Body weight estimation in the Italian elderly

We have developed two different equations, for each sex of the elderly italian population to predict weight from selected measures of recumbent anthropometry, using data of 172 females (72.8 +/- 8 years old) and 113 males (73.4 +/- 8 years old). The independent variables for both sexes were knee stature. subscapular skinfold, arm and calf circumferences. Cross validation was conducted on a free-living sample of 54 females and 30 males. The recommended equations have a 95% probability of predicting the weight of an elderly man or woman to be within plus or minus 4.9 or 6.1 Kg respectively.     

Anthropometric measurements as indicators of nutritional status of the elderly

This review contains details on anthropometric measurements required for assessment of nutritional status in the elderly. These measurements provide indicators of fat tissue content or body composition and evaluate trends in nutritional status. Anthropometric measurements in the elderly are similar to these in other groups of population but they have to be adopted according to changes in constitution and posture of elderly and disabled people. The following measurements are presented: stature, weight, skinfold thickness and mid upper-arm, waist and hip circumferences. Derived measurements and indices of nutritional status are also discussed.     

Risk factors in the occurence of short stature of preschool children]

A case-control study was conducted to know the magnitude of the effect of main risk factors for short stature of pre-school children in a city in S?o Paulo State, in 1995. An anthropometric survey carried out with all children (1201) attending public pre-school classes was used to select the case and the control groups. It was selected a random sample of 165 children among those with stature/age (-1 z score (case) and another sample of 165 among those with stature/age ( +1 z score (control). The mothers or persons responsible for these children were interviewed in order to obtain information on demographic, maternal and socio-economic variables. The multiple logistic hierarchical analysis showed the following variables as associated with pre school children's short stature: mother's educational level (OR = 2,1; CI: 1,1-3,8); per capita family income (0,5 SM (OR = 3,4; CI: 1,5-8,0); number of persons in the house (6 (OR = 3,7; CI: 1,5-9,0); number of domestic equipment (1 (OR = 4,4; CI: 1,8-10,7 ); birth length <48 cm (OR = 7,4; CI: 2,3-23,7 ), mother's stature ( 156,6 cm (OR = 5,9 CI 3,1-11,0) and father's stature (169,5 cm (OR = 4,2; CI: 2,1-8,6). We found that even in a population of preschool children without nutritional deficiency (as measured by the usual anthropometric index) it is possible to observe the effect of socio economic variables in children stature.     

Predictive equations for estimation of stature in Malaysian elderly people

Height is an important clinical indicator to derive body mass index (BMI), creatinine height index and also to estimate basal energy expenditure, basal metabolic rate and vital capacity through lung function. However, height measurement in the elderly may impose some difficulties and the reliability is doubtful. Equations estimating height from other anthropometric measures have been developed for Caucasians, but only one study has developed an equation (based on arm span only) for an Asian population. Therefore, a cross sectional study was conducted to develop equations using several anthropometric measurements for estimating stature in Malaysian elderly. A total of 100 adults (aged 30 to 49 y) and 100 elderly subjects (aged 60 to 86 y) from three major ethnic groups of Malays (52%), Chinese (38.5%) and Indians (9.5%) participated in this study. Anthropometric measurements included body weight, height, arm span, half arm span, demi span and knee height were carried out by trained nutritionists. Inter and intra observer errors and also % Coefficient Variation (%CV) were calculated for each anthropometric measurement. Equations to estimate stature were developed from the anthropometric measurements of arm span, demi span and knee height of adults using linear regression analysis according to sex. Elderly subjects were shorter and lighter compared to their younger counterparts. The %CV of anthropometric measurements in adults and elderly subjects ranged between 5 to 6%, with standing height having the lowest %CV. When the equations derived from adults were applied to elderly subjects, it was found that percentage difference between actual height and the estimated value ranged from 1.0 to 3.3%. However, the percentage difference between estimated height from the equations developed in this study compared to those derived from the equations of other populations ranged between 0.2 to 8.7%. In conclusion, standing height is an ideal technique for estimating the stature of individuals. However, in cases where its measurement is not possible or reliable, such as in elderly subjects, height can be estimated from proxy indicators of stature. In this study arm span showed the highest correlation with standing height, which is in agreement with other studies. It should be borne in mind that equations derived from taller statured populations (e.g. Caucasians) may be less accurate when applied to shorter statured populations.     

