anthropometry measurement.pptx

8/22/2019 ANTHROPOMETRY MEASUREMENT.pptx

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ANTHROPOMETRY

By Shiva Prasad tiwari

Mpt 1st year


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DEFINITION:-Greek anthropos = human, metro = measurementIsthe measurement of the human body,

Measurements of the variations of the physical dimensions and thegross composition of the human body at different age levels anddegrees of nutrition

jelliffe 1966 966

Measurement of physical characteristics e.g. height, weight, bodycomposition (fat!). Compare with standards for age, sex

Anthropometric measurement is a series of standardized measuring

techniques that express quantitavely dimensions of human body

It helps in measurements for determining the size proportion,&shape of an individuals body


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Uses or need

To evaluate progress of growth;identify people whosegrowth is outside normal values suggesting under orover nutrition so its a Screening tool to identifyindividual at high risk of malnutrition or any otherdisease

To measure change over time: monitor effects ofnutrition intervention for treatment of disease, surgeryor malnutrition. Also, can track weight changes that mayindicate disease

Helps in comparison of morphological status in b/windividuals. Ex: growth status of school children Used asan outcome variable in evaluating interventions such aseffects of exs & wt reduction on body wt &sc fatness


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The measurements include

Height

weight

height and weight

BMI Girth measurements

Skin fold thickness

Waist to hip ratio

Specific segmental length Head circumference

Other method


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height

Procedure

Person in standing erect position, without shoesask person to take deep breath and hold it.Weight equally distributed on both feet tighterarms hanging side head in Frankfort horizontalplane. Taken from standing surface to thetop(vertex) of the skull,

Body wt is measured of body mass .remove theshoes and as much other clothing.

Compare the subjects height and weight

Planning and policy making


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Demispan

A measurement of skeletal size

Used as an alternative to height measurement

when difficult to obtain an upright posture

Demispan is the distance between the sternal

notch and the roots of the middle and third

fingers with the arm stretched out at

shoulder height to the side of the body


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Height


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Height for age

Height should be taken in standing position.

Length for baby at birth is about 50cm it increase byabout 25 cm during first year and 12 cm during 2nd year

Indian girls reach 98%of final height at 16.5 years and

and boys at 17.75 years Low height for age :also known

as nutritional stunting ordwarfing .which reflect

malnutrition Use of 2SD VALUE

bellow the medianreference as cut off point.


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Weight for age

Measurement of weight as reference monthly

from birth to 1 year every 2 month during 2nd

year ,3 month thereafter up to 5 .to monitor

the physical growth

Average Indian weight at birth is 2.7 to2.9 kg

Baby should gain atleast 500gm wt in 1st 3

month there after 7 kg at end of 1st year 2.5 kg

thereafter


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Weight for height

Height and weight are interrelated and

consider important then single parameter

alone(height , weight)

Low weight for height: also known as

nutritional wasting or emaciation (acute mal

nutrition)a child who is less then 70% of

expected weight for height is classed a severewasted


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Growth chart used in India

Consist 4 line 1st topmost represent 80% of medianlower line 70%,60%,50% of standard

It shows 3 degree of malnutrition

Mild or first degree between 70to 80%

Moderate or 2nd degree between 60 and 70%

Severe or 3rd degree between 50 to 60%

Use of growth chart

1)For growth monitoring

2) Evaluation or diagnostic tool

3)Planning and policy making

4)Educational tool


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BMI

BMI is also called quetelets index

Used to access weight relative to height

BMI gives a single number for comparison ,as opposedto the weight to height range or table.

BMI=weight(kg)/height(m2)

BMI provides a slightly more accurate assessment ofbody composition than simple height/weight chartsbut the same bias is present

PROBLEM:1)it doesn't differentiate fat weight from fat free weight

2)It doesn't represent an improvement over therelationship between only weight and body mass


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Waist to hip ratio an effective way to examine regional fat distribution

Pattern of body wt distribution is important predictor of health risk of

obesity Individual with more weight or circumference on trunk are at

increased risk of hypertension ,type2dibetes, hyperlipidemia and CADcompared with individual who are equal wt but have their more wtdistribution on extremities

Waist :- its the smallest waist circumference .usually 1 inch abovethe level of umlicus

Hip :- maximum circumference of the buttocks above the gluetal fold

Normal values of waist: hip ratio

Healthy young men -0.94-1.00

young women 0.80 -0.90 Fat deposit in lower body is pear shaped and abdominal is apple

shaped

Subcutaneous and visceral fat deposition


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Waist hip circumference


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Circumference or girth

Uses:

1)for estimation of body composition

2)quantify change in the muscle bulk with

training (eg.resistance weight training)

Advantage:

Easily learned

Quick to administer

Inexpensive in equipments need

A t i l it f i f


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Anatomical sites for circumference

management

1)right upper arm:2)right forearm:

3)abdomen(waist)

4)hip;

5)right thigh:

6)right calf:

7)head circumference

To estimate %of body fat uses three sites (acsm)

Young man(18 to 26yrs):arm, forearm, abdomen

Yong women(18 to 26)forearm,thigh,abdomen Older man(27 and above )forearm, buttock(waist) abdomen

Older woman abdomen, thigh ,calf% fat = - 47.372 + (.579 x abdomen) + (.252 x hip) + (.214 x

iliac) + (.356 x BW)

A i f id i t


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Arm circumferennce:midpointbetween shoulder and elbow with arm

straight ,midway between acromianand olecranon


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Forearm:

Maximum girth around the forearm with rt

arm straight ,extended in front of body and

palm up.


