Screening for acute malnutrition should be done at any contact points. Midupperarm circumference development and its validity in assessment of undernutrition le thi hop1 md, r gross2 phd, s sastroamidjojo3 md, tu giay1 md, and w schultink2 phd 1 national institute of nutrition, ministry of health, hanoi, vietnam 2deutsche gesellschaft fur technische zusammenarbeit gtz gmbh, germany. Upper arm length was measured with a tape measure from the posterior border of the acromion process to the tip of the olecranon process. Use of midupper arm circumference for determining overweight and overfatness in children and adolescents. Mid arm circumference mac hospice fundamentals ask the experts march 2012. Pdf a growth reference for mid upper arm circumference. Mid arm circumference can be used to estimate weight of adult and adolescent patients article pdf available in emergency medicine journal 344 december 2016 with 1,510 reads. Association between midupper arm circumference and. Mid upper arm circumference muac is a useful tool for a fast assessment of the nutritional status. Monitoring changes in weight using mid upper arm circumference. Measuring midarm circumference and body mass index bmi measuring the mid arm circumference why should i get a mid arm circumference. Children with a muac less than 115 mm have a highly elevated risk of death compared to those who are above. Midupper arm circumference muac measuring tapes technical. The child should be immediately referred for treatment.
Mid upper arm circumference muac as a simple measure to assess the nutritional status of adolescent girls as compared with bmi angeline jeyakumar, mphil, phd, padmini ghugre, phd, and swapnil gadhave, msc adolescents doi. Who child growth standards 1 year 2 years 3 years 4 years 5 years head circumference forage, arm circumference forage, triceps skinfoldforage and subscapular skinfoldforage methods and development isbn 9789241547185. Midupperarm circumference and armtoheight ratio in. Midarm circumference mac is an important measure of nutritional status. Tracer center for human growth and development and department of anthropology, university of michigan, ann arbor, michigan 48108 key words nutritional status anthropometry, muscle area, growth, height. Muac tape screening for acute malnutrition mother, infant.
The mean muac of the group of patients with malnutrition 21. Objective midarm circumference measurement is a prerequisite to selection of proper sized blood pressure bp cuffs and accurate bp readings. Suggestions for improved documentation to support medicare hospice services. Acute malnutrition presents with wasting low weightforheight and or presence of pitting oedema of both feet. Pdf background severe acute malnutrition sam is currently defined by the who as either a low midupper arm circumference i. Objectives to construct growth curves for mid upper arm circumference muacforage z score for 519 year olds that accord with the world health organization growth standards, and to evaluate their discriminatory performance for subsequent mortality. Midupper arm circumference definition of midupper arm. Estimating equations and tables for adult midarm circumfere. Midupperarm circumference development and its validity in. Although midupper arm circumference muac is commonly used to. The simple rugged measuring device can determine whether an adolescent or child has sam or mam in order to determine next clinical steps. Relationship between mid upper arm circumference and weight. Mid upper arm circumference tapes for assessment of severe. Focus on undernutrition mid upper arm circumference.
Training manual for community and homebased care providers. For underfives, mid upper arm circumference muac is the mainstay of community diagnosis of acute malnutrition, is simple to perform and predicts survival better than weightforheight z scores. Mamc was calculated taking into account the mid upper arm circumference and the triceps skinfold thickness of the right arm. Midupper arm circumference muac measuring tapes technical bulletin.
Pdf use of midupper arm circumference for determining. Arm circumference is measured with the subject standing and with the right arm hanging loosely and relaxed. The mid arm circumference was measured with a tape. Percent of women with a low midupper arm circumference. Participants a total of 329 residents age 60 years and older median 79. If you are unable to weigh someone, measuring mid upper arm circumference muac is a way to determine if they are losing or gaining body weight. Sorry, you need the flash player to view these lessons.
