Triceps Skinfold Thickness Research Articles

Addition of arm anthropometry to body mass index for age, but not serum albumin, improves the accuracy of the nutritional assessment in severely and moderately malnourished children with cancer.

Arm anthropometry is a more sensitive measure of nutritional status than body mass index for age (BMI) in children with cancer, but the added utility of serum albumin remains uncertain. Concordance was determined among four forms of classifying nutritional status in a cohort of undernourished children with cancer: method 1: BMI-for-age Z score; method 2: method 1 + mid-upper arm circumference (MUAC) percentile; method 3: method 2 + triceps skinfold thickness (TSFT) percentile; and method 4: method 3 + serum albumin. Concordance was highest between methods 2 and 3, followed closely by 3 and 4, indicating that addition of arm anthropometry, but not serum albumin, to BMI increased the sensitivity of baseline nutritional assessment.

Associations of geriatric nutrition risk index and other nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis

ObjectiveStandard modalities recommended for sarcopenia diagnosis may be unavailable in primary care settings. We aimed to comprehensively evaluate and compare associations of some better popularized nutritional risk-related indexes with sarcopenia presence and their value in sarcopenia diagnosis in community-dwelling middle-aged and elderly adults, including geriatric nutrition risk index (GNRI), albumin (ALB), calf circumference (CC), mid-arm circumference (MAC), triceps skinfold thickness (TST) and body mass index (BMI).MethodsBased on the West China Health and Aging Trend study, the current study included participants aged 50 or older who were recruited in 2018. Sarcopenia-related assessment and diagnosis were in line with Asian Working Group for Sarcopenia 2019. For each single index, we assessed its association with sarcopenia presence by univariate and multivariate logistic regression analysis; we also computed diagnostic measures including the area under the receiver operating characteristic curve (AUC) and sensitivity, specificity, accuracy at the optimal cut-off value determined according to Youden’s index.ResultsA total of 3829 subjects were included, consisting of 516 and 3313 subjects in the sarcopenia and non-sarcopenia groups, respectively. Regarding the risk for sarcopenia presence, the fully adjusted odds ratios of GNRI, ALB, CC, MAC, TST and BMI per standard deviation decrease were 2.95 (95% CI 2.51–3.47, P < 0.001), 1.01 (95% CI 0.90–1.15, P = 0.816), 4.56 (95% CI 3.82–5.44, P < 0.001), 4.24 (95% CI 3.56–5.05, P < 0.001), 1.67 (95% CI 1.92–1.45, P < 0.001) and 4.09 (95% CI 3.41–4.91, P < 0.001), respectively. Regarding the value in sarcopenia diagnosis in the entire study population, their AUCs could be ordered as MAC (0.85, 95% CI 0.83–0.86) > GNRI (0.80, 95% CI 0.78–0.82), CC (0.83, 95% CI 0.81–0.85), BMI (0.81, 95% CI 0.79–0.83) > TST (0.72, 95% CI 0.70–0.74) > ALB (0.62, 95% CI 0.60–0.65). At the relevant optimal cut-off values, the sensitivity was the highest for CC (0.83, 95% CI 0.80–0.87) and MAC (0.80, 95% CI 0.77–0.84), while GNRI showed the highest specificity (0.79, 95% CI 0.78–0.81) and accuracy (0.78, 95% 0.76–0.79).ConclusionOverall diagnostic performance was the best for MAC, followed by GNRI, CC, BMI, and the worst for TST, ALB in distinguishing sarcopenia from non-sarcopenia in middle-aged and elderly adults in community-based settings. CC or MAC might do better in reducing missed diagnosis, while GNRI was superior in reducing misdiagnosis.

De novo Creation and Assessment of a Prognostic Fat-Age-Inflammation Index "FAIN" in Patients With Cancer: A Multicenter Cohort Study.