Anthropometric measurements in the elderly of Havana, Cuba: age and sex differences

OBJECTIVE: We present selected anthropometric data, specific for sex and age group, from a representative sample of elderly subjects living in Havana, Cuba. METHODS: This was a cross-sectional, population-based household survey. A total of 1905 subjects (1197 women and 708 men, > or = 60 y of age) were examined between 1999 and 2000 as selected by probabilistic sampling. Data were presented as means and percentiles for body mass; height or stature; body mass index; waist, arm, and calf circumferences; triceps skinfold thickness; and arm muscle circumference; and differences were described according to age (all variables) and sex (body mass index). RESULTS: All anthropometric variables showed a decrease in average values with aging in men and women. The age of 70 y appeared to be the decisive moment for the main anthropometric differences observed. The values in the female group were higher than those in the male group for body mass index and triceps skinfold thickness. An important segment of the population studied had a body mass index lower than normal values. Reductions in subcutaneous fat (indicated by triceps skinfold thickness) and muscle mass (verified by arm, arm muscle, and calf circumferences) with advancing age appeared to be greater among women than among men. CONCLUSION: The present study provides information that can be used for anthropometric evaluation of elderly people in Havana and other urban areas in Cuba. The observations suggest that there is loss of muscle mass and redistribution and reduction of fat mass with age (that is more severe in women).     

Leptin a new biological marker for evaluating malnutrition in elderly patients

BACKGROUND: There is no single universally accepted biochemical marker of nutritional status in the elderly. Many markers are affected by non-nutritional factors. OBJECTIVE: The purpose of this study was to determine the biological parameters best related to anthropometric markers of malnutrition in an elderly polypathological population, and determine cutoff values for these potential parameters to diagnose malnutrition. DESIGN: This prospective study enrolled 116 elderly hospitalized patients and 76 elderly outpatients. Nutritional status (albumin, transthyretin, body mass index (BMI), skinfold thickness) and biological parameters (leptin, insulin-like growth factor-1 (IGF-1), IGF binding protein-1 (IGFBP-1), IGFBP-3, C-reactive protein (CRP), orosomucoid) were assessed. We defined malnutrition according to the lowest quartile of BMI and skinfold thickness measured in a large healthy elderly French sample population. RESULTS: In this sample of elderly patients (age: 85+/-7 years old), leptin concentration was the only biological parameter significantly related to nutrition status. Independent correlations were found between leptin concentration and BMI, skinfold thickness and sex. The relationship between nutritional status and leptin concentration is significantly different in each sex: the more the patients are undernourished, the lower the leptin concentration in both sexes. The optimal leptin cutoff value for the diagnosis of malnutrition in this population was 4 microg/l in men (sensitivity 0.89, specificity 0.82) and 6.48 microg/l in women (sensitivity 0.90, specificity 0.83). CONCLUSION: Leptin concentration is highly correlated with anthropometric data whereas albumin or transthyretin are known to be also influenced by morbidity and inflammatory conditions. Serum leptin concentration could be used for nutritional assessment in elderly patients with acute diseases.     

Population-specific anthropometric cut-points improve the functionality of the Mini Nutritional Assessment (MNA) in elderly Taiwanese

The objective of this study was to determine the population-specific cut-points of body mass index (BMI), mid-arm circumference (MAC) and calf circumference (CC) for identifying subnormal nutritional status in elderly Taiwanese, and to evaluate the possibility of improving the functionality of the Mini Nutritional Assessment (MNA) by adopting these cut-points. This study analyzed data from 1583 men and 1307 women, 65 years or older, of a national survey. The survey involved in-home, face-to-face, interviews and anthropometric measurements. Results showed that based on the cumulative percentile curves, the fifth percentile values were: BMI, 17 kg/m2 for both men and women; MAC, 22.5 cm for men and 21 cm for women; and CC, 28 cm for men and 25 cm for women. Substitution of these population-specific cut-points for respective values in the MNA screen resulted in lowered proportions of elderly classified malnourished or at risk of malnutrition. The prevalence of malnutrition was reduced from 1.7% to 1.4% in men and from 2.4% to 1.5% in women. The proportions classified at risk of malnutrition were reduced from 10.1% to 8.9% for men and 16.8% to 12.8% for women. In conclusion, results suggest that the MNA is a valuable tool for geriatric nutritional risk assessment. However, in populations where significant differences exist in anthropometric measurements from the Caucasian populations, population-specific cut-points should be used.     