May 22, 2019 a study of patients aged 18 to 80 found a correlation between arm circumference and bmi, and undernutrition in adults. For decades the mid upper arm circumference muac measurement has been used in children as a measure of nutrition. Use of mid upper arm circumference for evaluation of. We aimed to investigate the associations between mid upper arm circumference muac, a novel indicator of upper body fat, and a wide spectrum of cardiometabolic risk profiles in chinese population. If there is an increase of 3cm or more, the provider is notified and typically a doppler study is performed. Use of cutoffs for midupper arm circumference muac as. A longitudinal study of mid upper arm circumference of infants at monthly intervals indicated statistically insignificant male and female differences, greater increase in the first six months of infancy than the second sixmonthperiod and significant positive correlation coefficients between weight and arm girth for all age periods and in both sexes. For children 659 months of age compareto who standards to obtain percentileszscores for olderchildren, p ercentil guidelines are available frisancho correlatedwith bmi more sensitive to changes in musclefat mass. The muac test measures the circumference of or distance around the mid upper arm. The use of midupper arm circumference muac has improved the ability of. Assessment of midupper arm circumference as a method for.
Anthropometry protocol circumferences, continued waist circumference. Design and setting crosssectional analyses were performed using data from a welldefined. I know this is not well supported but we measure the lower arm circumference 10cm below the insertion site daily. Use of mid upper arm circumference for determining. Uses the 19992012 cdc child growth standards for mid upper arm circumference forage, to report percentiles and zscores on children from 2 months to 18 years of age. Comparison of weightforheight zscore and midupper arm. National health and nutrition examination survey iii body measurements anthropometry westat, inc. On this page you can find the calculators for measuring the upper arm area circumference, the upperarm fat circumference area and the upper arm muscle area circumference. Measuring mid upper arm circumference muac what is a muac test.
A growth reference for mid upper arm circumference for age. Who arm circumference, triceps and subscapular skinfold. The mid upper arm circumference muac of children aged 6 59 months gives an indication of the degree of wasting and is a good predictor of mortality. Who standards for mid upper arm circumference muacforage show that in a well nourished population there are very few children aged 660 months with a muac less than 115 mm. It is an easy and inexpensive way to detect nutritional status and is used in developing countries for rapid and extensive nutrition surveillance and screening programs. Relationship between midupper arm circumference and body. A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality. This measurement is easiest to make with the participants shirt removed. Children with a muac less than 115 mm have a highly elevated.
Following a patients nutritional status is key for establishing eligibility for hospice care. Receiver operating characteristic roc curve analysis determined the. Mid arm circumference mac or thigh circumference measurement inches, centimeters abdominal girth inches, centimeters change in signs and symptoms. Use of cutoffs for midupper arm circumference muac as an. Pdf mid upper arm circumference muac as a feasible. Measuring the upper arm muscle circumferencethe upper arm muscle circumference is, together with the triceps skinfold, a measure for the quantity of fat and muscle mass in the body. The muac test can identify children between six months and five years old who have malnutrition wasting or thinness and are at risk of dying.
Ask subject to let arm hang loose and with tape measure, measure circumference of arm at the mid point. Palpate the olecranon tip of the elbow and mark it with a cross. How to measure mid upper arm circumference muac nnrrtc. Design growth curve construction and longitudinal cohort study. Determining a global mid upper arm circumference cutoff to assess malnutrition in pregnant women i acknowledgments the authors would like to thank the following investigators and coauthors for generously providing access to their data and for their feedback during the process. An alternative measure for screening low birth weight babies. Midarm circumference and midarmhead circumference ratio in. Using arm circumference to predict bmi can help indicate whether a person is at. Another anthropometric measure that can be used to evaluate adult nutritional status is mid upper arm circumference muac. Objective to assess the use of mid upper arm circumference muac for identification of overweight and overfatness in rural south african children and adolescents. Upper mid arm circumference is greater than 40 cm 40 cm upper arm is conical, not cylindrical, so that the upper arm cuff does not closewrap in straight alignment conical shape upper arm cuffs width is too long for the patients upper arm and overlaps the elbow short arm radialcuf ge healthcare color forearm circumference. Setting eight longterm care facilities in central taiwan. Its another method of estimating a persons body mass index bmi when scales arent available or if theyre unable to use one.
This study aimed to expand on the limited south african malnutrition prevalence data and investigate the feasibility of mid upper arm circumference muac as a malnutrition screening tool. Mean mid arm circumference in centimeters for adults age 20 years and over. If not, you will have to make this measurement underneath the shirt, while lifting and resting it on your left arm. A range of mid upper arm circumference muac measuring tapes are available through unicef supply division. Mid arm circumference mac and new york heart association nyha scaling and measurement tools properly to support eligibility identify the connection between these tools and care planning describe monitoring and auditing techniques to reinforce the proper use of the tools. Muac cutoffs for undernutrition are available for children and adults but not for adolescents. Midarm circumference values were significantly related to birth weight and gestational age, whereas midarmhead circumference ratio was related only to birth weight. Anthropometric reference data for children and adults.
