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HUMAN BODY MEASUREMENTS:
Concepts and Applications

S.P. Singh, Ph.D.

Professor,
Department of Human Biology
Punjabi University, Patiala

&

P. Mehta, Ph.D.
Professor,
Department of Human Biology
Punjabi University, Patiala
Table of Contents
Preface

1. Introduction

2. Body Measurements

2.1 Planes axes of the body

2.2 The body cavities
2.3 Instrumentation
2.4 Protocols for Anthropometric Measurements
2.5 IBP/HA Body Measurements
2.6 Kinanthropometric Measurements
2.7 Lohman et al. (1988) protocol of measurements
2.8 Accuracy and Reliability of Measurements
2.9 Which side to measure?
2.10 Age assessment and Age Grouping
2.11 Log Transformations
2.12 Human biological variations

3. Body Proportions
3.1 Body Proportions
3.2 The phantom stratagem
3.3 The O-scale system

4. Body Composition
4.1 Historical perspective
4.2 Conceptual models of body composition
4.3 Five level model of body composition
4.4 The ‘Reference’ Man and a ‘Reference’ Woman
4.5 Hydration of body compartments and body fat
4.6 Densities of body components
4.7 Cadaver analysis for revalidation of body composition
4.8 Densitometric determination of body composition
4.9 Anthropometric determination of body composition
4.10 Adipo-muscular relationship
4.11 Matiegka’s method
4.12 Drinkwater tactic for estimating fractional body masses
4.13 Roentgenogrammetry
4.14 Hydrometry
4.15 Dual Energy X-ray Absorptiometry (DXA)
4.16 Neutron Activation

5. Human Physique
5.1 Viola’s classification
5.2 Kretschmer’s classification
5.3 Sheldon’s Method of Somatotyping
5.4 Somatotyping Criteria
5.5 Dominance of endomorphy
5.6 Dominance of mesomorphy
5.7 Dominance of ectomorphy
5.8 The trunk index and somatotype
5.9 The second order variables of human physique
5.10 Gynandromorphy
5.11 Dysplasia
 5.12 Textural aspect
5.13 Hirsutism
5.14 Critical evaluation of Sheldon's method of Somatotyping
5.15 Parnell’s method of Somatotyping

6. HEATH-CARTER METHOD OF SOMATOTYPING

6.1 Heath-Carter method of Somatotyping

6.2 Anthropometric Measurement
6.3 Technique of Heath-Carter Anthropometric Somatotype
6.3.1 First component or endomorphy rating
6.3.2 Second component or mesomorphy rating
6.3.3 Third component or ectomorphy rating
6.3.4 Somatochart and Somatoplot
6.3. 5 Somatotype Distributions
6.3.6 Somatotyping Children
6.3.7 Critical Evaluation of Heath-Carter Anthropometric Somatotype Method
6.3.8 Calculating the Heath-Carter Anthropometric Somatotype

7. Anthropometry and Nutritional Status

7.1 The World Food Scenario

7.2 Anthropometry and Economic Development
7.3 Energy Homeostasis
7.4 Pregnant Mother and the Newborn
7.5 Anthropometric Indicators of Nutritional Status

8. Growth, Maturation and Physical performance

8.1 Physical growth

8.2 Physical fitness
8.2.1 AAHPERD Youth Fitness Test (1976)
8.2.2 The Presidential Youth Physical Fitness Award Program
8.3 Bodily Maturity, strength and physical fitness

9. Applications of Anthropometry
9.1 Growth and development
9.2 Prediction of adult height
9.3 Physique and disease
9.4 Nutritional Status
9.5 Estimating skeletal frame size
9.6 Obesity
9.7 Chronic illness and health
9.8 Sports
9.9 Human dimensions for design solutions
9.10 Appliances for left hander

References
Bibliography
Appendix I. Values of 1/cube root of weight
PREFACE

Human body measurements catch the fancy of every human being. Such curiosity often comes to our notice
at the railway stations and bus terminals where people jostle around the weighing machines to measure
their body weights. Though the physical appearance and bulk of the body is often visually appreciated in
the society yet actually how much it is has to be carefully assessed with the help of body measurements.
The purpose of this book is to acquaint the reader about various types of techniques for taking body
measurements and also to reflect on their importance. The body measurements take us into the realm of
human body composition, physique and nutrition. The under and over nutrition which has strong linkages
with different types of diseases is usually judged with the help of body measurements.

The reader is introduced to different aspects of human body measurements (anthropometry). It deals with
the recommendations of International Biologiocal Pragramme (IBP) on Human Adaptability. A growth
sub-committee under this programme designed the protocol for taking various body measurements. It is a
well known protocol which is widely in use throughout the world. Kinanthropometric techniques and those
of Lohman and colleagues which are somewhat different from those of IBP measurements are also included
which are used in the fields of sports sciences and physical education. Traditionally, body proportions
of one body measurement to another have usually been attempted to know the variations in one
body measurement by keeping the other constant. Such differences are of use in numerous situations
of an individual to show the differential pace of development of body parts. Traditionally, the methods
employing anthropometry, densitometry, roentgenogrammetry and hydrometry were used for the
assessments of human body composition. The most convenient model of human body composition was to
fractionate the body mass into fat mass and the fat free mass. But recently a five level model of body
composition is being vigorously investigated by researchers to find association of body composition
variables at each level. Human physique has always invited interest for its association with disease.
Numerous methods of studying physique including those of Viola, Sheldon, Kretschmer, Parnell and
Heath-Carter have been given in extensive detail. Basic information on physical growth of children is
provided here. There are wide differences between the two sexes in physical performance and muscular
strength. Various tests for judging physical performance like AAHPERD would prove useful not only to
sportsmen but also to those dealing with human health and disease. Human body measurements have
immense applications almost in every field since all the gadgets, machines and devices meant for human
use always rely on these measurements.