Nutritional status in chronically-ill elderly patients. Is it related to quality of life?

Objective

The aim of this study is to assess the quality of life in chronically-ill elderly patients and its relationship with parameters concerning the patients’ nutritional status.

Design

A cross-sectional study.

Setting

Primary health-care centres in Jaen, Spain.

Participants

A total of 168 chronically-ill elderly outpatients aged from 65 to 89 years.

Measurements

Quality of life was measured using the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. A nutritional assessment was undertaken including socio-demographic variables, anthropometric measurements (body-mass index and calf circumference), functional evaluation (Barthel index and Folstein mini-mental status test) and a dietetic questionnaire. The mini-nutritional assessment test was used as an assessment tool to detect nutritional risk.

Results

Quality of life in chronically-ill elderly subjects, as determined by the WHOQOL-BREF questionnaire, which diminishes with age, is independent of anthropometric parameters and a statistically significant difference was found between gender, socio-demographic characteristics, functional capacity, nutritional status and the kind of chronic disease (p<0.05).

Conclusion

The relationship between the quality of life with the patients’ socio-demographic characteristics, functional capacity and nutritional status underlines the importance of taking these factors into account in the management of chronically ill patients, especially women.     

Effects of a food delivery service on the nutritional status of elderly persons living at home alone

OBJECTIVE: The present study was carried out to determine whether a food delivery service can improve the nutritional status of elderly persons living at home alone. METHODS: The subjects were 74 elderly women (age range, 70-90 years; average age 80.2 +/- 3.6 years) living in T town, Miyazaki Prefecture. All were independent in activities of daily living and their nutritional status was individually evaluated using anthropometric, biochemical and dietary methods. We then compared the nutritional status between persons who used the delivery service for more than 3 months and persons who lived alone and did not use the delivery service or who lived with their families. RESULTS: Based on the anthropometric examination, all persons appeared to be in a good nutritional state. However, their total serum protein and albumin levels demonstrated some undernutrition. Total serum protein, albumin, total cholesterol, and HDL cholesterol were all higher in persons who received food from a delivery service than in the control group living alone. Persons who lived with their families had similar levels as persons using the delivery service. Individuals who lived alone tended to eat sweets more frequently than those with their families. The food delivery service resulted in a higher consumption of fat. CONCLUSIONS: The nutritional status of elderly persons living alone may be improved by dishes high in fat delivered for lunch or supper. These results suggest that food delivery services run by municipalities are efficient for nutritional care.     

Influence of parental height and sociodemographic factors on adolescent height in brazil

Objective: To analyze the influence of parental stature and environmental factors on the stature of adolescents from a national survey sample.

Methods: A nationwide survey was carried out in 1989 among a stratified, two-stage, probability cluster sample of 14,455 Brazilian households to provide estimates of anthropometric deficits for urban and rural populations from the five regions of the country. Stature was measured for 5681 boys and girls age 14–18 years, 78.9% of their fathers, and 93.8% of their mothers. Associations between explanatory variables and adolescent height in centimeters were assessed by fitting multiple linear models to the data.

Results: The predicted effects of parental stature and environmental conditions together sum to a total of 17 cm when comparing a boy born to parents with stature below the median and living in the underdeveloped rural Northeast region (1.56 m) with one born to parents with stature above the median and living in the partially industrialized urban South region (1.73 m). For girls, this estimated difference was 12 cm. For boys, the overall influence of parents’ stature was 10 cm (R²= 0.40) and the sociodemographic factors had an overall influence of 7 cm (R² = 0.29). For girls, these values were 7 cm (R²= 0.35) for the parental influence and 5 cm (R² = 0.11) for the sociodemographic factors.

Conclusions: Mother’s stature had the same influence on adolescent’s stature as father’s stature. Independent of parental stature, environmental factors have a strong influence on adolescent stature, particularly among boys.     