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Proximal thigh:

Subject standing leg slightly apart(10cm)

maximum circumference at hip just bellow

the gluetal fold


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Right calf: subject standing erect(feet apart

20cm )horizontal measure is taken at the

level of maximum circumference between

knee and ankle usually midpoint.


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Head circumference

Also known occipitofrontal circumference

Widest anteroposterior diameter

Normal 32 to 38 Vary with age and sex .


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Skinfold measurement

Procedure for measuring fat fold thickness is to grasp afold of skin and subcutaneous fat firmly with thethumb and forefingers. Pulling it away from theunderlying muscle tissue following the natural contourof the fat fold. The calliper is applied worth it jaws

exerting constant tension of 10gm/mm2

at the point ofcontact with the skin. The thickness of the double layerof skin and subcutaneous tissue is then read directlyfrom the calliper dial and recorded in millimetreswithin several seconds after applying the calliper

principle :the amount of subcutaneous fat isproportional to total amount of body fat .

the proportion of subcutaneous fat to body fat mayvary with gender, age so regression equation

considering to predict body density or %of body fat


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Skin fold technique

Layers of subcutaneous

fat are measured at

different sites of body

to estimate total body

fat levels


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Benefits

Easy to perform

Inexpensive

Widely used method

Gives reasonable accuracy

Measurement errors

Poor technique

Inexperienced examine

Improper calibrated caliper


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Triceps

Vertical fold on the Midline of the posterior

aspect of the arm over the triceps muscle.

Halfway between the acromian and olecranon

process


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bicep

Vertical fold on anterior aspect of arm 1 cm

above level used to mark the tricep


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sub scapular

Diagonal fold (at45degree) at 1 to 2 cm bellow

the inferior angle of scapula.


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Suprailliac

Diagonal fold in line with the natural angle of

iliac crest taken in anterior axillaries line

immediately above iliac crest.


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abdomen

Vertical fold 2cm right to the umbilicus


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thigh

Vertical fold on anterior midline of the thigh

,midway between proximal boarder of patella

and inguinal crease


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Chest /pectoral

Diagonal fold one half the distance between

anterior axillary line and nipple in man

In women one third of distance between

anterior axillary line and nipple.


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Medial calf

Vertical fold at the maximum circumference of

calf on midline of its medial boarder


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midaxillary

Vertical fold on mid axillary line at level of

xiphoid process of sternum .alternatively

horizontal fold at level of xiphoid sternal

boarder in mid axillary line


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Skin fold prediction equation

Jackson pollock 7 site formula Men and women sites:(chest,midaxillary,tricep

,sub scapular ,abdomen,suprailliac ,thigh)

For man BD=1.112-0.00043499(sum of sevenfold)+0.00000055(square of sum of seven fold )-

0.00028826(age)

For women BD=1.097-0.00046971(SUM OFseven skin fold +0.00000056(square of sum of

seven skin fold)-0.00012828(age)


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Jackson pollock 3 sites skin fold formula

For man(chest, thigh ,abdomen)

Body density (BD)=1.10938-0.0008267(sum

of three skin fold)+0.00000016(square of sumof three skin fold)-0.0002574(age)

For women site are tricep,suprailliac,thigh

BD=1.099421-0.0009929(sum of three skinfold)+0.0000023(square of sum of three sites)-0.00001392(age)


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How to identify %of body weight

Siri equation

%of body fat=(495/BD)-450

Brozek equation

%of body fat=(457/BD)-414.2


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Body fat % rating

Male Female Rating34 Poor

Body fat% using Jackson Pollock equation


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Limb length measurement

1)true limb length2)apparent limb length

Procedure

Patient position: supine lying the distance between 2

medial malleoli should be 15 to 20 cm Squaring of pelvis : bilateral measurement from lower

boarder of umbilicus to iliac crest if their is significantdifference in measurement that suggest either the leg

is in abduction or adduction Then correct it by doing adduction or abduction to

opposite side leg respectively.


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. Whole upper limb length:

Measurement is taken from most superior lateral point of acromion

process (acrmorial landmark) to the lower and lateral border of styloid

process of radius (radial landmark). The arm is positioned in theanatomical position, relaxed at the side of the subject

Segmental measurement:

- Upper arm length: With arm flexed at 90, so that ulnar surface of

forearm and hand are horizontal and palms facing medially with

fingers extended, measurement is taken from acromial landmark to

the posterior surface of olecranon process of ulna.

