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Cut-offs of mid-upper arm circumference to predict the double burden of malnutrition among Indian pre-adolescent children (5-9 years): Insights from Comprehensive National Nutrition Survey data 2016-18

Author:

Suman Chakrabarty

Mrinalini Datta Mahavidyapith Birati, Kolkata, IN
About Suman

Assistant Professor and Head, Department of Anthropology

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Abstract

Introduction: In low and middle-income countries, there is a growing trend of the double burden of malnutrition in children. Most popular way of screening nutritional status of children is use of anthropometric measures, where the Mid-Upper Arm Circumference (MUAC) is important for its operational simplicity. Despite several studies favouring MUAC, studies of optimal cutoff defining malnutrition are few at national level, even in India.


Objectives: To assess the prediction of the double burden of malnutrition by MUAC in Indian pre-adolescent children using Comprehensive National Nutrition Survey (CNNS) data 2016-18.


Method: The participants were 36,347 children (18,992 boys, 17,355 girls) aged 5–9 years. I have done Spearman’s rank correlation to determine the relationship between MUAC and Z score of Body Mass Index (BAZ) and height for age (HAZ). To assess the ability of MUAC to classify the double burden of malnutrition accurately, I did Receiver Operating Characteristic (ROC) analysis after stratification for age and sex.


Results: There was significant correlation of MUAC with BAZ (r = 0.61) and HAZ (r = 0.42). Areas under ROC curve were 0.78, 0.71, 0.85, and 0.84 for thinness, stunting, overweight, and obesity, respectively. It was observed that optimal MUAC cutoff values for prediction of thinness and stunting were 16.0 cm and 16.1 cm respectively. In contrast, optimal cutoffs for prediction of overweight and obesity were 18.8 cm and 19.5 cm respectively. These cutoffs of MUAC differed after stratification by age group and sex.


Conclusions: MUAC is a good predictor of malnutrition in national representative Indian children aged 5 to 9 years. However MUAC identifies over-nutrition with higher accuracy than under-nutrition in this age group.


Sri Lanka Journal of Child Health, 2022; 51(2): 189-195

How to Cite: Chakrabarty, S., 2022. Cut-offs of mid-upper arm circumference to predict the double burden of malnutrition among Indian pre-adolescent children (5-9 years): Insights from Comprehensive National Nutrition Survey data 2016-18. Sri Lanka Journal of Child Health, 51(2), pp.189–195. DOI: http://doi.org/10.4038/sljch.v51i2.10116
Published on 05 Jun 2022.
Peer Reviewed

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