Nutritional status and food habits assessed by dietary intake and anthropometrical parameters in anorexia nervosa

A nutritional study was carried out on 43 adolescents females (5 hospitalized and 38 ambulatory) suffering from anorexia nervosa and on a control group matched for sex and age. The study consisted of an interview, a "48 h. recall" and anthropometric measurements. The results have demonstrated that the nutritional status of anoretics are characterized by a total energy restriction resulting in a drastically reduced intake of macronutrients and selected micronutrients, an increased proportion of energy derived from protein. Finally, preferences and aversions are conditioned by calories content of food.     

Nutrition and immunocompetence of the elderly: Effect of short-term nutritional supplementation on cell-mediated immunity and lymphocyte subsets

Fifty-one subjects above the age of 60 years were examined. Assesement of immunocompetence showed a progressive age-related decline in cell-mediated immunity and marked reduction in serum thymic factor activity. Twenty-one (41%) individuals showed clinical, anthropometric, biochemical or hematologic evidence of nutritional deficiency. In these patients, there was evidence of reduced number of rosette-forming T lymphocytes, both T4+ and T8+ subsets, especially the latter. The role of nutritional factors in contributing to impaired immunity was evaluated by providing oral supplementation of approximately 500 Kcal per day for 8 weeks in a formula containing proteins, fats and carbohydrates as well as minerals, vitamins and trace elements, and reassessment of immunocompetence. Nutritional therapy resulted in a marked improvement in clinical and biochemical indices of nutrition, T lymphocyte subpopulations and cell-mediated immunity. The results indicate that malnutrition is a frequent problem in the elderly and contributes to reversible impairment of immunocompetence     

Anthropometry and health in the elderly

Measurements of height, weight, skinfold thicknesses, and circumferences were obtained along with data on health practices and disease from 424 independent-living elderly in the Houston area. The objectives of the study were to examine anthropometric measurements of younger (58 through 74 years) and older (75 through 100 years) elderly individuals and to assess relationships between these measurements and health behaviors and disorders. Results demonstrated differences in anthropometric indexes due to aging and sex. Individuals who considered themselves to be more active than peers or who smoked had lower values for some anthropometric variables such as body mass index and waist circumference. Those who drank alcoholic beverages had lower values for some variables than those who stated that they did not drink alcohol. Diabetes and hypertension in the younger elderly were associated with higher values of some measurements, including waist circumference and body mass index. Anthropometric measurements in the elderly varied with sex, age, health practices, and the presence of certain disorders.     

Routine anthropometry and arm radiography in assessment of nutritional status: its potential

Elementary anthropometric and radiographic techniques, carefully executed and routinely employed in definitive surveys of healthy persons, are of potential value in assessment of patients, and provide the following: 1. Formulas to compute mean "ideal body weights" of young adults from stature (W = kh1.7). 2. A "unit size-weight" index (uS-W) with a mean value of 100 or nearly identical to 100 for all mean "ideal weights" relative to stature. 3. The distribution of values of the uS-W index for 80 and 90% of the population of young adults around the mean. 4. Conversion of body girths and stature to ponderal equivalents such that component A reflects fatness (if present) and component B, leanness and muscularity. 5. Conversion of skeletal diameters and stature to a relative "frame" size weight, designated component C, and employed as a "reference weight" (Ref W) for the calculation of lean body weight (LBW) in the male, and "minimal weight" as well as LBW in the female. 6. Conversion of skinfold thickness to estimates of body fat by means of a surface area formulation where: Weight of fat = SA x skinfold widths x k(fat). 7. The introduction of comprehensive arm radiography to reveal presumptive estimates of body fat from SA and of the amount of bone and muscle in the arm to LBW. 8. The visualization of body shape in the somatogram, and the value of photography under strictly controlled conditions.     

Physical growth in stature of school children of Japanese ancestry in the city of São Paulo, Brazil

This paper reports the results of a cross-sectional survey describing the growth in stature of a sample of school children of Japanese ancestry (three or four grandparents born in Japan) and of high socio-economic status living in S?o Paulo, Brazil. The sample comprises 124 individuals 7-10 years of age, of both sexes. The results show that the children present mean values of stature below the median values of the NCHS curves ("National Center for Health Statistics", U.S.A.). The values are similar to the medians of a sample of Japanese children and below those of well-to-do Brazilian children of non-Japanese ancestry studied by the PNSN ("Pesquisa Nacional sobre Saúde e Nutri??o", Brazil). The findings do not support the hypothesis of uniformity of growth potential in stature, casting doubts on the utilization of a single anthropometric reference in the assessment of nutritional status.     