Background and AimsMalnutrition is highly prevalent and is related to multiple impaired clinical outcomes in cancer patients. This study aimed to de novo create an objective, nutrition-related index specially for prognostic purposes in oncology populations.MethodsWe performed a multicenter cohort study including 14,134 cancer patients. The prognostic impact for each baseline characteristic was estimated by calculating Harrell's C-index. The optimal parameters reflecting the nutritional and inflammatory impact on patients' overall survival were selected to develop the fat-age-inflammation (FAIN) index. The associations of the FAIN with the nutritional status, physical performance, quality of life, short-term outcomes and mortality of patients were comprehensively evaluated. Independent external validation was performed to further assess the prognostic value of the FAIN.ResultsThe study enrolled 7,468 men and 6,666 women with a median age of 57 years and a median follow-up of 42 months. The FAIN index was defined as: (triceps skinfold thickness + albumin) / [age + 5 × (neutrophil count/lymphocyte count)]. There were significant associations of the FAIN with the nutritional status, physical performance, quality of life and short-term outcomes. The FAIN also showed better discrimination performance than the Nutritional Risk Index, the Prognostic Nutritional Index and the Controlling Nutritional Status index (all P < 0.05). In multivariable-adjusted models, the FAIN was independently associated with a reduced death hazard both as a continuous variable (HR = 0.57, 95%CI = 0.47–0.68) and per one standard deviation (HR = 0.83, 95%CI = 0.78–0.88). External validation in a multicenter lung cancer cohort (n = 227) further confirmed the prognostic value of the FAIN.ConclusionsThis study created and assessed the prognostic FAIN index, which might act as a feasible option to monitor the nutritional status and help develop intervention strategies to optimize the survival outcomes of cancer patients.

Dual-Energy X-Ray Absorptiometry and Anthropometry for Assessment of Nutritional Status at Diagnosis in Children with Cancer: A Single-Center Experience from India.

Gauri KapoorBackground The survival of children with cancer has improved owing to advances in chemotherapy and better supportive care, and nutritional support is an important component of the latter especially in low- and middle-income countries like India. Materials and Methods A prospective observational study of 137 newly diagnosed children with cancer aged less than 18 years was planned. Nutritional assessment was done using dual-energy X-ray absorptiometry (DXA), anthropometry, and serum albumin. Patients were followed for 3 months for assessment of treatment-related morbidity. Results Lean body mass (LBM; DXA), mid-upper arm circumference (MUAC), and body mass index detected undernutrition in 44, 45, and 14% patients, respectively. Combination of arm anthropometry (MUAC and triceps skinfold thickness) with serum albumin categorized patients as adequately nourished (32%), moderately depleted (18%), and severely depleted (49%). Patients with hematological malignancy had a higher prevalence of undernutrition but there was no difference in morbidities between the undernourished and adequately nourished children by any parameter. Hypoalbuminemia observed in 25% patients was associated with significant chemotherapy delays ( p , 0.01) and interval admissions ( p , 0.03). Using LBM as a criterion, linear regression analysis revealed MUAC ( R 2 = 0.681) as the best predictor of undernutrition with lowest standard error. Conclusion Our study reports undernutrition among two-fifths of newly diagnosed patients of childhood cancer associated with high prevalence of sarcopenia and adiposity. These findings are of utmost clinical relevance in planning interventional strategies.

Dual-Energy X-Ray Absorptiometry and Anthropometry for Assessment of Nutritional Status at Diagnosis in Children with Cancer: A Single-Center Experience from India

Background The survival of children with cancer has improved owing to advances in chemotherapy and better supportive care, and nutritional support is an important component of the latter especially in low- and middle-income countries like India. Materials and Methods A prospective observational study of 137 newly diagnosed children with cancer aged less than 18 years was planned. Nutritional assessment was done using dual-energy X-ray absorptiometry (DXA), anthropometry, and serum albumin. Patients were followed for 3 months for assessment of treatment-related morbidity. Results Lean body mass (LBM; DXA), mid-upper arm circumference (MUAC), and body mass index detected undernutrition in 44, 45, and 14% patients, respectively. Combination of arm anthropometry (MUAC and triceps skinfold thickness) with serum albumin categorized patients as adequately nourished (32%), moderately depleted (18%), and severely depleted (49%). Patients with hematological malignancy had a higher prevalence of undernutrition but there was no difference in morbidities between the undernourished and adequately nourished children by any parameter. Hypoalbuminemia observed in 25% patients was associated with significant chemotherapy delays (p, 0.01) and interval admissions (p, 0.03). Using LBM as a criterion, linear regression analysis revealed MUAC (R 2 = 0.681) as the best predictor of undernutrition with lowest standard error. Conclusion Our study reports undernutrition among two-fifths of newly diagnosed patients of childhood cancer associated with high prevalence of sarcopenia and adiposity. These findings are of utmost clinical relevance in planning interventional strategies.

