Mid-upper arm circumference as a screening tool for identifying children with obesity: a 12-country study

Public in The Authors. Pediatric Obesity © 2016 International Association for the Study of Obesity. Written by J.-P. Chaput, P. T. Katzmarzyk, J. D. Barnes, M. Fogelholm, G. Hu, R. Kuriyan, A. Kurpad, E. V. Lambert, C. Maher, J. Maia, V. Matsudo,T. Olds, V. Onywera, O. L. Sarmiento, M. Standage, C. Tudor-Locke, P. Zhao, M. S. Tremblay for the ISCOLE Research Group


Background: No studies have examined if mid-upper arm circumference (MUAC) can be an alternative screening tool for obesity in an international sample of children differing widely in levels of human development. Objective: Our aim is to determine whether MUAC could be used to identify obesity in children from 12 countries in five major geographic regions of the world. Methods: This observational, multinational cross-sectional study included 7337 children aged 9–11 years. Anthropometric measurements were objectivelyassessed, and obesity was defined according to the World Health Organization reference data. Results: In the total sample, MUAC was strongly correlated with adiposity indicators in both boys and girls (r > 0.86, p < 0.001). The accuracy level of MUAC for identifying obesity was high in both sexes and across study sites (overall area under the curve of 0.97, sensitivity of 95% and specificity of 90%). The MUAC cut-off value to identify obesity was ~25 cm for both boys and girls. In country-specific analyses, the cut-off value to identify obesity ranged from 23.2 cm (boys in South Africa) to 26.2 cm (girls in the UK). Conclusions: Results from this 12-country study suggest that MUAC is a simple and accurate measurement that may be used to identify obesity in children aged 9–11 years. MUAC may be a promising screening tool for obesity in resource limited settings.

Keywords: Adiposity, arm circumference, body mass index, children.

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