The present book is a compendium of numerous conceptual issues dealing with human physique, body
composition, and nutritional status and how these can be approached through the use of body
measurements. It would fulfill a much needed gap in this area of information for the post graduate students
of different courses in Indian universities especially in the subject of Human Biology, Anthropology,
Sports Science, Physical Education, Physiotherapy, Medical Sciences. It lays special emphasis on concept
building supplemented with solutions to practical problems wherever necessary.

The authors are thankful to Professor J.E.L. Carter, Ph.D. formerly of the Department of Physical
education, San Diego State University, San Diego, USA, who is a pioneer in somatotyping and
kinanthropometry. He has been kind enough to suggest valuable modifications in somatotyping which are
explicit in the text. We feel greatly obliged to him for his going through our draft and also for allowing us
to use some of the material on somatotyping. Professor William D. Ross, Ph.D., formerly of the
Department of Kinesiology, Simon Fraser University, Burnaby, Canada has also critically examined our
text particularly related with body measurements, body proportions and phantom stratagem. We thank him
and his colleagues for being so generous in providing us their material and allowing us to use some of it in
our book.

The teachers, students and research scholars of the Department of Human Biology have always been a
source of inspiration to us and the present book is an outcome of interactions with all of them. First and
foremost, we wish to acknowledge Professor L.S. Sidhu, our teacher for teaching us the very basics of the
subject. The fruitful discussions, suggestions and help provided by our former doctoral students Dr.
Jaswinder Singh, Dr. Abha Mandira, Dr. Sarita, Dr. Amrit Pal Kaur, Dr. Zora Singh, Nirlep Kaur, Dr. Prit
Pal Singh, Dr. Ranbir Singh Parmar, Dr. Rupinder Kaur Bansal, Dr. Kamaljit Kaur, Dr. Dolly Monisha, Dr.
Ajit Pal Singh, Gulshan Veer Kaur, Dr. Ginjinder Kaur and Dr. Rupinder Kaur has really improved the
draft of this book and their efforts would always be kept in mind. Our special appreciation is for many of
our M.Sc. Human Biology students for proof checking and especially for Ms Parminder Kaur, Ms
Meenakshi and Mr Sudhanshu Abhishek who have gladly posed for photographs depicting the techniques
of some body measurements.

We feel indebted to Mrs. Narinder Jit Kaur wife of the senior author for the editorial work of checking the
manuscript.

We are thankful to Mr. Darshan Singh for his help in making the necessary drawings and to Mr Devinder
Singh Dhiman for typing the manuscript.

S.P. Singh
P.Mehta
 1. INTRODUCTION

Human body measurements convey a lot of information about the individual’s physical

status, shape, size, and physique and body composition. There has been a variety of procedures

for taking any measurement. That asks for standardization for taking different measurements. One

of the most important objectives of kinanthropometry is to observe variations in various body

measurements among different individuals and among different populations for understanding the

processes of growth and maturation and ultimately its bearing upon physical performance and

work capacity of the individual. This objective can be achieved by reaching a consensus on the

techniques of measurements and standardizing them. The new emerging scientific specialization

of kinanthropometry devoted to body measurements and its use in body dynamics was first

conceived and developed during the nineteen seventies. According to its foremost proponents

Ross et al. (1978) “it is the application of measurement to the study of human size, shape,

proportion, composition, maturation and gross function. Its purpose is to help understand human

movement in the context of growth, exercise, performance and nutrition”. The word

kinanthropometry is an acronym of three Greek words, viz., kineein means to move, anthropos

means man and metreein means to measure.

A description of kinanthropometry after Ross et al. (1980) has been given below:

1. IDENTIFICATION

Kinanthropometry

 Movement

 Human

 Measurement

2. SPECIFICATION

For the study of

  Size

 Shape

 Proportion

 Composition

 Maturation

 Gross function

3. APPLICATION

To help understand

 Growth

 Exercise

 Performance

 Nutrition

4. RELEVANCE

With implications for

 Medicine

 Education

 Government

Various terms of dynamic anthropometry, sport anthropometry, physiological

anthropometry, anthropomotorika, etc., often used by different scientists fall easily in the realm of

kinanthropometry. The roots of kinanthropometry can be traced to various scientific fields and it

gets its strength from them. The interested readers in various fields such as human biology,

anthropology, auxology, physical education, sport sciences, etc., will find some of the concepts of

these fields imbibed in kinanthropometry. To illustrate this point, as Ross et al. (1980) put it that

Galileo Galilee gave the theoretical concept of geometric forms which finds its applicability in

kinanthropometry. He stated that if shape and composition of a body remain constant, volume or
mass increase as cube of the linear dimensions whereas strength would increase only as its

square. This law is called cube-square law, which finds its use in kinanthropometry.