Assessment of Body Composition among the Sabar Preschool Children of Purulia districts, West Bengal, India

There is scanty information on body composition characteristics among preschool children from underprivileged communities of India. Therefore, the present cross-sectional study was designed to assess the body composition characteristics among Sabar preschool children aged 1-5 years. The present study was conducted at six different villages of three blocks under Purulia district, West Bengal, India. The subjects were randomly selected from house-to-house visit from studied villages. Significant age variations were noticed in mean height, weight, and Body mass index (BMI) among both sexes. Boys showed significant age variation in mean triceps skinfold thickness (TRISKF), whereas the girls showed significant age variation in mean Mid-upper arm circumference. Maximum significant age variation was observed in mean height (Boys: F = 52.36, P &lt; 0.001; Girls: F = 49.78, P &lt; 0.001), and minimum significant age variation was noticed in mean TRISKF among boys (F = 3.78, P &lt; 0.05) and in mean BMI (F = 5.13, P &lt; 0.05). Age-combined mean values of percent body fat (PBF) and fat mass (FM) were significantly higher among girls (20.39% and 2.36 kg) than boys (16.17% and1.84 kg). The Pearson correlation coefficients (r) showed that body composition measurers were significantly correlated with the majority of variables among these children. In conclusion, the results revealed that PBF, FM, and fat-free mass were good indicators to measure the degree of fat deposition, which could be used as a nutritional indicator in terms of leanness.

The association between skinfold thicknesses and estimated glomerular filtration rate in adolescents: a cross-sectional study

BackgroundObesity is one of the causes of glomerular hyperfiltration. Studies on the relationship between body fat content and glomerular hyperfiltration have been limited to special children. Therefore, we aimed to evaluate the correlation between skinfold thickness, which represents body fat content, and estimated glomerular filtration rate (eGFR).MethodsThe cross-sectional study included 6655 participants (3532 boys and 3123 girls; age: 12 − 17.99 years); data was obtained from the National Health and Nutrition Examination Survey (NHANES; 2001–2010). The independent variables were subscapular skinfold thickness and triceps skinfold thickness. The dependent variable was eGFR. We used multivariate linear regression models to evaluate their associations and also performed subgroup analyses.ResultsAfter adjusting for age, standing height, race, family income, blood urea nitrogen and uric acid variables, multivariate regression analysis identified that triceps skinfold thickness and subscapular skinfold thickness were positively correlated with eGFR and glomerular hyperfiltration in boys. In subgroup analyses stratified by age and body mass index, triceps skinfold thickness was also associated with glomerular hyperfiltration in boys. There was a linear relationship between triceps skinfold thickness and eGFR in boys (β = 0.389, P < 0.001) and girls (β = 0.159, P = 0.0003).ConclusionsTriceps skinfold thickness and subscapular skinfold thickness are positively correlated with eGFR and glomerular hyperfiltration in US male adolescents. In all adolescents, there is a linear relationship between triceps skinfold thickness and eGFR.

EVALUATING THE IMPACT OF EARLY NUTRITIONAL ASSESSMENT AND INTERVENTION IN HOSPITALIZED LIVER CIRRHOSIS PATIENTS.

Malnutrition is common in liver cirrhosis patients that is correlated with early complications, morbidity and mortality. The purpose of the study was to assess nutritional status, impact of nutritional screening and intervention in liver cirrhosis patients by evaluating their actual energy and protein intake during hospital stay. A cross sectional study was conducted wherein all patients' nutritional status was defined by Subjective Global Assessment tool. Adequate energy and protein supply were planned and executed by using individualized nutritional plan for patients with dietitian's collaboration. Anthropometric measurements included height, weight, body mass index, mid upper arm circumference, hand grip strength and triceps skin-fold thickness. Biochemical tests included haemoglobin, mean corpuscular haemoglobin, volume and concentration, albumin and liver function tests. To record the daily food intake, a 24-hour dietary recall was used. Overall 83 patients (mean age 55) were included, among them 46% of patients were moderately malnourished, 12% were normal, while 42% of cirrhotic patients were severely depleted according to Subjective Global Assessment. The mean intake of calories and protein was improved during stay in hospital after nutritional intervention and critical monitoring (P<0.05). Anthropometric measurements at baseline and discharge showed significant differences (P <0.05) in weight, body mass index, triceps skin fold thickness and mid upper arm circumference values, but not in hand grip strength that was associated with malnourishment among patients. Providing individualized nutritional intervention and its monitoring by qualified dietitians during hospital stay helps to improve intake in patients that prevent further risk of malnutrition and related complications.

