9/22/2013

PENENTUAN STATUS GIZI

Evaluasi Indeks Antropometri

Rahayu Indriasari, SKM., MPHCN, PhD

9/22/2013

Anthropometric measurement
Technique of measuring people
Measure

Index

Reference
Indicator

Information

Evaluation of anthropometric indices

Standardized methods are essential for identifying
malnourished individuals and for assessing nutritional
status of population groups
Methods selected depend on the study objectives and
available resources
Individual level :
1. to track the persons pattern of growth over time
2. identify and classify as malnourished or normal by
comparison with reference limits or cut-off points
3. classify into risk categories indicative of the severity
or type of malnutrition or mortality risk

9/22/2013

Evaluation of anthropometric indices

Population studies (nutrition surveys, nutrition
surveillance) :
1. can characterise nutritional status of the population in
relation to reference population or highlight changes
with successive measurements
2. determine proportion of individuals in the population
with indices below or above reference limits
(prevalence data)

To evaluate anthropometric indices at individual and

population level requires appropriate reference data
for each index

Growth Indices

Requires for correct interpretation of

anthropometric measurement
Calculated from two or more anthropometric
measurements
Combinations, numerical ratios
Compare data to appropriate reference data for
evaluation

9/22/2013

Growth Indices

Head circumference for age index of chronic

protein-energy deficiency for children < 2 y
Weight for age to assess under- and over-nutrition
in children from 6 mo to 7 y.
Weight for height to assess under- and overnutrition in children and adolescents. Low weight for
height results in wasting
Height for age linear growth, index of past
nutritional or health status. Low height for age results
in stunting

BMI for adults

Weight to Height ratios indicate body weight in relation to

height measure overweight or obesity in adults
Body Mass Index = Quetelets index
weight (kg) / height (m)2
Employed in large-scale nutritional survey and
epidemiological studies (obesity) because the
measurements are easy, quick, relatively non-invasive,
and more precise than skin fold thickness measurements
BMI not distinguish between weight associated with
muscle and with body fat elevated BMI related to
excess adiposity, muscularity, or oedema

9/22/2013

BMI for adults

BMI gives no indication of distribution of body fat
abdominal fat related to great risk factor for disease
The International Classification
of adult underweight,
overweight and obesity
according to BMI

BMI for children and adolescents

Indicator of overweight or obesity in children and

adolescents (2-18 years)
Body Mass Index = Quetelets index
weight (kg) / height (m)2
Cole et al. (2000) international age-specific BMI
percentile cutoffs for boys and for girls 2-18 y
CDC (2000) USA age-specific BMI percentile cutoffs
for boys and for girls 2-20 y
WHO (2005) - BMI percentile and z-score cuttoffs for
boys and for girls 2-18 y

9/22/2013

BMI for children and adolescents

BMI for children and adolescents

9/22/2013

Methods of comparison (Percentiles)

Percentiles : the position of the measurement value in

relation to all measurements for the reference population,
ranked in order of magnitude
Percentile for an individual can be calculated, or the
percentile range within which the individuals measurement
falls can be read from reference data
For population studies, the number and percentage of
individuals falling within specified percentiles of reference
data can be calculated to provide an estimate of relative
status
Not recommend for individuals or populations from low
income countries when using reference data from
industrialised countries

Methods of comparison (Z(Z-scores)

WHO recommends to use for low income countries

data
Z-scores: measures the deviation of the
anthropometric measurement from the reference
mean or median in terms of standard deviation score
is a measure of an individuals value with respect to
the distribution of the reference population
Z-score for individual can be calculated (example p.
337)
For population studies, the number and proportion of
individuals within specified range of Z-scores for each
age and sex group can be calculated

9/22/2013

Methods of comparison
(percent--of
(percent
of--median)

Percent-of-median : ratio of a measured

anthropometric value in the individual to the median
value of the reference data for the same age,
expressed as percentage
Can be used when the distribution around median
value is not known or when the distribution of the
reference data is not normalized

www.who.int/childgrowth/en/
http://www.who.int/growthref/en/