Metaphorical models find their use in various fields and are of immense value. In

kinanthropometry also, the metaphorical models get their due place. Torricelli conceived the air

pressure as "sea of air" which puts pressure on all subjects which can be thought of as immersed

in air. It was an example of a metaphorical model! Experts in the fields of mathematics and

natural sciences who propounded various statistical theories, which are being widely used,

naturally become the contributors to kinanthropometry. Ross (1978) has emphasized that

metaphorical models may serve as reference models in kinanthropometry and lead to new

inferences and understanding. The importance of unisex universal reference theoretical human or

phantom can be appreciated in proportionality profiling of the subjects to evaluate differences

between subjects and groups and to study temporal changes in the same subject.

Kinanthropometry is thus a useful tool in the hands of sports scientists, physical

educationists, coaches, pediatricians, human biologists, anthropologists, etc. The research

workers in such fields can pursue their research ideals of understanding and exploring the

mysteries of various dynamic processes and phenomena of life with the help of

kinanthropometry. For example, a human biologist may like to know the dynamic pattern of

height growth of an individual. How does the size change with age of a person? He would

measure the child's height at various ages and would find out that the child races very fast on the

track of his growth at some ages and slows down at others. What causes such changes can be

answered by the knowledge generated at the tissue, cellular and molecular levels.

Kinanthropometry equips us with the techniques of various body measurements, e.g.,

height, body weight, transverse diameters of various parts of the body, circumferences and

lengths of various parts of the body and skin and subcutaneous tissue fold thicknesses, etc. The

body measurements can be utilized to study the gross size of an individual. How tall and heavy is

a person? An idea about his shape, size and proportion can be generated. How does an individual
look like from various directions and with respect to his various body parts? What are the

relationships of length, breadth and height of any body part with respect to another? How would

be the three dimensional outlook and perception of the head, neck, trunk and extremities? Shape

is thus a composite picture of various segments of the body and their proportions. The

relationships of lengths to breadths, height to thickness, length to length, etc., of various parts of

body represent proportions. The importance of proportions becomes evident when we want to

compare a particular body part of two persons who are otherwise different in overall size. The

proportions or ratios keep one measurement constant in all subjects compared and evaluate the

differences in the other measurement. Physical and physiological maturity can be evaluated by

taking body measurements. It can be useful in monitoring the health and nutritional regimens of

the human subjects.

It must be noted that anybody with a beautiful body must have it well proportioned. The

famous 15th century Italian artist, engineer and architect, Leonardo da Vinci (1452-1519) gave the

concept and drawing of such a well proportioned physique. His ‘Vitruvian Man’ survives till date

and is widely used as a logo. It says that if you set your legs apart in such a way that this distance

is one-fourteenth part of your height and you open and raise your arms so that the middle fingers

touch the horizontal line drawn from the crown of your head, then the circle thus formed of the

extremities would be situated at the naval. The span of the stretched arms will be equal to the

height and the legs would form an equilateral triangle. If the trunk length is the same, Blacks

show longer arms and legs. There are vast differences in the bodily proportions of different races.

It has been well established till now that people of African origin have relatively longer lower

extremities than others. Tracking the growth of children determines how the extremities had a

very small proportion to height at the time of birth as compared to that of the head circumference.

The role of body proportions is now being appreciated in the selection of world class athletes.

There are indications that the longevity of adult humans is closely associated with a

desirable body weight for height. That’s why during the earlier part of the twentieth century these
standards became very popular to designate individuals within the normal range. Body mass

index (BMI) which was earlier known as Quetelet’s index became very important to health

authorities. Weight for height standards are being used by the insurance companies and the

military authorities to assess the desirable weight of the persons during the first half of the

twentieth century. Employers are now increasingly seeking the desirable people they wish to

employ on the basis of weight for height standards so as they may prove to be assets to their

companies. But it must be noted that in case of trained athletes having large body weight, the

BMI would designate them as overweight. It goes to the credit of Professor Behnke (1942) who

exposed the fallacy of such weight for height standards and found these athletes highly muscular

and extremely fit individuals with very little amounts of fat. Terming them as physically non-fit

simply for being overweight was a cruel joke on them as they were the best by virtue of their

body composition analysis. This landmark study opened new vistas in body composition research

which later found wider applications in the fields of physical fitness, sports science and medicine.

The human body mass may be conceptually divided into numerous fractional masses.

Various concepts make use of the qualities of body tissues, their water holding qualities and

differential densities of various tissues. On the basis of these qualities, the models may be

conceived of as a range from a single-compartment to multi-compartment models. There are

different levels of the organization of the body. Making use of this concept Wang et al. (1992)

proposed a five-level model of body composition. These levels started with the atomic or

elemental level and proceeded on to molecular, cellular and tissue level and culminated with the

whole body level model. The models detailing fractionation of body mass qualitatively can be

very useful in correlating physical performance with the fractional masses. There can be many

approaches to the assessment of body composition. The various techniques for estimating body

composition include densitometry, hydrometry, roentgenogrammetry, ultrasound, photon

absorptiometry, neutron activation, bioelectrical impedance, total body water by dilution, CAT

scanning, total body potassium, anthropometry, creatinine excretion, etc. While some of these
methods are highly invasive others are very costly, time consuming and need lots of equipment.

