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

Abstract

Background Body mass index (BMI) remains the most used indicator of nutritional status despite the presence of a potentially credible alternative. Mid-upper arm circumference (MUAC) is an anthropometric measure that requires simple equipment and minimal training. The aim of this study was to compare MUAC with BMI and propose a MUAC cut-off point corresponding to a BMI of < 18.5 kg/m2 (underweight) and ≥ 30.0 kg/m2 (obesity) among Sudanese adults. Methods A cross-sectional study using multistage cluster sampling was conducted in New-Halfa, eastern Sudan. Participants’ age and sex were recorded and their MUAC, weight and height were measured using the standard procedures. The MUAC (cm) cut-offs corresponding to < 18.5 kg/m2 and ≥ 30.0 kg/m2 were calculated and determined using receiver operating characteristic (ROC) curve analysis Results Five hundreds and fifty-two adults were enrolled in the study. The median (interquartile range, IQR) of the participants age was 31.0 (24.0 ̶ 40.0) years and 331 (60.0%) of them were females. The medians (IQR) of BMI and MUAC were 22.4 (19.1 ̶ 26.3) kg/m2 and 25.0 (23.0 ̶ 28.0) cm, respectively. There was a significant positive correlation between MUAC and BMI (r = 0.673, p < 0.001). Of the 552 enrolled participants, 104 (18.8%), 282 (51.1%), 89 (16.1%) and 77 (13.9%) were normal weight, underweight, overweight and obese, respectively. Best statistically derived MUAC cut-off corresponding to a BMI < 18.5 kg/m2 (underweight) was ≤ 25.5 cm in both males and females (Youden’s Index, YI = 0.51; sensitivity = 96.0%; specificity = 54.0%), with a good predictive value (AUROCC = 0.82). Best statistically derived MUAC cut-off corresponding to a BMI ≥ 30.0 kg/m2 (obesity) was ≥ 29.5 cm in both males and females (YI = 0.62, sensitivity = 70.3%, specificity = 92.0%), with a good predictive value (AUROCC = 0.86, 95.0% CI = 0.76 – 0.95). Conclusion The results suggest that the cut-offs based on MUAC can be used for community-based screening of underweight and obesity

Transferrin levels are associated with malnutrition markers in hemodialysis patients in KwaZulu-Natal, South Africa

“…Musa et al. [ 37 ] conducted a study in Sudan and reported that 51.1% of arm circumferences in both genders were malnourished using a MUAC cutoff of 25.5 cm for both genders with a BMI of less than 18.5 kg/m 2 [ 37 ]. Further studies conducted with children concluded that edema might increase a limb’s circumference, but it is not usually a problem of the upper arm [ 38 ].…”

Associations between Neck Circumference, Mid-Upper Arm Circumference, Wrist Circumference, and High Blood Pressure among Lithuanian Children and Adolescents: A Cross-Sectional Study

“…MUAC stands out as a cost-effective, quick, non-invasive, and easily measurable anthropometric index [ 60 ], and it can be employed in research studies to identify individuals with central obesity and insulin resistance in type 2 diabetes [ 61 ]. In comparison to the BMI method, MUAC presents clear benefits, particularly in its straightforward measurement without requiring mathematical derivation [ 62 ]. In an observational multinational cross-sectional study including 9–11-year-old children from 12 countries, MUAC was demonstrated as an alternative screening measure for obesity [ 63 ].…”

Development and Validation of Estimation Equations for Appendicular Skeletal Muscle Mass in Chinese Community-Dwelling Older Adults

“…The subjects were instructed to expose the non-dominant side of their body and relax their arm. The circumference of the midpoint between the acromion and olecranon of the arm 30 was measured in centimeters (cm) with a precision of 0.1, and the average of the two measurements was used as the final result in this study.…”