- Forearm length: It is the distance from the head of radius (upper

radial landmark) to the most distal point of the styloid process of

radius (or styloin). - Hand length: With hand extended and the palm rested in the

direction of the longitudinal axis of forearm, measurement is taken

from styloid process at base of thumb to the tip of middle finger.


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.Whole lower limb length: To determine true leg length, first place the patient's

legs in precisely comparable positions and measure the

distance from the anterior superior iliac spines (ASIS) tothe medial malleoli of the ankles (from one fixed bonypoint to another). Begin measurement at the slightconcavity just below the anterior superior iliac spine, as

the tape measure may slide if pressed directly onto thespine. If there is tilting of pelvis. Measurement will betaken from the umbilicus to the medial or lateralmalleolus. If there is shifted umbilicus, measurement isthen taken from xyphoid process to the medial or lateral

malleolus. Apparent shortening (due to pelvic tilt)should be differentiated from true shortening (bony).Unequal distances between these fixed points verify thatone lower extremity is shorter than the other.


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. To determine in short order where the

discrepancy lies (whether in the tibia or in the

femur), ask the patient to lie supine, with hisknees flexed to 90 and his feet flat on the

table. If one knee appears higher than the

other, the tibia of that extremity is longer;while if one knee projects furthers anteriorly

than the other, the femur of that extremity is

longer(telescopic view or gallent sign). A true

shortening may be due to poliomyelitis or a

fracture that crossed the epiphyseal plate

during childhood


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Segmental

For neck of femur: From asis to greatertrochanter

For femoral shaft : from greater trochanter to

lateral epicondyle of femur For tibia length:from medial tibia tubercle to

medial malleolus

Foot length: It is the distance between themost posterior part (center) of the heel to themost anterior part of the longest toe (2nd toe).


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Apparent leg length discrepancy: Before testing for apparent leg length discrepancy, no true

leg length discrepancy should be confirmed (no true bonyinequality). Apparent shortening may arise from pelvicobliquity, hip adduction or flexion deformity. During

inspection, pelvic obliquity manifests itself as uneven ASISor PSIS while the patient is standing. While the patient is insupine with his legs in the neutral position, measurement istaken from the umbilicus (or xiphi-sternal juncture ) ifobese 2 cm bellow the umbilicus to the medial malleolus

(from a non-fixed point to a fixed bony point). Unequaldistances signify an apparent leg length discrepancy, if thetrue leg length measurements are equal

O h h d b d


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Other method to measure body

composition

Direct method Two approaches have been used for direct assessing body

composition

In one the body is literally dissolved in the chemical solutionand the fat and non fat component mixture is determined

The other techniques involves the physical dissection ofvariety of body component such as fat, fat free adiposetissue, muscle &bone

Disadvantage

Time consuming & tedious Specialized lab equipments needed

Ethical &legal problems in obtaining cadavers for research


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Indirect method

Anthropometry

Hydrostatic weighing

Air plethysmography

Bioelectric impedance analysis

dexa

h


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Hydrostatic weighting Its an technique where the density of a persons

body is measured .Use to be a gold standard Based on Archimedes principle which states A

body immerses in a fluid experience a loss in

weight equals to the weight of displaced fluid


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Procedure The subject to be submerged in water & body

volume is determined by displacement of water.

Calculating body density &volume of waterdisplaced .Density=Weight/Volume

Compute relative fat, fat mass &fat free mass

Relative fat estimated using siri equation

%fat=495/BD-450

Lean weight= body weight-fat weight

Fat weight = (%fat /100)*body weightSource of error

Residual lung volume

Body density varies with age& activity level


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Air Pletsmography

Bod pod

Dual chambered plethysmography

In contrast to hydrostatic weighing,Bodpod

uses air displacement rather than waterdisplacement to determine body density

Th l f t t h b


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The volume of empty measurement chamber

is determined first

The test is then perfomed with the subjectinside, and that volume is measured

In the second measurement the chamber

volume has been reduced by an amount equalto the subjects volume So by subtraction ,the

volume of the subject can be calculated

To obtain an accurate volume, thoracic gasvolume(residual gas)to be taken into account

Normal value:0.003-.007g/cc


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Bioelectrical impendence

Based on resistance to current flow

Lean tissue has more water So less resistance.

Fat tissue has less water So more resistance

A small portable instrument is used to pass anelectric current of

50 x 10 -6A at 50 KHzSources of error

Temperature Hydration status

DEXA


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DEXA

Dual energy x-ray absorptiometry

High technology procedure

Mostly used for bone density assessment for

osteoporosis diagnostic purposes


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Used to estimate regional bone mineral

content and bone mineral density primarily

spine, pelvis, femur

Advantage;-

Precise

Reliable


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estimates bone density and mineral content

Normal bone mineral density

Males:3.88g/cm3

Females:2.90g/cm3


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Rest is yours

anthropometry measurement.pptx

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