Performance of mid-upper arm circumference as a screening tool for identifying adolescents with overweight and obesity

Sisay, Binyam Girma; Haile, Demewoz; Hassen, Hamid Yimam; Gebreyesus, Seifu Hagos

doi:10.1371/journal.pone.0235063

Cited by 23 publications

(25 citation statements)

References 27 publications

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“…Lower cut-offs for overweight of 27.7 and 27.9 cm were also identified for male and female adolescents (15-19 years) living in Addis Ababa, Ethiopia [38]; this suggests that MUAC could be influenced by factors such as age, and thus appropriate cut-offs for specific age groups such as adolescents and the elderly should be evaluated. Furthermore, MUAC itself can be considered a valuable additional and independent marker for assessing nutritional status, rather than just a simpler method and substitute of the BMI.…”

Section: Discussionmentioning

confidence: 93%

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

Eleraky¹,

Issa²,

Maciel³

et al. 2021

IJERPH

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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.

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Section: Discussionmentioning

confidence: 93%

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

Eleraky¹,

Issa²,

Maciel³

et al. 2021

IJERPH

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“…Even though BMI is highly correlated with excess adiposity, it misclassifies a significant number of children and adolescents (9) . Except for one (20) , none of the included studies reported the time interval between performing the index test and reference standard. However, it is unlikely that any time delay between conducting the index test and the reference standard would introduce bias.…”

Section: Risk Of Bias and Publication Biasmentioning

confidence: 99%

“…The mid-upper arm circumference (MUAC) has been proposed as one such alternative to screen for overweight and obesity in children and adolescents (17)(18)(19)(20) . It is a simple measure commonly used to screen for undernutrition in infants and children aged 6-59 months (21) as well as thinness and severe thinness in adolescents (22,23) .The existing evidence of the usefulness of the MUAC against the BMI Z-score among children and adolescents is limited and unclear (17)(18)(19)(20)(24)(25)(26) . Therefore, this systematic review and meta-analysis aim to summarise the currently available evidence on the performance of MUAC to identify children and adolescents with overweight and obesity.…”

mentioning

confidence: 99%

The performance of mid-upper arm circumference for identifying children and adolescents with overweight and obesity: a systematic review and meta-analysis

Sisay

Hassen

Jima

et al. 2022

Public Health Nutr.

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Objective: This study aimed to synthesize the existing evidence on the performance of Mid-Upper Arm Circumference (MUAC) to identify children and adolescents with overweight and obesity. Design: Systematic review and meta-analysis. Setting: We searched PubMed, EMBASE, SCOPUS, Cochrane Library, Web of Science, CINAHL, and Google scholar databases from their inception to December 10, 2021, for relevant studies. There were no restrictions regarding the language of publication. Studies reporting measures for the diagnostic performance of MUAC compared to a reference standard for diagnosing overweight and obesity in children and adolescents aged 2 to 19 years were included. Participants: A total of 54,381 children and adolescents from twenty-one studies were reviewed; 10 studies contributed to meta-analyses. Results: In Boys, MUAC showed a pooled Area Under the Curve (AUC) of 0.92 (95% CI 0.89 - 0.94), sensitivity of 84.4 (95% CI 84.6-.90.8), and a specificity of 86.0 (95% CI 79.2-90.8), when compared against BMI z-score, defined overweight and obesity. As for girls, MUAC showed a pooled AUC of 0.93 (95% CI 0.90 - 0.95) sensitivity of 86.4 (95% CI 79.8- 91.0), specificity of 86.6 (95% CI 82.2-90.1) when compared against overweight and obesity defined using BMI z-scores. Conclusion: In comparison with BMI, MUAC has an excellent performance to identify overweight and obesity in children and adolescents. However, no sufficient evidence on the performance of MUAC compared to gold standard measures of adiposity. Future research should compare performance of MUAC to the “golden standard” measure of excess adiposity.

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“…DXA is in fact considered the gold standard to measure body composition [19][20][21]. Mid-upper arm circumference (MUAC) has shown potential as a low cost, convenient, and reliable alternative to BMI to identify overweight and obesity in all pediatric age groups [22,23]. When it comes to global relevance of MUAC, a study across 12 countries and the socioeconomic spectrum, including an SA country, stated that MUAC as a tool is accurate for identifying obesity in 9-11-year-old children across the 12 countries.…”

Section: Literature Reviewmentioning

confidence: 99%

Obesity and Metabolic Care of Children of South Asian Ethnicity in Western Society

et al. 2021

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South Asians constitute one-fourth of the world’s population and are distributed significantly in western countries. With exponentially growing numbers, childhood obesity is of global concern. Children of South Asian ancestry have a higher likelihood of developing obesity and associated metabolic risks. The validity of commonly used measures for quantifying adiposity and its impact on metabolic outcomes differ by race and ethnicity. In this review we aim to discuss the validity of body mass index (BMI) and other tools in screening for adiposity in South Asian children. We also discuss the prevalence of overweight and obesity amongst South Asian children in western countries and the differences in body fat percentage, adiposity distribution, and metabolic risks specific to these children compared to Caucasian children. South Asian children have a characteristic phenotype: lower lean mass and higher body fat percentage favoring central fat accumulation. Hence, BMI is a less reliable predictor of metabolic status in these children than it is for Caucasian children. Furthermore, the relatively lower birth weight and rapid growth acceleration in early childhood of South Asian children increase the risk of their developing cardiometabolic disorders at a younger age than that of Caucasians. We emphasize the need to use modified tools for assessment of adiposity, which take into consideration the ethnic differences and provide early and appropriate intervention to prevent obesity and its complications.

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Performance of mid-upper arm circumference as a screening tool for identifying adolescents with overweight and obesity

Cited by 23 publications

References 27 publications

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

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

The performance of mid-upper arm circumference for identifying children and adolescents with overweight and obesity: a systematic review and meta-analysis

Obesity and Metabolic Care of Children of South Asian Ethnicity in Western Society

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