Course

Anthropometric Measures

Height/Weight

Knee Height

Weight for Height

Circumference

Circumference Tables

Body Fat

Body Fat Tables

Lean Body Mass

Abdominal Fatfolds

Anthro Tables

Summary

Resources

Evaluations Based on Weight for Height

Once height, weight, and frame size are determined several evaluations can be accomplished. Comparison of weights can be made to ideal body weight (IBW) and to usual body weight (UBW) estimates. Ideal body weight can be estimated using the Hamwi formula of 106 pounds for the first 60" of height and 6 additional pounds for each inch over 60" in males or 100 pounds for the first 60" of height and 5 additional pounds for each inch over 60" in females.⁴ A person with a small frame size may have an ideal weight of up to 10% less than calculated by the Hamwi formula and the person with a large frame may carry up to 10% more weight. The percentage of ideal body weight (%IBW) can be figured by dividing current weight by calculated ideal weight and multiplying the result by 100 (for percentage).

Several schematics have been developed to classify malnutrition using anthropometric measurements. These levels were developed through clinical review of the severity of a malnutrition problem. Some of these levels have been used to determine interventions. In the age of managed care, appropriate use of these levels can determine the economic support for nutrition interventions. Protocols defining an intervention level are usually standardized.

In addition to the ideal weight, an important piece of information is the usual weight and whether or not any weight gain or loss was unintentional. A percentage of usual weight (%UBW) can be calculated by dividing current weight by usual weight and multiplying the result by 100 (for percentage). Persons who have unintentionally lost more than 10% of their body weight unintentionally will require intervention. Other categories of weight loss from usual weight are mild at <5% and moderate at <10%. The time period in which the person loses weight unintentionally will also help to categorize the severity of the problem.

The system of International Classification of Diseases (9th Edition) with clinical modification (ICD-9-CM Codes) used to document morbidities includes weight loss information. Kwashiorkor (ICD-9-CM 260.0) is defined as >90% of standard weight for height with depressed albumin and/or transferrin along with symptoms of edema, muscle tissue loss, and other complications that occur in acute protein and energy malnutrition or as a part of the stress response to infection or injury. Marasmus (ICD-9-CM 261.0) is defined as weight at <80% of standard with or without a weight loss of >10% usual weight over a period of six months along with the preservation of albumin levels and loss of fat and muscle tissues. Severe protein-energy malnutrition (3rd degree PEM or ICD-9-CM 262.0) is defined with weight at a level of <60% of standard and depressed albumin; moderate PEM (ICD-9-CM 263.0) is defined with weight at 60-75% of standard; and mild PEM (ICD-9-CM 263.1) characterizes weight at 75-90% of standard.⁵

An additional characterization of levels of weight according to height is body mass index (BMI) also known as the Quetelet index. This can be calculated by dividing weight in kilograms by squared height in meters.⁶ Levels associated with the least health risk are from 22-25. A BMI of >25 is associated with health risk of cardiovascular disease and a level of <18 is associated with risk of disease associated with malnutrition. However, BMI does not consider sex (men are typically heavier than women for their height), race, or age differences and has limited value in making valuable recommendations for weight loss or gain. It is certainly not a valid evaluation for persons under 20 or over 65 years old and for pregnant or lactating women.⁷