Anthropometry is the easiest of all; it is non-invasive, very economical and subject friendly. In

the era of computers the need of the hour is to develop and use simple techniques with wide

applications which can be processed through computers using all the statistical tools to extract the

maximum information out of it. The body measurements especially the skinfolds are useful in

evaluating body fat and lean body mass. The percentage of body fat is a good indicator of the

obesity of an individual. Effect of physical activities on percentage of body fat can also be gauged

from the skinfold measurement. The fatty tissue is a storehouse of energy but can be considered

as an additional burden on athletes and physically active persons. The body mass which is simply

put as the body weight less the amount of body fat can find its value in monitoring the health of

the individuals and their physical fitness. The maximum the quantity the better it would seem to

be. The percentage of lean body mass would be more authoritatively interpreted if its distribution

per unit height is attempted otherwise an athletic and a lean individual cannot be distinguished

from each other. The lean body mass seems to have a direct proportion to the strength of the

body.

One always wonders about his body and its form. Human physique which explains how a

human body looks like seems to be a formidable concept. Popular wisdom has given its three

forms. Almost all cultures of the world have been identifying human physique as thin, muscular

and fat. But this classification is qualitative and very discrete which does not allow numerous

other types of physique to be explained. Cherished human bodies seem to promise youthfulness,

health and vigour and have always attracted the opposite sex. Hippocrates a great Greek

philosopher and physician of the fifth century BC described two different types of people as

habitus phthisicus who were thin and lean persons with long extremities and habitus apoplecticus

who were short persons with thick and massive bodies. In the context of classification of human

physique, the efforts of Kretschmer, a German psychiatrist, in the beginning of the twentieth

century are appreciable. He gave a detailed account of the characteristics of three categories of
humans which were named as pyknic or fatty, athletic or muscular and leptosome or lean. His

method was based on making anthroposcopic observations on the human subjects. Kretschmer

wanted to explore further by explaining temperaments along with the human physique. This was

done by the studies of physique classification and that of temperament then correlating the two.

The earliest attempt at classification of human physique with the help of body measurements was

done by an Italian physician Viola during the early part of the twentieth century. His four-way

classification of human physique as longitype having relatively long limbs, brachitype or broad

type, normotype which fall in between the above two categories and mixed type who show

characteristics of different types in different parts of the body. William H. Sheldon, S.S. Stevens

and W.B Tucker appreciated that the human physique is a continuously distributed characteristic.

They successfully devised a method in 1940 to analyse and quantify human body form called

Somatotyping. According to Sheldon, somatotype shows the variations in human morphology

which is represented on a continua of variation and it may be considered as a step towards human

taxonomy. The somatotype is aimed at providing some sort of identification tag to the subject and

may also be referred to as something similar to the Mendeleyev’s periodic table of the elements in

chemistry. Sheldon recognised three basic components of physique, viz., endomorphy,

mesomorphy, ectomorphy. Each individual has varying degrees of development of these three

components. The somatotype is always written in three numerals: the first indicating the

development of endomorphy, the second the mesomorphy and the third the ectomorphy. Sheldon

was perhaps the first scientist to appreciate the continuity of human physique (not a few discrete

types) and invented a workable method to achieve this.

After Sheldon's method of somatotyping, there have been many attempts to make it simpler,

easily executable and more objective. Later on, Heath and Carter in 1967 gave their own

modified method of somatotyping. This method, however, differs from that of Sheldon's in the

sense that it evaluates the body form or physique at the given time compared to the unchanging

somatotype of Sheldon. The ratings of three primary components of physique are assigned from
the tables on the basis of the anthropometric measurements. Before going into the details of the

method, it is necessary to acquaint with their concepts of somatotype and the three components,

viz., endomorphy, mesomorphy, ectomorphy.

Growth process of children is highly organised. Generally the children follow a predestined

curve of growth. It can be said that the route of growth of children is established early in life and

they follow it normally except for the situations of stress. Children and adolescents provide

excellent opportunities of such episodes of undernutrition, physiological distress or disease for

research on their growth and physical performance. It is quite interesting to note that during

adolescent period the boys and girls can be seen in all stages of their development. For example,

at 14 years, in boys and 12 years in the case of girls, there will be a certain number of them who

are still to enter their adolescent or pubertal periods, and look like preadolescent children, having

no growth of sexual hair, and no abrupt increase in height. There can be another group of children

midway through their adolescent cycles. They may show certain level of development of sexual

maturation characteristics and may exhibit increased velocities. Still some others may have

completed their full sexual growth. The growth of genitalia and pubic hair may be complete in

them and physically they may look like full grown adults. This is all part of the normal pubertal

variations in human which are so dramatic. The children who enter adolescence later are called

late maturers and those entering early are referred to as early maturers. There is no indication that

the late maturers will end up smaller than their early maturing counterparts. Rather they will get

more years to grow and have tendencies of linearity. Not only do the variations in ages at entry of

various pubertal characteristics exist but the duration of various developmental stages and

complete maturation processes also vary greatly. It is largely their genetic make-up which sets up

the tempo of growth and development. However, this developmental status has a lot of bearing on

the child with respect to his physical performance as also to his social status and peer

relationships. The maximum gain in height around the period of adolescence is called ‘Peak

Height Velocity’ (PHV). There are large variations in the ages of adolescence in boys and girls in
different populations. Generally the populations of the west and those more affluent are advanced

in reaching adolescent periods. The ages at PHV and its intensity are very informative and refer

to an important developmental milestone.