Assessment of Severity of Liver Cirrhosis and Nutritional status of Cirrhotic patients in Tribhuvan University Teaching Hospital, Kathmandu

Malnutrition is common in chronic liver disease. The general objective of this study was to assess severity and nutritional status of cirrhotic patients in Tribhuvan University Teaching Hospital (TUTH). A cross-sectional study was carried out among 88 cirrhotic patients of age group of ≥18 years. Information regarding general profile of patient, Child Turcotte Pugh score (CTP), Model for End Stage Liver Diseases-Na Score ( MELD-Na), Subjective Global Assessment (SGA), Mid Arm Circumference (MAC), Triceps Skin Fold Thickness (TST), Mid Arm Muscle Circumference (MAMC) and Functional Assessment: Handgrip Strength (HGS) was collected. SPSS version 20 was used to analyse data. Majority (56.8%) belonged to CTP grade C, 31.8% belonged to CTP grade B and 11.4% patients belonged to CTP grade A. Majority, 72.7%, 71.6% and 65.9% were malnourished when assessed using SGA, TST and MAC respectively. Majority, 86.4% of the patients had impaired handgrip strength. SGA, TST, MAC and HGS were significantly associated with CTP whereas no any statistically significant association was found between Child-Pugh and MAMC. There was statistically significant difference among the MELD Na means among SGA and HGS classes. The mean MELD Na scores did not significantly differ between among the TST, MAC and MAMC classes. The early diagnosis of the nutritional state and the treatment of malnutrition in cirrhotic patients can contribute to a reduction in the frequency and/or severity of these complications. SGA, TST, MAC and HGS are the non-invasive and easy methods of nutritional assessment of cirrhotic patients to use in regular clinical practice at bed side.

A prospective cohort study on the association of lean body mass estimated by mid-upper arm muscle circumference with hypertension risk in Chinese residents.

The associations of lean body mass (LBM) with elevated blood pressure (BP) and hypertension were controversial, and the causalities have never been shown. Mid‐upper arm muscle circumference (MAMC), an easily obtained anthropometric measurement, could provide an accurate estimate for LBM. Therefore, a prospective cohort study in general Chinese residents aiming to find out the relationship between LBM estimated using MAMC and hypertension risk was performed. Eight thousand one hundred eighty‐five eligible participants were included in the baseline analysis, among whom 3442 were subsequently selected into cohort analysis. MAMC was calculated using mid‐upper arm circumference (MUAC) and triceps skinfold thickness (TST). Associations of MAMC with BP values and hypertension prevalence were estimated by linear and logistic regression models. Associations with hypertension incidence were estimated by COX regression models, hazard ratio (HR) and 95% confidence interval (CI) were given. Nonlinear relationship between MAMC and hypertension risk was estimated using restricted cubic spline method. Standardized coefficients of MUAC and TST were compared to estimate their strengths of associations with hypertension. Baseline analysis showed that after adjusted for confounders, the increase of systolic BP per standard deviation (SD) of MAMC were 1.97 mmHg (95%CI: 1.46, 2.48) and 1.63 mmHg (95%CI: 1.10, 2.16) respectively in men and women, and the increases of diastolic BP per SD were 1.58 mmHg (95%CI: 1.23, 1.92) and 1.08 mmHg (95%CI: 0.74, 1.42). Additionally, the association of MAMC with the prevalence of hypertension were also found in both men and women (OR = 1.36, 95%CI: 1.26, 1.47 in men; OR = 1.33, 95%CI: 1.22, 1.44 in women). Cohort analysis showed that MAMC increased the risk of hypertension (HR = 1.10, 95%CI: 1.01, 1.19 for men; HR = 1.15, 95%CI: 1.06, 1.26 for women), and a trend of J‐shaped relationship was found. Additionally, the stronger associations of MUAC with both BP values and hypertension than that of TST were found in both baseline and cohort analyses. Findings in our study implied that we cannot neglect the capacity of LBM in predicting hypertension risk, and LBM estimates should be recommended in general health surveys or examinations.

A high neutrophil to lymphocyte ratio is associated with poor nutritional status in chronic kidney disease patients.

