Utilizing Upper Arm Images in Determining Body Mass Index and Nutritional Status
Body mass index (BMI) is the most widely used index for determining the fitness status of an individual. Midd-upper arm circumference (MUAC) is another commonly used anthropometric index, providing a simple measurement widely used for nutrition level screening. However, building a massive population database based on both BMI and MUAC measurements is time-consuming and may introduce errors due to instrumentations and different operators. In this paper, a measurement technique of BMI from photographic images of the upper arm is presented. Three parameters are measured from the subject photos with a scale attached, and these are upper arm length, sagittal plane middle arm thickness (SMT), and frontal plane middle thickness (FMT). Different parameters are derived from the SMT and the FMT. These parameters are used to study the correlation and measurements agreements with the BMI. It is found that all parameters related to SMT correlate very well with the BMI with correlation coefficients of more than 90%. In addition, the SMT measurement limits (both upper and lower) are acceptable and within the clinical significance range. Finally, the receiver operating characteristics analysis of both SMT and MUAC has been evaluated. The findings show that SMT is slightly better than MUAC since it gives excellent sensitivity (94.7%) without compromising the specificity (88.5%) when compared to the MUAC results.
Keywords:BMI, obesity, sagittal plane
M. M. Finucane, G. A. Stevens, M. J. Cowan, G. Danaei, J. K. Lin, C. J. Paciorek, G. M. Singh, H. R. Gutierrez, Y. Lu, A. N. Bahalim, F. Farzadfar, L. M. Riley, M. Ezzati, “National, regional, and global trends in body-mass index since 1980: Systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants”, Lancet, Vol. 377, No. 9765, pp. 557-567, 2011 DOI: https://doi.org/10.1016/S0140-6736(10)62037-5
M. Marmot, T. Atinmo, T. Byers, J. Chen, T. Hirohata, A. Jackson, W. P. T. James, L. Kolonel, S. Kumanyika, C. Leitzmann, J. Mann, H. J. Powers, K. S. Reddy, E. Riboli, J. A. Rivera, A. Schatzkin, J. C. Seidell, D. E. G. Shuker, R. Uauy, W. C. Willett, S. H. Zeisel, Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective, American Institute for Cancer Research, 2007
D. P. Guh, W. Zhang, N. Bansback, Z. Amarsi, C. L. Birmingham, A. H. Anis, “The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis”, BMC Public Health, Vol. 9, No. 1, 2009 DOI: https://doi.org/10.1186/1471-2458-9-88
G. Whitlock, S. Lewington, P. Sherliker, R. Clarke, J. Emberson, J. Halsey, N. Qizilbash, R. Collins, R. Peto, “Body-mass index and cause specific mortality in 900,000 adults: Collaborative analyses of 57 prospective studies”, Lancet, Vol. 373, No. 9669, pp. 1083-1096, 2009 DOI: https://doi.org/10.1016/S0140-6736(09)60318-4
F. Q. Nuttall, “Body mass index: Obesity, BMI, and health: A critical review”, Nutrition Today, Vol. 50, No. 3, pp. 117-128, 2015 DOI: https://doi.org/10.1097/NT.0000000000000092
A. Keys, F. Fidanza, M. J. Karvonen, N. Kimura, H. L. Taylor, “Indices of relative weight and obesity”, International Journal of Epidemiology Vol. 43, No. 3, pp. 655-665, 2014 DOI: https://doi.org/10.1093/ije/dyu058
World Health Organization, Physical Status: The Use and Interpretation of Anthropometry, Technical Report Series, Vol. 854, WHO, 1995
K. M. Flegal, M. D. Carroll, R. J. Kuczmarski, C. L. Johnson, “Overweight and obesity in the United States: Prevalence and trends, 1960-1994”, International Journal of Obesity and Related Metabolic Disorders, Vol. 22, No. 1, pp. 39-47, 1998 DOI: https://doi.org/10.1038/sj.ijo.0800541
J. S. Garrow, Treat Obesity Seriously: A Clinical Manual, Churchill Livingstone, 1981
World Health Organization, Obesity: Preventing and Managing the Global Epidemic, Technical Report Series, Vol. 894, WHO, 2000
R. T. Benn, “Some mathematical properties of weight-for-height indices used as measures of adiposity”, British Journal of Preventive and Social Medicine, Vol. 25, No. 1, pp. 42-50, 1971 DOI: https://doi.org/10.1136/jech.25.1.42
J. Wang, J. C. Thornton, M. Russell, S. Burastero, S. Heymseld, R. N. Pierson, “Asians have lower body mass index (BMI) but higher percent body fat than do whites: Comparisons of anthropometric measurements”, The American Journal of Clinical Nutrition, Vol. 60, No. 1, pp. 23-28, 1994 DOI: https://doi.org/10.1093/ajcn/60.1.23
C. L. Ogden, C. D. Fryar, M. D. Carroll, K. M. Flegal, “Mean body weight, height, and body mass index, United States 1960-2002”, Advance Data, Vol. 347, pp. 1-17, 2004
A. Zajacova, J. B. Dowd, S. A. Burgard, “Overweight adults may have the lowest mortality–do they have the best health?”, American Journal of Epidemiology, Vol. 173, No. 4, pp. 430–437, 2011 DOI: https://doi.org/10.1093/aje/kwq382
T. Sultana, M. N. Karim, T. Ahmed, M. I. Hossain, “Assessment of Under Nutrition of Bangladeshi Adults Using Anthropometry: Can Body Mass Index be Replaced by Mid-Upper-Arm-Circumference?”, PloS One, Vol. 10, No. 4, Article ID e0121456, 2015 DOI: https://doi.org/10.1371/journal.pone.0121456
P. Nguyen, U. Ramakrishnan, B. Katz, I. G. Casanova, A. E. Lowe, H. Nguyen, H. Pham, T. Truong, S. Nguyen, R. Martorell, “Mid-upper-arm and calf circumferences are useful predictors of underweight in women of reproductive age in northern Vietnam”, Food and Nutrition Bulletin, Vol. 35, No. 3, pp. 301-311, 2014 DOI: https://doi.org/10.1177/156482651403500303
T. Khadivzadeh, “Mid upper arm and calf circumferences as indicators of nutritional status in women of reproductive age”, Eastern Mediterranean Health Journal, Vol. 8, No. 4-5, pp. 612-618, 2002
R. Chakraborty, K. Bose, S. Koziel, “Use of Mid-Upper Arm Circumference in Determining Undernutrition and Illness in Rural Adult Oraon Men of Gumla District, Jharkhand, India”, Rural Remote Health, Vol. 11, No. 3, Article ID 1754, 2011
V. A. Leandro-Merhi, J. Luiz Braga de Aquino, J. Gonzaga Teixeira de Camargo, “Agreement between body mass index, calf circumference, arm circumference, habitual energy intake and the MNA in hospitalized elderly”, Journal of Nutrition Health and Aging, Vol. 16, No. 2, pp. 128-132, 2012 DOI: https://doi.org/10.1007/s12603-011-0098-1
J. M. Bland, D. G. Altman, “Statistical methods for assessing agreement between two methods of clinical measurement”, Lancet, Vol. 1, No. 8476, pp. 307-310, 1986 DOI: https://doi.org/10.1016/S0140-6736(86)90837-8
D. Giavarina, “Understanding Bland Altman analysis”, Biochemia Medica, Vol. 25, No. 2, pp. 141-151, 2015 DOI: https://doi.org/10.11613/BM.2015.015
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