World Health Organization and the health authorities of different nations put a lot of

emphasis on the growth, health and nutrition of the children of the world. Weight for age, height

for age and weight-height standards are available on numerous world populations through which

the children can be screened for malnutrition. Children with deficit in height and weight carry

health risks. It is now well understood that they have a greater chance of morbidity and mortality.

Cut-off lines have also been standardized for height-age and weight-age of children not only to

distinguish between normal and undernourished ones but also to discriminate between acute and

chronic under-nourished children using 2-Z and 3-Z scores (Waterlow et al., 1977; WHO 1986,

1995a, 1995b). In order to use height-age and weight-age standards accurately the exact date of

birth/ age of the child must be known. But weight-height standards can be used even if the

accurate age of the child is not known. Mother’s health is the all important determinant of the

health and well being of the newborn. Maternal anthropometric status has emerged as a good

indicator of the birth outcome of the baby. It is a generally accepted fact that overweight women

with excessive weight gain during pregnancy give birth to large-for-dates babies. Among the

various parameters of the pregnant mothers influencing birth outcome include the pre-pregnancy

weight, weight gain during pregnancy, pregnancy weight gain at each trimester, skinfold

thicknesses and limb circumferences.

Anthropometry, the science of measurements of human body, is of immense use to the

society. The knowledge of these characteristics is undoubtedly very useful in almost every sphere

of human affairs. All the utilities are so deigned which fit in the needs of every particular group.

The articles of use by human beings are being designed on the basis of anthropometric

measurements even though the designers of these articles may be unaware about the science of
anthropometry. Ergonomics is a special field which deals with this interface of human need and

instrumentation.

The populations living under these conditions have undergone special changes in their

bodies which provide them selective advantage for survival and procreating. For example, to be

successful in a desert climate, the body must evolve a strategy to dissipate body heat which can

be done by increasing the surface area. This seems to be the reason for thin and elongated bodies

of the inhabitants of the deserts. On the other hand, people of the arctic have thick bodies which

prevent heat loss. Similarly, the residents of the high altitude have greater chest diameters in

order to increase the pulmonary ventilation which provides them with an opportunity to increase

the availability of the oxygen which otherwise is less in the rarefied atmosphere of the altitude.

The populations of the world have lots of variations in body size and structure. There are very tall

populations measuring as much as 180 cm in comparison to the pygmies of central Africa who

are barely 130 cm in height. This range of averages of body height of the two extremes amply

point towards the need of having specific reference data for different populations. Because of

these adaptations, the humans have inhabited the globe successfully from equator to the poles and

from deserts to the high altitude zones which have drastically different climatic conditions and

physical properties of the environment.

 2. BODY MEASUREMENTS

Chapter details

Planes and axes of the body

The body cavities
Instrumentation
Protocols for Anthropometric Measurements
IBP/HA Body Measurements
Kinanthropometric Measurements
Lohman et al. (1988) protocol of measurements
Accuracy and Reliability of Measurements
Which side to measure?
Age assessment and Age Grouping
Log Transformations
Human biological variations

The overall size and mass of the human body are used as proxy measures for many purposes for

the assessment of health status, obesity, malnutrition, disease and work capacity. The

measurements of different body parts which include the segmental lengths, bodily breadths,

circumferences of the trunk and limbs and skin and subcutaneous tissue fold thicknesses are used

for research and for designing the instruments and equipments for human use.

Measurement techniques need to be standardized so that different studies may become

comparable. One of the most important objectives of kinanthropometry is to observe variations in

various body measurements among different individuals and among different populations for

understanding the processes of growth and maturation and ultimately its bearing upon physical

performance and work capacity of the individual. This objective can be achieved by reaching a

consensus on the techniques of measurements and standardizing them.

The exact location of the landmarks and position of various reference points for the purpose of

taking body measurements can best be understood by first acquainting with different planes and

axes of the body. These have been explained below.

2.1 Planes and axes of the body
Sagittal plane or antero-posterior plane

This plane is parallel to the vertical plane and divides the whole body into two parts, right

and left. The plane which divides the body exactly into left and right halves is called mid-sagittal

plane.

Coronal plane or frontal plane

This plane is at right angles to the abovementioned sagittal plane and divides the body into

front and rear parts.

Transverse plane

This plane is at right angles to the above two planes and divides the body into upper and

lower parts. Fig 2.1 displays various axes and planes of the human body.

Insert Fig 2.1 somewhere here

The lateral axis

Any line resulting from the intersection of frontal and transverse planes is called the lateral

axis.

Longitudinal axis

Any line resulting from the intersection of frontal and sagittal planes represents the

longitudinal axis.

Antero-posterior or sagittal axis

Any line resulting from the intersection of sagittal and transverse planes represents the

antero-posterior or sagittal axis.

2.2 The Body Cavities

The human body is constituted by two major portions called the axial portion and the

appendicular portion. The head, neck and truck are included in the axial portion whereas the arms

and legs are included in the appendicular portion. The axial portion has two cavities, viz., the

dorsal cavity and the ventral cavity. Fig. 2.2 shows various bodily cavities.

The dorsal cavity contains the brain and the spinal cord.

The diaphragm which is a muscular sheet divides the ventral cavity into an upper thoracic cavity

which houses the visceral organs such as lungs and heart and a lower abdomino-pelvic cavity.

The abdominal cavity contains stomach, spleen, liver gall bladder and most portions of small and

large intestines. The pelvic cavity contains the internal reproductive organs, urinary bladder and

some portions of the large intestines.