We aimed to investigate the relationship between the neutrophil to lymphocyte ratio (NLR) and nutritional parameters in chronic kidney disease (CKD) patients. In this cross-sectional study, 187 non-dialysis CKD patients were enrolled. Daily dietary energy intake (DEI) and daily dietary protein intake (DPI) were assessed by 3-d dietary records. Protein-energy wasting (PEW) was defined as Subjective Global Assessment (SGA) class B and C. Spearman correlation analysis, logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed. The median NLR was 2·51 (1·83, 3·83). Patients with CKD stage 5 had the highest NLR level. A total of 19·3 % (n 36) of patients suffered from PEW. The NLR was positively correlated with SGA and serum P, and the NLR was negatively correlated with BMI, waist and hip circumference, triceps skinfold thickness, mid-arm muscle circumference, DPI and Hb. Multivariate logistic regression analysis adjusted for DPI, DEI, serum creatinine, blood urea nitrogen, uric acid and Hb showed that a high NLR was an independent risk factor for PEW (OR = 1·393, 95 % CI 1·078, 1·800, P = 0·011). ROC analysis showed that an NLR ≥ 2·62 had the ability to identify PEW among CKD patients, with a sensitivity of 77·8 %, a specificity of 62·3 % and an AUC of 0·71 (95 % CI 0·63, 0·81, P < 0·001). The NLR was closely associated with nutritional status. NLR may be an indicator of PEW in CKD patients.

Homemade blenderized Ryles tube formula is equally efficient as commercial formula in terms of anthropometric and biochemical measurements in tertiary care neurologic intensive care unit: A single center study

Objectives: In Indian intensive care units (ICUs), malnutrition is a leading cause of death and morbidity. There is a scarcity of information on the state of malnutrition in India and the efficacy of homemade Ryle’s tube formula in neurologic cases as compared to commercial formula feed. The goals of the present study were to evaluate the nutritional status of neurological disorder patients, to prepare a home-based feed using locally available cereal and pulse combinations, and to investigate the impact of two different Ryes tube formulas on nutritional status. Material and Methods: A prospective, randomized comparative study was conducted in the neurological ICU of a tertiary care medical college hospital located in rural Telangana. Group A was given commercial formula, while Group B was given homemade Ryle’s tube formula, which was calorically equivalent to commercial formula. The Harris-Benedict equation was used to determine the patients’ caloric requirements. During hospital stay, both groups received a comparable amount of Ryle’s tube feeding. The impact of two different formulations was evaluated using quantitative indices including weight, body mass index, triceps skinfold thickness, and serum albumin over a period of 2 weeks. The standard deviation and mean were determined. The researchers used a paired t-test with a two-tailed distribution. If the P &lt; 0.05, it was considered significant. For data processing, open-source software open Epi 2007 was used. Results: In both classes, thirty patients were enrolled. On admission, the demographic profiles of both groups were identical, as evidenced by non-significant P-values. According to the sample parameters, there was no substantial difference between the two formulas at the end of the study period. Both formulas were equally efficacious for the nutritional assessment parameters during the study period. Conclusion: On initial admission, malnutrition was uncommon in the neurologic ICU. In terms of study parameters, both formulas were equally efficient. The homemade blenderized formula was 50% less expensive than commercial formula, making it an important nutritional supplementation option for the deprived strata of the population.

Homemade blenderized Ryles tube formula is equally efficient as commercial formula in terms of anthropometric and biochemical measurements in tertiary care neurologic intensive care unit: A single center study

OBJECTIVES:In Indian intensive care units (ICUs), malnutrition is a leading cause of death and morbidity. There is a scarcity of information on the state of malnutrition in India and the efficacy of homemade Ryle’s tube formula in neurologic cases as compared to commercial formula feed. The goals of the present study were to evaluate the nutritional status of neurological disorder patients, to prepare a home-based feed using locally available cereal and pulse combinations, and to investigate the impact of two different Ryes tube formulas on nutritional status.MATERIAL AND METHODS:A prospective, randomized comparative study was conducted in the neurological ICU of a tertiary care medical college hospital located in rural Telangana. Group A was given commercial formula, while Group B was given homemade Ryle’s tube formula, which was calorically equivalent to commercial formula. The Harris-Benedict equation was used to determine the patients’ caloric requirements. During hospital stay, both groups received a comparable amount of Ryle’s tube feeding. The impact of two different formulations was evaluated using quantitative indices including weight, body mass index, triceps skinfold thickness, and serum albumin over a period of 2 weeks. The standard deviation and mean were determined. The researchers used a paired t-test with a two-tailed distribution. If the P &lt; 0.05, it was considered significant. For data processing, open-source software open Epi 2007 was used.RESULTS:In both classes, thirty patients were enrolled. On admission, the demographic profiles of both groups were identical, as evidenced by non-significant P-values. According to the sample parameters, there was no substantial difference between the two formulas at the end of the study period. Both formulas were equally efficacious for the nutritional assessment parameters during the study period.CONCLUSION:On initial admission, malnutrition was uncommon in the neurologic ICU. In terms of study parameters, both formulas were equally efficient. The homemade blenderized formula was 50% less expensive than commercial formula, making it an important nutritional supplementation option for the deprived strata of the population.

