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Body composition unaltered for African women classified as 'normal but vulnerable' by body mass index and mid-upper-arm-circumference criteria.
Eur J Clin Nutr. 2001 May; 55(5):393-9.EJ

Abstract

OBJECTIVE

To test the hypothesis that 'normal but vulnerable' adults, as defined by body mass index (BMI) in combination with mid-upper-arm-circumference (MUAC), are closer to normal than to malnourished ones. For that purpose body composition measurements were compared between normal and low BMI categories and according to MUAC value in an African context and for different age groups.

DESIGN

Reanalysis of data from a previous cross-sectional cluster sample nutrition survey.

SETTING

A rural area of the Republic of Congo, Central Africa.

SUBJECTS

A representative sample (n=544) of non-pregnant women.

MAIN OUTCOME MEASURES

Arm muscle area was calculated from measurements of triceps skinfold thickness and MUAC. Peripheral body fat was assessed by the sum of four skinfold thicknesses. The ratio of resistance at high and low frequencies was derived from whole body measurement of multifrequency bioelectrical impedance analysis and used as the extracellular to total body water ratio index.

RESULTS

The prevalence of thinness decreased from 18.7% as defined by BMI alone to 9.0% as defined by BMI and MUAC. This difference was due to the group of subjects classified as 'normal but vulnerable' (9.7%). Prevalence of thinness increased with age when assessed by BMI alone, but no longer when assessed by BMI and MUAC. Comparison with the BMI> or =18.5 kg/m(2) category showed that in 'normal but vulnerable' subjects lower BMI was accompanied by lower both fat and lean compartments, in absolute values, but the equilibrium of body water compartments was not altered. In BMI<18.5 women, low MUAC was associated with altered lean tissues, at peripheral and whole body level, whereas fat tissue did not differ.

CONCLUSIONS

'Normal but vulnerable' subjects appeared as 'thin but healthy' rather than malnourished, at all ages, even though their BMI was lower than 18.5 kg/m(2). The new classification of thinness based on BMI and MUAC provides a more specific index of nutritional status when restricting the thin category to more at-risk subjects.

Authors+Show Affiliations

Nutrition Unit, IRD (Institut de Recherche pour le Développement), WHO Collaborating Center for Nutrition, Montpellier, France. gartner@dakar.ird.snNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11378814

Citation

Gartner, A, et al. "Body Composition Unaltered for African Women Classified as 'normal but Vulnerable' By Body Mass Index and Mid-upper-arm-circumference Criteria." European Journal of Clinical Nutrition, vol. 55, no. 5, 2001, pp. 393-9.
Gartner A, Maire B, Kameli Y, et al. Body composition unaltered for African women classified as 'normal but vulnerable' by body mass index and mid-upper-arm-circumference criteria. Eur J Clin Nutr. 2001;55(5):393-9.
Gartner, A., Maire, B., Kameli, Y., Traissac, P., & Delpeuch, F. (2001). Body composition unaltered for African women classified as 'normal but vulnerable' by body mass index and mid-upper-arm-circumference criteria. European Journal of Clinical Nutrition, 55(5), 393-9.
Gartner A, et al. Body Composition Unaltered for African Women Classified as 'normal but Vulnerable' By Body Mass Index and Mid-upper-arm-circumference Criteria. Eur J Clin Nutr. 2001;55(5):393-9. PubMed PMID: 11378814.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Body composition unaltered for African women classified as 'normal but vulnerable' by body mass index and mid-upper-arm-circumference criteria. AU - Gartner,A, AU - Maire,B, AU - Kameli,Y, AU - Traissac,P, AU - Delpeuch,F, PY - 2000/08/14/received PY - 2000/12/01/revised PY - 2000/12/06/accepted PY - 2001/5/30/pubmed PY - 2001/8/17/medline PY - 2001/5/30/entrez SP - 393 EP - 9 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 55 IS - 5 N2 - OBJECTIVE: To test the hypothesis that 'normal but vulnerable' adults, as defined by body mass index (BMI) in combination with mid-upper-arm-circumference (MUAC), are closer to normal than to malnourished ones. For that purpose body composition measurements were compared between normal and low BMI categories and according to MUAC value in an African context and for different age groups. DESIGN: Reanalysis of data from a previous cross-sectional cluster sample nutrition survey. SETTING: A rural area of the Republic of Congo, Central Africa. SUBJECTS: A representative sample (n=544) of non-pregnant women. MAIN OUTCOME MEASURES: Arm muscle area was calculated from measurements of triceps skinfold thickness and MUAC. Peripheral body fat was assessed by the sum of four skinfold thicknesses. The ratio of resistance at high and low frequencies was derived from whole body measurement of multifrequency bioelectrical impedance analysis and used as the extracellular to total body water ratio index. RESULTS: The prevalence of thinness decreased from 18.7% as defined by BMI alone to 9.0% as defined by BMI and MUAC. This difference was due to the group of subjects classified as 'normal but vulnerable' (9.7%). Prevalence of thinness increased with age when assessed by BMI alone, but no longer when assessed by BMI and MUAC. Comparison with the BMI> or =18.5 kg/m(2) category showed that in 'normal but vulnerable' subjects lower BMI was accompanied by lower both fat and lean compartments, in absolute values, but the equilibrium of body water compartments was not altered. In BMI<18.5 women, low MUAC was associated with altered lean tissues, at peripheral and whole body level, whereas fat tissue did not differ. CONCLUSIONS: 'Normal but vulnerable' subjects appeared as 'thin but healthy' rather than malnourished, at all ages, even though their BMI was lower than 18.5 kg/m(2). The new classification of thinness based on BMI and MUAC provides a more specific index of nutritional status when restricting the thin category to more at-risk subjects. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/11378814/Body_composition_unaltered_for_African_women_classified_as_'normal_but_vulnerable'_by_body_mass_index_and_mid_upper_arm_circumference_criteria_ L2 - http://dx.doi.org/10.1038/sj.ejcn.1601171 DB - PRIME DP - Unbound Medicine ER -