Analyses have been conducted on the distribution of wfh but there are no equivalent studies on the distribution of muac. What you will learn the purpose of documentation the role of the clinician in documentation. Measuring the mid upper arm circumference muac can determine whether or not a child or adult is malnourished and at risk for complications. The percent of women with a mid upper arm circumference muac below 22. Useful when eight is confoundedor unreliable due to medical. Paediatric weight is often estimated in emergency situations using methods based on age or height when direct measurement is not possible, and recently, methods based on mid arm circumference mac have also been developed.
Body mass index is calculated by dividing weight in kilograms by height in metres squared. Pdf relationship between midupper arm circumference and. Setting united states and international growth data, and cohorts in. Anthropometry guideline paediatrics cape town metropole paediatric interest group final. Mid upper arm circumference muac may be a feasible option as it is relatively easy to measure,7 requires little equipment and calculations, and is transportable and inexpensive. Measuring mid arm circumference and body mass index bmi. The aim of this study was to derive and validate an accurate macbased method for weight estimation for use in all age groups. Muac is littleused in older children and adolescents because there. Mid upper arm circumference muac measuring tapes background.
Click the button below to go to the adobe website and download it. Its important to be certain that the muscle of the arm is not flexed or tightened which could yield a larger and inaccurate reading. Dec 21, 2015 the objectives of this study were to i describe the relationship between weight changes and muac changes in children aged between 6 and 59 months during treatment for sam in cmam programmes in three country contexts malawi, ethiopia and bangladesh admitted using muac and ii describe the sensitivity of both muac and weight to episodes of disease experienced during the sam treatment. Thus, for the middleupper arm circumference for age indicator, the assessment interval was from 0. Pdf midarm circumference can be used to estimate weight. Muac community website this is a free and open site for the dissemination and discussion of issues related to the use of mid upper arm circumference muac including, but not restricted to, casedefinitions, surveys, and patient monitoring. People with a below normal arm circumference were more likely to have undernutrition and at an increased risk for related health complications. This investigation examined the relationship between muac z. Measuring mid upper arm circumference muac unicef lesson muac discussions on ennet. Mid upper arm circumference muac as a feasible tool in. Midarm muscle circumference, physical performance and. Measuring midupper arm circumference muac examples. Mid upper arm circumference does not correspond to a specific body weight.
Determining a global midupper arm circumference cutoff to. Use of cutoffs for mid upper arm circumference muac as an indicator or predictor of nutritional and healthrelated outcomes in adolescents and adults. Midupper arm circumference muac notes the template aims at providing a standard framework for compiling key information on food and nutrition security indicators or measures. The auxologic parameters recorded were birth weight bw, crown heel length chl, chest circumference ch c, mid arm circumference mac, thigh circumference tc, calf circumference cc, and occipito frontal circumference ofc using standard procedures by a trained senior resident ensuring intraobserver reliability. Following a patients nutritional status is key for establishing eligibility for. Do not take skinfold measurements after the person has exercised, swam, or showered since skinfold thickness will be increased due to increased blood flow to the skin. Methods anthropometric data weight, height, muac and % body fat from a crosssectional sample of 978 black south african 514yearolds were analysed. Male participants in old age homes n215 and community based n239 were measured for. Detection and referral of children with acute malnutrition, muac resources, interpretation of mid upper arm circumference muac indicators, muac less than 110mm 11. Measuring mid upper arm circumference to assist in monitoring changes in weight when you are unable to weigh someone. Mid upper arm circumference muac as a simple measure.
Measure the distance between the bony protrusion on the shoulder acromion and the point of the elbow olecranon process. To compare weight for height whz and mid upper arm circumference muac to diagnose malnutrition in children aged 659 months and to determine the. Percent of women with a low midupper arm circumference mid upper arm circumference muac below 22. Growth curve construction and longitudinal cohort study. Aug 05, 2016 relationship between mid upper arm circumference and body mass index in women and men. Midupper arm circumference in infants springerlink.