Anthropometric Measurements to Predict NICU Admission for Infants of Diabetic Mothers

Aim: Can NICU admission of IDM be predicted by anthropometric measurements like birth weight, lenght, head circumference (HC), mid upper arm circumference (MUAC) or triceps skin fold thickness (TSFT). Method: Eighty-six-term IDMs were analyzed prospectively. MUAC, HC and TSFT were measured within 48 hours of life. Prenatal-natal-postnatal problems; NICU admission; maternal characteristics, HbA1c were recorded. Results: Mean birth weight, gestational age were 3453.3±582.4g and 38.0±0.97weeks. 63.9% of IDMs was admitted to NICU. 56.3% hospitalized due respiratory problems; 32,7 % required endotracheal intubation. Mean MUAC, TSFT, HC and MUAC/HC ratio were 11.2±1.1 cm, 7.1±2.2 mm, 35.0±1.8 cm and 0.32±0.03 cm respectively for all. Although there was no significant relation between NICU admission and MUAC (p=0.071), TSFT and MUAC/HC were significantly higher in babies admitted to NICU (p=0.006 for TSFT, p&lt;0.001 for MUAC/HC). HC was significantly low in babies followed in NICU (P&lt;0.001). With increment of TSFT, MUAC/HC and HbA1c, NICU admission increases positively, but HC affects NICU admission negatively (OR for TSFT:1.6, OR for MUAC/HC: 2.1, OR for HbA1c: OR for HC:0,3). Mechanic ventilation requirement is affected positively by TSFT (p=0.008, OR:1.5) and affected negatively by HC (p=0.004, OR:0.6). Conclusion: This preliminary study showed; TSFT, HC and MUAC/HC ratio are helpful criterias to predict NICU admission risk for IDMs and might be helpful for risk assesment in limited settings. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 72-78

Maternal anthropometric measurements and correlation to maternal and fetal outcomes in late pregnancy.

Background:Body mass index does not distinguish between lean and fat body mass; therefore, its utility defining body composition is limited in pregnancy. Anthropometric measurements may better represent variation in body composition among women who are overweight or obese. We sought to examine body fat composition using maternal anthropometric measurements in late pregnancy and correlate with mode of delivery.Methods:A prospective study of pregnant patients who were overweight (body mass index: 25–29.9 kg/m2) or obese (body mass index ⩾ 30 kg/m2) with singleton pregnancies who underwent anthropometric measurements between 27 weeks, 0 days to 34 weeks, 6 days gestation. Maternal skinfold thicknesses from eight sites were used to estimate body fat mass. Correlation of skinfold thickness, anthroprometric measurements, and estimated body fat percentage on mode of delivery were analyzed with p < .05 as significant.Results:A total of 41 women with overweight (34.1%) or obese (65.9%) body habitus were included. Mean age was 29.9 years, and the majority (43.9%) were Black and 31.7% identified Hispanic/Latinx. The average gestational age at recruitment was 30 weeks, 2 days and 38 weeks, 6 days at delivery. A greater weight at recruitment (94.2 vs 81.8 kg, p = .023), waist circumference (47.1 vs 43.5 inches, p = .010), Huston–Presley body fat percentage (36.4% vs 31.8%, p = .030), triceps skinfold thickness (20.1 vs 15.7 mm, p = .030), biceps skinfold thickness (18.6 vs 15.0 mm, p = .042), and skinfold thickness, as well as sum of skinfold sites (83.3 vs 68.8 mm, p = .049) were associated with cesarean delivery compared to vaginal delivery on univariate analysis.Conclusion:Third-trimester anthropometric measurements may help predict increased risk for c-section in women with obesity. Further research may elucidate utility in nutritional counseling and delivery planning.

Nutritional assessment with skinfold thickness and body- fat proportion in tribal and urban schoolchildren in Nashik district: A cross sectional study.