Insert Fig 2.2 somewhere here

2.3 Instrumentation

A brief introduction of various instruments used for taking body measurements appears

below:

 Weighing scales

There are two different types of weighing scales or weighing machines generally used. One is a

round disc on which the subject stands and the reading is taken directly from the scale which is

inset at the top of the weighing machine. Usually, weight up to the nearest 0.5 kg can be taken.

The other is a beam balance which is level actuated and the person stands on the platform and

reading is taken after balancing the beam with appropriate weights. The calibration of this type of

machine is much more precise and up to 50 gm can be measured.

  Stadiometer

Stadiometer is used for measuring height and sitting height of the subjects. It comprises of a

platform to which a rectangular vertical column is attached (Fig. 2.3). The subject has to stand

against this column with his back touching it. A movable horizontal plate is attached to this

vertical column which is brought down on the head of the subject. Alongside this movable plate,

there is a counter from which the reading is taken directly.

Insert Fig 2.3 somewhere here

 Anthropometer rod

An anthropometer rod is generally 2 meter long. A single rod of such length can be very

inconvenient to carry. Therefore it has been designed in the form of 4 inter-fitting rods of 50 cm

each (Fig. 2.4). The rods carry a Batch number specific for the instrument and another number

which is similar for the inter-fitting edges of two segments of the rod. The rod is calibrated in

centimeters and can measure up to a minimum value of 1 millimeter. A movable socket is also

included which can be moved up or down for taking the measurements and it has a place for

fitting a cross-bar. When the rod is held vertically the cross bar is in a horizontal position with

which the top of the head is touched for the measurement of height.
 Insert Fig 2.4 somewhere here

The anthropometer has a fixed socket at the top in which another horizontal bar can be attached.

The top segment has two calibrations; one which increases upwards from the first segment and is

used for reading the measurements and the other starts from the top. Two cross-bars can be fit

each into each socket in the top segment of the anthropometer rod; one which is fixed at the top

and the other which is movable. This forms a big caliper called “anthropometer compass” and is

used for measuring major breadths and diameters of the body.

 Infantometer

It consists of a rectangular plate which is to be kept horizontally and on which the infant has to lie

down. One end of this plate is fixed to a vertical plate. The top of the head of the infant has to

touch this vertical plate. On the other side, there is another horizontal plate which slides over the

first horizontal plate in order to adjust to the size of the infant. This movable horizontal plate is

also attached to a fixed vertical plate. The infant is placed in the infantometer, his head touching

the vertical plate and the movable plate is brought towards the feet of the infant till it touches

them. A measuring scale is attached to it for recording the measurement.

 Sliding calipers

The sliding calipers are ordinary calipers used in physical sciences for measuring straight

distances. The sliding caliper has a thick metallic bar in which the metric scale is engraved. One

end of this bar has a fixed cross bar whereas and the second cross bar slides over it which is

moved in either direction to fit in the points over which the measurement is to be taken (Fig. 2.5).

The calipers used for taking body measurements should have the two cross bars with blunt edges
and not with sharp edges so that the subject is not injured. The reading is generally taken up to the

nearest millimeter.

 Spreading calipers

The points for measuring on the curved surfaces cannot be taken with the sliding calipers

therefore spreading calipers are used for taking such measurements. The edges of one side of the

two curved arms of the spreading caliper are joined with a screw whereas those of the other side

have blunt points which are moved and brought in contact with the points over which the

measurements is to be taken (Fig. 2.5). A proportionate scale is attached closer towards the screw

which joins the ends of the caliper and it gives the actual distance between the two points over

which the measurement has been taken.

Insert Fig 2.5 somewhere here

 Skinfold caliper

The skinfold calipers measure the thickness of skin and subcutaneous tissue folds. Since the

subcutaneous tissue is compressible hence there is a need to apply some sort of pressure for

measuring it. The skinfold calipers are generally designed with a standard pressure of 10 g/mm 2

on the measuring surfaces exerted with the help of springs. The surfaces of the skinfold calipers

which measure the skinfold should be sufficiently large so as to hold the fold of the skinfold

tissue comfortably. The popular brands of skinfold calipers include Harpenden, Lange, Skyndex

and Slim Guide.

 Insert Fig 2.6 somewhere here

 Steel tape

A flexible but non-stretchable tape made of steel is used for measuring circumferences of the

body. A one meter tape should have a width of less than one centimeter so that it should fit

snuggly over the soft tissues. A measurement up to the nearest millimeter is taken.

2.4 Protocols for Anthropometric Measurements

The anthropometric measurements must be taken according to some standard procedures so that

the variations in taking measurements should be minimized and also the values of variables

become comparable with other studies. One of the oldest classical standard procedure appeared in

a book entitled ‘Lehrbuch der Anthropologie’ by Martin and Saller (1959) which served the

purpose of a hallmark in anthropological research. Later on during the last quarter of the 20 th

century many recommendations were given about the techniques to be used for taking

measurements. Some of these have been provided below:

 One of the most important protocols has been suggested by an expert committee of three

scientists, viz., Tanner, Jarman and Heirnaux, under the aegis of International Biological

Programme/Human Adaptability Section (IBP/HA) (Weiner and Lourie 1969, 1981).

