High Prevalence of Overweight and Its Association with Mid-Upper Arm Circumference among Female and Male Farmers in Tanzania and Mozambique

Abstract

The increasing prevalence of overweight/obesity may already have reached the farmers in Tanzania and Mozambique. Here, the measurement of the mid-upper-arm-circumference (MUAC) could become a simple and sensitive tool for early detection of at-risk groups of overweight as well as underweight. Body Mass Index (BMI) and MUAC of female and male farmers (n = 2106) from different regions of Tanzania and the Zambézia province, Mozambique, were analyzed by region, sex, age, and correlates. MUAC cut-offs, calculated via BMI cut-offs (<18.5, ≥25, and ≥30 kg/m2), and multiple linear regression (MLR), compared to those selected by highest Youden’s index (YI) value, were assessed. The study showed an overall higher prevalence of overweight (19%) than underweight (10%) due to the high number of overweight female farmers (up to 35%) in southern Tanzania. BMI, which was mainly and positively predicted by MUAC, was higher in Tanzania and among female farmers, and decreased significantly from the age of ≥65 years. MUAC cut-offs of <24 cm and ≥30.5 cm, calculated by MLR, detected 55% of farmers being underweight and 74% being overweight, with a specificity of 96%; the higher cut-off <25 cm and lower cut-off ≥29 cm, each selected according to YI, consequently detected more underweight (80%) and overweight farmers (91%), but on the basis of a lower specificity (87–88%). Overweight was evident among female farmers in East Africa. MUAC cut-offs, whether defined via linear regression or Youden’s Index, could prove to be easy-to-use tools for large-scale screenings of both underweight and overweight.

Mid upper arm circumference as screening tool of overweight or obesity among adult employees of Mizan Tepi University, Southwest Ethiopia

“…Similarly, MUAC has good discriminatory ability with an AUC of 0.83 for overweight and obesity among females. These findings are supported by previous studies conducted in China, India, Japan, Tanzania and Mozambique, South Africa, and Juba which revealed that MUAC is an effective alternative tool to predict overweight or obesity among the adult population [ 34 , 35 , 47 , 49 , 50 , 51 ]. The study conducted in Japan stated that MUAC is a cheap and easily measurable tool to assess overweight or obesity than BMI [ 51 ].…”

“…Our study revealed that MAUC has a strong positive correlation with BMI, which is indicative of MUAC screening capacity for overweight and obesity in adults. Previous similar studies affirmed that MUAC has a strong positive correlation with BMI [ 21 , 28 , 32 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. This strong positive correlation between MUAC and BMI suggests that these indices could give us comparable measurements while being utilized to assess the nutritional status of the adult population.…”

Anthropometrics, Hemoglobin Status and Dietary Micronutrient Intake among Tanzanian and Mozambican Pigeon Pea Farmers

“…Body mass index (BMI) was calculated from weight and height measured at admission; cut-offs for underweight (<18.5 kg/m 2 ), overweight (≥25 kg/m 2 ) and obesity (≥30 kg/m 2 ) were used according to WHO and FANTA instructions [ 25 , 26 ]. MUAC cut-offs demonstrating underweight at <24 cm, overweight at ≥30 cm and obesity at ≥33.5 cm were set based on suggestions from recent studies [ 27 , 28 ].…”

“…Differences between individual groups were assessed by the Kruskal–Wallis and pairwise multiple comparison tests or the Chi Square test as appropriate (all p values are <0.001 for general group comparisons); values within a row not sharing a common superscript letter ( a,b,c,d ) are significantly different at p < 0.05. MUAC cut-off <24 cm for underweight [ 28 ], ≥30 cm for overweight and ≥33.5 cm for obesity [ 27 ]. Anemia is defined as hemoglobin <120 g/L for non-pregnant and <110 g/L for pregnant women and <130 g/L for men [ 29 ].…”

Mid-upper arm circumference as a substitute for body mass index in the assessment of nutritional status among adults in eastern Sudan

“…The simplicity of MUAC measurement means it does not require mathematical derivation [ 11 ], frontline professionals or expensive equipment compared to the requirements for measuring BMI [ 11 ]. MUAC is a practical tool for screening and grading the severity of nutritional status problems in the general population [ 12 , 13 ] and it has demonstrated superiority over BMI [ 6 ]. Moreover, previous studies have reported a positive correlation between MUAC and BMI [ 11 , 14 ].…”