An evaluation of upper arm measurements used in nutritional assessment.

Triceps skinfold thickness and upper arm circumference (parameters used in assessing protein-calorie malnutrition) were measured on both arms of 91 adult volunteers who fulfilled criteria for absence of disease and conditions affecting nutritional status. For the total study group and subgroups of men only and women only, no significant differences were noted between right and left arm measurements of triceps skinfold thickness, arm circumference, or arm muscle circumference. Median values for significant right-left arm measurement differences were + 1.7 mm for the triceps skinfold thickness of left-handed subjects (P less than 0.05) and + 0.3 cm for the arm circumference of volunteers regularly engaged in predominately right-armed activities (P less than 0.05). Criteria of weight within 15% of "ideal" and nine serum and plasma values within a specified range were fulfilled by 77 subjects, and they comprised the "healthy" subgroup. Left arm median values for healthy men and healthy women differed from a currently accepted standard for each of three anthropometric parameters: triceps skinfold thickness (P less than 0.05), arm circumference (P less than 0.05), and arm muscle circumference (P less than 0.01).     

Prise en charge nutritionnelle en oncogériatrie

Determination of the nutritional status of elderly patients with cancer is essential before to make any decision of therapeutic strategy. It is part of a comprehensive geriatric assessment of the patient whose purpose is to identify frailty that may interfere with the development of the disease and tolerance of treatments. This initial assessment allows for a personalized healthcare for the elderly patient with cancer. Determination of nutritional status combines anthropometric indexes, evaluation of biological data and measure of food intake. The diagnosis of malnutrition or risk of malnutrition is crucial because this is a risk factor for toxicity of the treatment and impaired quality of life. Refeeding has a beneficial impact on the efficiency of the treatment and quality of life of patients with cancer.     

Anthropometry of the trunk and extremities in nutritional assessment of children with chronic renal failure.

OBJECTIVE: Comparison of anthropometric parameters of the trunk and extremities between 2 groups of children with chronic renal failure (CRF) with different levels of nutritional status and healthy controls. DESIGN: A prospective cross-sectional study. SETTINGS: Department of Physiology and Anthropology, University Ss. Cyril and Methodius, Skopje. PATIENTS: Twenty-one patients with a mean age of 10.5 +/- 3.2 years (10 boys and 11 girls) with mild to moderate CRF were divided into well-nourished (chronic renal failure children [CRFC] I) and undernourished (CRFC II) children according to their nutritional status. The control group was 22 healthy children with a mean age of 10.7 +/- 3.8 years (10 boys and 12 girls). Nutritional status of the children was assessed by comparing anthropometric parameters with National Center for Health Statistics references. INTERVENTIONS: Anthropometry. Main Outcome Measurements: Body weight, height, sitting height, arm and leg length, knee height, chest circumference, midarm circumference, triceps skin-fold thickness, and upper arm muscle and fat area. RESULTS: Mean sitting height, leg length, and chest circumference were significantly lower in both the CRFC I group (67.8 +/- 3.5, 57.5 +/- 4.2, and 53.0 +/- 3.9 cm) and the CRFC II group (65.6 +/- 2.2, 56.1 +/- 4.1, and 50.6 +/- 2.7 cm) compared with the healthy controls (72.5 +/- 2.9, 61.3 +/- 3.5, and 62.4 +/- 4.1 cm, respectively). The highest significant correlations to height were for sitting height (r = +0.82, P <.05) and knee height (r = +0.72, P <.05) in CRFC I and for leg length (r = +0.74, P <.05) in CRFC II. There was no correlation between anthropometric parameters of the trunk and extremities and upper muscle and fat area in both groups of CRF children. CONCLUSION: The sitting height, knee height, and leg length can be used in nutritional and growth assessment when it is impossible to make a reliable measurement of height in CRF children.