 The second protocol is that of Kinanthropometric approach suggested by Leon and

Thea Koerner Foundation Study Group held at the University of British Columbia IN

1973. This group included authorities on kinanthropometry, viz., Drs. J.E.L. Carter,

William D. Ross, A. R. Behnke Jr., S. Brown, M. Hebbelinck and M.V. Savage. The

recommendations of this group as well as those modified later on were published in the

electronic version of Anthropometry Illustrated by Ross, Karr and Carter (2000).

  The third set of recommendations on the measurement techniques and applications along

with their special issues was presented by Lohman, Roche and Martorell (1988).

The measurements recommended by all these three protocols have been given.

2.5 IBP/HA Body Measurements

One of the most important protocol of taking these measurements had been standardized

by the International Biological Programme/Human Adaptability (IBP/HA) growth sub-

committee in 1969 (Tanner et al. 1969, 1981). This protocol has immensely been used since then

and innumerable studies are available which have utilized these recommendations. This is

perhaps one of the best reasons why these recommendations find their place in this manual.

The following is the list of measurements which have been standardized by the IBP/HA

growth sub-committee:

2.5.1 Gross Body Measurements

Body weight Stature/Supine length

2.5.2 Lengths or Heights of Body Parts

Sitting height/Crown-rump length Lower leg length

Suprasternal height Foot length

Total arm length Buttocks-knee length

Upper arm length Head length

Forearm length Nose height

Height of anterior superior iliac Morphological face height

spine Upper face height

Height of tibiale Ear length

 Head height

2.5.3 Diameters or Breadths of Body Parts

Biacromial diameter Lip thickness

Biiliocristal diameter Minimum frontal diameter

Transverse chest Ear breadth

Antero-posterior chest Bicondylar femur

Head breadth Bicondylar humerus

Bizygomatic diameter Wrist breadth

Nose breadth Hand breadth

Bigonial diameter Ankle breadth

Mouth width

2.5.4 Circumferences or Girths of Body Parts

Chest circumference Head circumference

Upper arm circumference (relaxed) Neck circumference

Upper arm circumference Abdominal circumference

(contracted) Forearm circumference

Calf circumference Wrist circumference

Thigh circumference Ankle circumference

2.5.5 Skinfold Thickness

Biceps Forearm

Triceps Thigh

Subscapular Medial calf

Suprailiac Chest (juxta nipple)

 Midaxillary Abdomen

There is no substitute to hard work and practice. The readers are advised to master the techniques

before starting the work. Most of the experts on kinanthropometry feel that techniques for taking

each measurement be repeated a large number of times. In order to have a check on accuracy, the

same sample of a few subjects should be measured on two different occasions and the differences

be noted. Most of the measurements should not differ more than one or two percent on two

different occasions.

It must be noted that all the bilaterally represented measurements must be taken on

the left side of the body as recommended by the expert committee. The following is the detailed

outline for taking these measurements. The names of the instruments appear in brackets along

with the measurement.

2.5.1 Gross Size and Mass

 Body weight (Weighing machine)

Body weight is the weight of the nude body when the bowels are empty. Normally it is

not possible to take the nude weight of the body. In such circumstances it is advised to take care

of the weight of the clothes worn by the subject when he is being weighed. This weight of the

clothes must be subtracted from his recorded weight in order to obtain the nude weight. Or the

investigator can provide a standard garment to be worn by the subject while he is being weighed.

The weight of this garment should later be deducted from the body weight. In most studies a

minimum of up to 0.5 kg measurements can be alright but in certain studies on infants and

longitudinal records, the measurements should be more precise, in order to gain more valuable

information.

 Stature or standing height (Stadiometer or Anthropometer)

 The subject should stand erect on a horizontal surface. Ask him to stretch as much as

possible taking care that his heels are touching each other and the horizontal surface. Slight

upward pressure is applied below the mastoid processes in order to help in stretching to the

fullest. The head should be held so that his Frankfort plane becomes horizontal. Frankfort plane is

that plane which touches the inferior most point on the infraorbital crest (lower border of the eye

orbit) and the point situated in the ear notch above the tragus of the ear. The counter-weighted

board of the stadiometer is brought down till it touches gently the head (See Fig.2.7). In case of

anthropometer, the rod is held vertically & the horizontal arm is brought down so that it touches

the highest point on the head in the midsagittal plane. The stature is highly sensitive to fatigue

and even up to 3 cm of diurnal differences have been recorded in it in the same subjects (Tanner

1964). So, it is necessary to take all precautions in positioning the subject and preferably the

measurement be taken in the morning to minimize the effect of fatigue.

Insert Fig. 2.7 somewhere here

 Supine length (Infantometer)

Supine length is the length of the infant when he is lying supine. The infants cannot

stand, so they cannot be measured that way. It is advised that infants and children up to about two

years be measured for the supine length. The infant's head is held in such a position so as the

Frankfort plane be parallel to the headboard and the top of his head is brought in contact with the

fixed headboard by putting slight upward pressure so that he is slightly stretched. The infant's feet

be held in such a way so as his toes point upwards and he is gently stretched. The footboard of the

infantometer is brought to touch firmly with the heels of the infant.

2.5.2 Lengths or Heights of Various Body Parts

The importance of extremities of the human body and the trunk cannot be undervalued because of

the habitual physical activity functions these have been performing and also because of their role
during the course of human evolution. Stature is in fact a composite measure of different

segments of the body which include lower extremity length, trunk, neck length and head height.