Mid arm circumference mac is an important measure of nutritional status. Many statistical procedures are based on the assumption that the data used are normally distributed. Standing committee on nutrition task force on assessment, monitoring, and evaluation fact sheets on food and nutrition security indicatorsmeasures. Measuring midupper arm circumference muac measuring muac. Measuring midarm circumference and body mass index bmi measuring the midarm circumference why should i get a midarm circumference. Muac tape mid upper arm circumference maternova inc. A description of the muac tapes available through unicef supply division. Uses the 2007 who child growth standards for arm circumference forage, triceps skinfoldforage and subscapular skinfoldforage, to report percentiles and zscores on infants from 3 to 60 months of age. Number of women ages 15 to 49 with mid upper arm circumference mid upper arm circumference for 2 months to 18 years for u.
Mid arm circumference mac and body mass index bmi the. Midarm circumference can be used to estimate weight of. The effectiveness of bmi, calf circumference and midarm. Standards of arm muscle by stature for the assessment. Research shows that it is equally good, if not better, than other measurements for screening young children and selecting those needing therapeutic feeding 1. Mid arm circumference can be used to estimate weight of adult and adolescent patients giles n cattermole,1 colin a graham,2 timothy h rainer3 additional material is published online only. Estimating bmi category from mid upper arm circumference muac the subjects left arm should be bent at the elbow at a 90 degree angle, with the upper arm held parallel to the side of the body. Assessment tools in hospice cognition measurement tools. The anthropometry of the upper arm is a set of measurements of the shape of the upper arms the principal anthropometry measures are the upper arm length, the triceps skin fold tsf, and the mid upper arm circumference muac. Muac tape interpretation of muac indicators mother. Mid arm circumference mac is widely used as an indicator of childhood nutrition status in resourcelimited countries. Pdf low midupper arm circumference identifies children with a.
The effectiveness of bmi, calf circumference and mid arm circumference in predicting subsequent mortality risk in elderly taiwanese volume 105 issue 2 alan c. A range of mid upper arm circumference muac measuring tapes are available through unicef. The use of mid upper arm circumference muac as a screening measure for assessing undernutrition has the following advantages. Nutritional screening is a fundamental aspect of the initial evaluation of the hospitalised patient. Formulas using mid upper arm circumference mac and tsf provide indirect assessment of the arm muscle area and arm fat area. Tapes for measuring mid upper arm circumference muac. Mid upper arm circumference muac as a simple measure to. A growth reference for mid upper arm circumference for. Relationship between mid upper arm circumference and body mass index in women and men. Body mass index bmi, on the other hand, has been used in adults as a measure of body weight and of under nutrition. Summary mid upper arm circumference muac tapes are simple, inexpensive tools that can be used in both community.
To use mid upper arm circumference muac as a proxy measure of undernutrition in elderly males of punjab, india. Muac tapes are predominately used to measure the upper arm circumference of children but also that of pregnant women, helping identify malnutrition. Put the tape measure on the mark made at the shoulder and drop it down to the tip of the elbow by the side of the arm. This video was developed by kalawati saran childrens hospital, new delhi for assessment of nutritional status of children with severe acute malnutrition by taking their muac.
Objectives upper body fat has been associated with an unfavourable cardiometabolic risk. You may need to take this measurement as a volunteer, social worker, pediatric aide, or medical assistant. This study aimed to expand on the limited south african malnutrition prevalence data and investigate the feasibility of mid upper arm circumference muac as a. Standardized midupper arm circumference cutoffs for adolescents.
Standards of arm muscle by stature for the assessment of nutritional status of children a. Do not pull the tape measure tight it should just fit comfortably round the arm. This has been our practice for some time now and we have identified dvts based on increasing lower arm circumference. Midarm circumference and mid armhead circumference ratio values were established for the studied population. Women may be willing to tuck the shirt underneath their bra strap. Objective to investigate the association between mid upper arm circumference muac, calf circumference cc and allcause mortality in a chinese population. Physical performance was assessed using the physical performance battery score, which is based on three timed tests. Mid upper arm circumference, calf circumference and. The inbody test not only examines your total body water, fat, protein, and minerals, it also reveals percentage of body fat, muscle distribution, and body water balance. Mid upper arm circumference muac may be a feasible option as it is relatively easy to measure, 7 requires little equipment and calculations, and is transportable and inexpensive.