ABSTRACTContext:Skinfold thickness (SFT) and body-fat (BF%) are infrequently used for childhood undernutrition.Aims:(a) Estimation of SFT at peripheral and truncal sites (b) Estimation of BF% from SFTs (c) Correlate SFT estimates with MUAC, BMI and Waist. (d) Compare rural/tribal SFTs with urban schoolchildren.Settings and Design:Ashram schools in rural/tribal settings and one urban school.Methods and Material:Using three stage sampling, four tribal schools were randomly selected and an urban school was added for comparison. A sub sample of 405 students in the age group of 7 to 15 years were included. Height, weight, MUAC and SFTs were measured BF% was estimated with Slaughter equation.Statistical Analysis:Using Excel, Epi Info 7.1 and R software, appropriate t tests were applied for comparisons, and correlation was estimated between the quantitative variables.Results:Average SFT among schoolchildren (405) was 6.64 mm. Girls (n = 215) had a BF% of 13.1%, while boys (n = 190) had BF at 11.5%. Average SFT for boys (6.69) and girls (6.48) had no statistically significant difference (t = 1.3, P = 0.1929). Boys had higher average peripheral SFT than truncal SFT while girls had higher truncal SFTs. In girls subscapular SFT was higher than triceps SFT. Median BF% in rural was lower than urban schoolchildren. BF% correlated strongly with BMI (0.56), Waist (0.63), Hip (0.61) and MUAC (0.59).Conclusion:SFT and BF % can be effectively used to detect undernutrition. Geographical and Gender differences are observed. SFT and BF% correlated well with BMI and MUAC.

Anthropometric indicators of body fat as discriminators of low levels of cardiorespiratory fitness in adolescents

PurposeTo evaluate the discriminatory power of anthropometric indicators of body fat (BF) for identifying low levels of cardiorespiratory fitness, as well as the association between cutoff points and low levels of cardiorespiratory fitness in adolescents. Design and methodsThis is a cross-sectional study involving 1132 students (age 14–19 years). The following anthropometric variables were measured according to international standards: body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), triceps skinfold thickness (TR), subscapular skinfold (SS), suprailiac skinfold (SI), sum of triceps and subscapular skinfolds (∑TR + SS), and sum of triceps, subscapular and suprailiac skinfolds (∑TR + SS + SI). The BF percentage was calculated using the equations of Lohman (1986) (%FL), Slaughter et al. (1988) (%FS), and Boileau et al. (1985) (%FB). ResultsExcept for TR, WC, WHtR and BMI, boys with values for the other anthropometric indicators (SS, SI, ∑TR + SS, ∑TR + SS + SI, %FL, %FS, %FB) above the cutoff point were more likely to have low levels of cardiorespiratory fitness. Girls with values for TR, ∑TR + SS, %FB and %FL above the cutoff points were more likely to have low levels of cardiorespiratory fitness. ConclusionsAnthropometric indicators had discriminatory power to identify low levels of cardiorespiratory fitness. Practice implicationsThe reported anthropometric indicators, indexes and equations can be used by healthcare professionals in clinical practice and by school teachers as a simple, fast and inexpensive alternative to identify low levels of cardiorespiratory fitness.

Triceps skinfold thickness and body mass index and the risk of gestational diabetes mellitus: Evidence from a multigenerational cohort study

BackgroundPre-pregnancy obesity is a well-recognized risk factor for gestational diabetes mellitus (GDM). There is a continuity of obesity from childhood to adolescence and then adulthood. However, it is unknown whether early childhood obesity predicts GDM. MethodsWe investigated the prospective association of childhood triceps skinfold thickness and body mass index (BMI) with GDM risk among women from the Mater-University of Queensland Study of Pregnancy (MUSP), a multigenerational cohort study. A multiple logistic regression model was applied to estimate the odds of experiencing GDM by childhood skinfold thickness and BMI. ResultsOut of 552 women in the study for whom data were available on triceps skinfold thickness and BMI at average age 5 (range 3–7) years old, 52 (9.42%) developed GDM by average age 30 (range 28–33) years. We found that the risk of developing GDM was greater among women who had greater skinfold thickness but not greater BMI at age 5 years. Women who were classified as overweight or obese based on skinfold thickness at age 5 years had an increased odds ratio of GDM compared to women who had normal skinfold thickness. This association remained significant after adjustment for the potential confounders (OR 2.74; 95% confidence interval=1.28–5.86). ConclusionThe risk of developing GDM was associated with higher skinfold thickness at age 5 years.

