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Related Experiment Videos

Mid-arm circumference for detecting malnutrition during infancy.

R C Bhatia1, P A Pooni, H Singh

  • 1Department of Pediatrics, Dyanand Medical College and Hospital, Ludhiana.

Indian Journal of Pediatrics
|May 8, 2000
PubMed
Summary

Mid-arm circumference (MAC) is a reliable indicator for detecting protein-energy malnutrition (PEM) in infants aged 6-12 months. A cut-off of 12.5 cm or less demonstrates high sensitivity and specificity for early PEM assessment.

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Area of Science:

  • Pediatric Nutrition
  • Anthropometry
  • Public Health

Background:

  • Mid-arm circumference (MAC) is a recognized age-independent indicator for protein-energy malnutrition (PEM) in children aged 1-5 years.
  • The utility and optimal cut-off for MAC in infants under 12 months remain inadequately studied.
  • Early and accurate detection of PEM in infants is crucial for timely intervention and program targeting.

Purpose of the Study:

  • To establish the age-independent nature of MAC in infants aged 6-12 months.
  • To identify a reliable MAC cut-off point for detecting PEM with maximum sensitivity and specificity in this age group.
  • To assess the feasibility of using existing MAC measurement tools for infant PEM screening.

Main Methods:

  • A cross-sectional study involving 240 malnourished infants (weight-for-age < 80% of NCHS 50th percentile) and 240 healthy controls, aged 6-12 months.

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  • MAC measurements were taken and analyzed for age independence within the 6-12 month range.
  • Various MAC cut-off points were evaluated to determine the optimal threshold for PEM detection based on sensitivity and specificity.

    • Main Results:

    • Mid-arm circumference was found to be age-independent in infants aged 6-12 months, with a minimal overall increase of 5.1%.
    • A MAC cut-off of ≤12.5 cm demonstrated the highest sensitivity (92.1%) and specificity (88.3%) for identifying PEM.
    • Existing MAC measurement tapes often feature a ≤12.5 cm color-coded cut-off, facilitating immediate application.

    Conclusions:

    • Mid-arm circumference is a simple, age-independent, and informative anthropometric measure for the early assessment of protein-energy malnutrition in infants aged 6-12 months.
    • A single cut-off point of ≤12.5 cm for MAC is recommended as an effective screening tool for targeting infants in nutritional programs.
    • The widespread availability of MAC tapes with the recommended cut-off eliminates the need for new equipment, promoting efficient implementation of screening initiatives.