birthweight, maternal and child anthropometry were measured. Multiple regression analysis that accounted for potential confounders demonstrated a small magnitude of effect for breastfeeding duration or introduction of solid feeds on the risk of high BMI but not for lower skinfold thickness. Breastfeeding duration was strongly negatively associated with weight gain (0-2 years) [adjusted β = -0.12 standard deviation, 95% confidence interval (CI): -0.19 to -0.05 per category change in breastfeeding duration, P = 0.001], and weight gain (0-2 years) was strongly associated with high BMI at 5 years (adjusted odds ratio = 3.8, 95% CI: 2.53-5.56, P < 0.001). In our sample, findings suggest that longer breastfeeding duration and later introduction of solids has a small reduction on later high BMI risk and a negligible effect on skinfold thickness. However, accounting for sampling variability, these findings cannot exclude the possibility of no effect at the population level.

Randomized Intervention Study of Solar Disinfection of Drinking Water in the Prevention of Dysentery in Kenyan Children Aged under 5 Years

We report the results of a randomized controlled intervention study (September 2007 to March 2009) investigating the effect of solar disinfection (SODIS) of drinking water on the incidence of dysentery, nondysentery diarrhea, and anthropometric measurements of height and weight among children of age 6 months to 5 years living in peri-urban and rural communities in Nakuru, Kenya. We compared 555 children in 404 households using SODIS with 534 children in 361 households with no intervention. Dysentery was recorded using a pictorial diary. Incidence rate ratios (IRR) for both number of days and episodes of dysentery and nondysentery diarrhea were significantly (P < 0.001) reduced by use of solar disinfection: dysentery days IRR = 0.56 (95% CI 0.40 to 0.79); dysentery episodes IRR = 0.55 (95% CI 0.42 to 0.73); nondysentery days IRR = 0.70 (95% CI 0.59 to 0.84); nondysentery episodes IRR = 0.73 (95% CI 0.63 to 0.84). Anthropometry measurements of weight and height showed median height-for-age was significantly increased in those on SODIS, corresponding to an average of 0.8 cm over a 1-year period over the group as a whole (95% CI 0.7 to 1.6 cm, P = 0.031). Median weight-for-age was higher in those on SODIS, corresponding to a 0.23 kg difference in weight over the same period; however, the confidence interval spanned zero and the effect fell short of statistical significance (95% CI -0.02 to 0.47 kg, P = 0.068). SODIS and control households did not differ in the microbial quality of their untreated household water over the follow-up period (P = 0.119), but E. coli concentrations in SODIS bottles were significantly lower than those in storage containers over all follow-up visits (P < 0.001). This is the first trial to show evidence of the effect of SODIS on childhood anthropometry, compared with children in the control group and should alleviate concerns expressed by some commentators that the lower rates of dysentery associated with SODIS are the product of biased reporting rather than reflective of genuinely decreased incidence.

English

This study was conducted to assess deficiencies in iron, folic acid and Vitamin B12as well as nutritional status in a sample of school-age children in Turkey. The study was conducted on 172 children (boys: 80; girls: 92) aged 6 to 13 years from two different primary schools in the capital city of Turkey, Ankara. Data were obtained on children anthropometry, 24 dietary recalls, hematological and biochemical parameters of vitamin and iron bioavailability. The prevalence of deficiencies in iron, folic acid and Vitamin B12 were 15.7, 0.6 and 3.5%, respectively. In this study 18% of children were determined underweight or risk of underweight and 15.2% of children were determined overweight or obese. Body weight measurements for age were significantly low in children who had iron, folic acid or Vitamin B12 deficiency (p<0.01). Intake of energy was inadequate in 38% of the subjects, while iron and Vitamin B12 intake were inadequate in 29 and 58%, respectively. As a result of this study many dietary deficiencies especially for iron, are still common and vitamin B12 deficiency rather than folic acid deficiency was seemed to be the more prominent in Turkish grade school children. Key words: School-aged children, folic acid, vitamin B12, iron, anemia.

Feet and anthropometry in Australian school children

Feet and anthropometry in Australian school children

Ghrelin, leptin and insulin in healthy children: Relationship with anthropometry, gender, and age distribution

ObjectivesThis study aimed to establish the relationship between total ghrelin, acyl ghrelin, des-acyl ghrelin, leptin, and insulin with anthropometry, gender, and age distribution in healthy children. ResultsData from 111 healthy children aged 4months to 10years were studied. All the participants underwent a pre-study screening clinical evaluation and were separated in 3 age groups. All had blood collected to assay. Anthropometric parameters were measured according to World Health Organization. In order to determine the correlation between dependent and independent variables, a multiple linear regression analysis was used. Overall median age of subjects was 60.0months. After multiple regression analysis, correlation between total ghrelin, acyl ghrelin and des-acyl ghrelin remained significant with age. Correlation between leptin values and age, body mass index-for-age ratio, height-for-age ratio, and female gender remained significant. There was no significant correlation between insulin and ghrelin, and between insulin and leptin in all age groups. There was an inverse significant correlation between total ghrelin and des-acyl ghrelin with leptin in the whole group. ConclusionsGhrelin showed an inverse correlation with age and leptin showed a direct correlation with anthropometric parameters and female gender in healthy children. Insulin did not show any correlation.

Child Computer Use and Anthropometry

Despite all of the literature that exists on ergonomic considerations for adult computer use, there is a deficit of established objective data on how computer input device designs may affect children. By applying the relevant anthropometric data from children to the design of computer input devices, we have developed recommendations which may lead to new standards for child- and gender-specific computer input device designs, specifically, regarding mouse size (length, width, height, switch location), and mouse-button activation forces. Trends yielded four major size delineations based on age and gender, which happen to correspond well with the conventional grouping of grades in school in the United States. The data support that children and adult females may benefit from stature proportionate mice based on anthropometry.

Nutritional status at diagnosis is related to clinical outcomes in children and adolescents with cancer: A perspective from Central America

BackgroundThe prevalence of malnutrition in children may exceed 50% in countries with limited resources. The aims of this study were to assess nutritional status at diagnosis in children and adolescents with cancer, and to correlate it with clinical outcomes in the Spanish speaking countries of Central America that formed the AHOPCA (Asociacion de Hemato-Oncologia Pediatrica de Centro America) consortium. MethodsPatients aged 1–18years, diagnosed with cancer between 1st October 2004 and 30th September 2007, were eligible for study. Weight (kg) and height or length (m), mid upper arm circumference – MUAC and triceps skin fold thickness – TSFT were measured and their Z-scores or percentiles were calculated. Three categories of nutritional status were defined according to these parameters. ResultsA total of 2954 new patients were enrolled; 1787 had all anthropometric measurements performed and 1513 also had measurements of serum albumin. By arm anthropometry 322/1787 patients (18%) had moderate nutritional depletion and 813/1787 patients (45%) were severely depleted. Adding serum albumin, the proportion classified as severely depleted rose to 59%. Malnourished children more often abandoned therapy and their event free survival was inferior to that of other children. ConclusionsArm anthropometry in children with cancer is a sensitive measure of nutritional status. Since malnutrition at diagnosis was related to important clinical outcomes, an opportunity exists to devise simple, cost-effective nutritional interventions in such children that may enhance their prospects for survival.