ОСОБЕННОСТИ НУТРИТИВНОГО СТАТУСА У ДЕТЕЙ СО СПАСТИЧЕСКИМИ ФОРМАМИ ДЕТСКОГО ЦЕРЕБРАЛЬНОГО ПАРАЛИЧА

Children with spastic cerebral palsy (CP) are at risk of undernutrition, which increases with the severity of movement disorders. Objective of the study: to assess and compare anthropometric indicators and body composition in children with cerebral palsy, depending on the level of impairment of gross motor function classification system (GMFCS). Materials and methods of research: 102 children were included in a prospective open-label comparative single-center non-randomized study: 58 (56.8%) boys and 44 (43.1%) girls with cerebral palsy aged 2 years to 16 years and 9 months who were undergoing rehabilitation in the National Medical Research Center of Children's Health in the period from 2019 to 2021. Anthropometric measurements (body weight, length, knee height, triceps and subscapular skinfold thicknesses) were performed on admission. Body fat percentage (%FM) was calculated by CP-modified (Gurka) equations and compared with results obtained using bioelectrical impedance analysis. A survey on the EDACS scale was performed to determine the ability to eat and drink. Results: patients were divided into 2 groups: the main group – 53 children (52%) with GMFCS levels IV–V and a comparison group – 49 children (48%) with GMFCS levels I–III. The groups did not differ statistically significantly in terms of gender (p=0.956) and age (p=0.207). The median age in the main group was 7.1 years, in the comparison group – 5.3 years. Children of the main group had statistically significantly lower growth indicators (HAZ1 –1.5 [–2.6; –0.74] and HAZ2 –0.58 [–1.59; 0.44], p=0.003), BMI (BAZ1 –2.43 [–3.67; –0.93]; BAZ2 –0.91 [–1.942; 0.28], p&lt;0.001), higher frequency of oromotor dysfunction (42% and 4%, p&lt; 0.001), the percentage of severe wasting (59% and 16%, p&lt;0.001; OR 7.2 (95% CI 2.8–18.4) (p&lt;0.001). There was no significant difference in %FM between children of main and comparison groups. Patients even with moderate and severe undernutrition according to WHO criteria had normal or excess %FM. A moderate positive correlation was found between %FM calculated using the Gurka equations and those obtained by bioelectrical impedance analysis (r=0.565, p=0.002). Conclusions: anthropometric indicators in children with CP deteriorate with an increase in the degree of neurological deficit. The use of BMI as the only marker of nutritional status is insufficient to properly diagnose of undernutrition and identify patients needed in nutritional interventions. For an adequate analysis of the nutritional status of children with CP, it is necessary to assess the body composition (measurement of the skinfold thicknesses or bioelectrical impedance analysis).

Growth patterns of uninfected children born to women living with perinatally versus nonperinatally acquired HIV.

The aim of this study was to compare long-term growth between HIV-exposed uninfected children (CHEU) born to women with perinatally acquired HIV (CHEU-PHIV) and CHEU born to women with nonperinatally acquired HIV (CHEU-NPHIV). A longitudinal analysis of anthropometric measurements from a U.S.-based multisite prospective cohort study enrolling CHEU and their mothers since April 2007. CHEU were evaluated for growth annually from birth through age 5 and again at age 7 years. Z-scores were calculated using U.S. growth references for weight (WTZ), height (HTZ), and weight-for-length or BMI-for-age (WLZ/BMIZ). Mid-upper arm circumference (MUACZ) and triceps skinfold thickness (TSFZ) Z-scores were obtained from ages 1 and 2, respectively, through age 7 years. Piecewise mixed-effects models, overall and stratified by race and sex, were fit to assess differential growth patterns across age by maternal PHIV status. One thousand four hundred fifty-four singleton infants (286 CHEU-PHIV and 1168 CHEU-NPHIV) were included. CHEU-PHIV had slower growth rates than CHEU-NPHIV for WTZ and WLZ/BMIZ at earlier ages and continued to have lower mean WTZ [-0.27, 95% confidence interval (95% CI): -0.50, -0.04] and WLZ/BMIZ (-0.39, 95% CI: -0.67, -0.11) through age 7. Among non-Black boys, CHEU-PHIV had slightly lower WTZ and WLZ/BMIZ at birth than CHEU-NPHIV and these growth deficits persisted through age 7 years. Compared with CHEU-NPHIV, CHEU-PHIV had diminished growth in early childhood with differences most pronounced among non-Black male children. Further longitudinal follow-up of CHEU-PHIV into young adulthood is needed to understand whether these early effects of maternal PHIV status on growth persist and have other health consequences.