Malawi maternal and child nutrition study: Study design and anthropometric characteristics of children and adults

The Malawi Maternal and Child Nutrition (MMCN) Study is a three-year longitudinal investigation of some of the determinants and consequences of protein-energy malnutrition in a rural African population. This paper describes the anthropometric characteristics of children and adults based on the baseline census conducted in the 89 villages included in the MMCN Study. Mean length-for-age of Malawian children (birth-60 months) is very low (Z-score = -2.21) and, unlike most other populations, continues to decline with advancing age. Weight-for-length is more nearly normal (mean Z-score = -0.21) but shows the same age-related decline between birth and 18 months (and subsequent return to normal levels) as that seen in many other developing countries. This age pattern is also reflected in upper arm anthropometry, notably estimated arm fat area. Length-for-age and weight-for-age of children is associated with birthweight in the 40% of children having health cards, but body composition indicators do not show the same consistent association with birthweight at all ages. Adult men and women have very low skinfold thicknesses relative to U.S. blacks (50-60% of U.S. medians at the triceps and subscapular sites). Estimated upper arm cross-sectional muscle (plus bone) area for Malawian men averages 74% of U.S. white values, while that for women averages 100% of U.S. white values.