Similarly the extremities have also different segments. The upper extremity length is composed of

upper arm length, forearm length and hand length whereas lower extremity length includes thigh

length and the lower leg length. The variations exist in different segments of the body in different

populations groups living under various ecological conditions. The importance of these measures

is perceived in the fields of medicine, designing of the occupational utilities and in the ergonomic

context. Lohman et al. (1988) have highlighted that the actual and proportional lengths of various

segments of the body or with respect to the trunk are of major diagnostic value in order to find

out the abnormal situations or dys-morphology. The designing of utilities for humans like

clothing, shoes, chairs and sitting furniture, aircrafts and vehicles, machines and tools have to be

undertaken on the basis of segmental lengths and gross size of the human beings.

Segmental lengths are generally taken from a bony landmark to the flat surface as a vertical

distance or between two bony landmarks. These should not be taken from the creases of the joints

because that will always lead to small errors due to the soft tissues lying underneath.

The segmental measures can be taken directly or indirectly. The measurements taken indirectly

are called projected measurements. For example the direct measurements of upper arm length can

be taken across the acromiale and radiale points whereas the indirect or projected estimate of this

measurement will be to subtract height radiale from height acromiale.

The projected measurements run the risk of being inaccurate if necessary precautions in the

positioning of the subject are not taken. If many measurements are to be taken on a subject,

especially on a young one, his posture must be checked every time so that a correct measurement

could be taken.

Positioning of the subject

In most of the segmental lengths of the body, an erect posture is recommended. The heels should

touch each other with toes a little apart and the body weight equally supported on both the feet.

The arms should be by the sides of the individual and palms facing the thighs.

 Sitting height (Stadiometer or Anthropometer)

The subject sits on a stool or table top. His legs hang down freely. The back of the subject

be stretched as far as possible. The head is held so that Frankfort plane becomes horizontal and

gentle upward pressure is applied to the mastoid processes. The muscles of the thigh and buttocks

be contracted so that they may help in stretching the subject to the fullest. The counter-weighted

board of the stadiometer is brought gently in contact with the head. Or the horizontal bar of the

anthropometer rod is brought down so as it touches the highest point on the head.

 Crown-rump length (Infantometer)

It is the length of the infant or child from his head to the buttocks when legs are bent at

right angles. The child or infant is so positioned that his back is towards the infantometer. The

head is held in the Frankfort plane being parallel to the headboard of infantometer. Gentle upward

pressure is applied to the mastoid processes of the subject. The knee is bent at right angles and the

footboard of infantometer is brought inwards to touch the buttocks.

 Suprasternal height (Anthropometer)

Mark the suprasternal point which is the deepest point in the suprasternal notch. The

position of the subject is upright as has been in the case of taking stature. The horizontal bar of

anthropometer is brought in contact with the marked suprasternal point. Care must be taken to

keep the rod vertical.

 Total arm length (Anthropometer)

 This is the distance between the inferior border of acromion process to the tip of the

middle finger or the longest finger. Arm should be hanging down by the side and fully stretched.

 Upper arm length (Anthropometer)

This is the distance between the inferior border of the acromion process and the external

superior border of the head of radius. The arm should be hanging down normally, the palm of the

hand directed towards the thigh. Mark the two abovementioned points and measure the distance

between them with the help of the anthropometer.

 Forearm length (Anthropometer)

It is the distance between the head of radius and the tip of the lateral styloid process.

Mark the superior border of head of radius and the tip of the lateral styloid process. Arm should

be hanging down and the distance between these two points is measured.

 Height of anterior superior iliac spine (Anthropometer)

This is the height of the anterior superior iliac spine from the ground. The point is

situated on the anterior superior iliac crest medially and is the most prominent. The subject should

stand erect and the body weight equally supported on both the feet. Mark the point and measure

the distance from the ground keeping anthropometer rod vertical.

 Height of tibiale (Anthropometer)

It is the height of tibiale point from the ground. Tibiale is the upper point of the inner

border of the medial condyle of the tibia. The subject should stand erect, feet a little apart and

body weight equally distributed. Measure the distance of point tibiale from the ground keeping

the rod vertical.

 Lower leg length (Anthropometer)

It is the vertical distance from tibiale to malleolus. Malleolus is the lowermost or most

inferior point. Mark the tibiale and malleolus points and measure the distance between them.

 Foot length (Anthropometer or sliding caliper)

 The subject is asked to sit. Place the anthropometer or sliding caliper along the axis of the

foot. Bring one arm of the instrument in contact with the centre of the heel and the other with the

longest toe. Care should be taken to touch the toe and not the nail which may be sometimes

overgrown.

 Buttocks knee length (Anthropometer)

The subject should sit erect in such a way so as his knees are bent at right angle. The

horizontal distance between the fronts of the kneecap to the rearmost point on the left buttock is

measured.

 Head length (Spreading caliper)

It is the maximum distance between the most prominent point between the eyebrows and

the most prominent point on the occiput at the back of the head. Pressure must be applied to press

the soft tissues beneath while measuring.

 Nose height (Sliding caliper)

It is the distance between the nasion and the point of union of nasal septum with the

upper lip. Nasion lies at the root of the nose where frontal and nasal bones unite. It can also be

located by joining the left and right epicanthic eye folds by a horizontal line. The distance

between the two points is measured with a sliding caliper.

 Morphological face height (Sliding caliper)

It is the distance between the nasion and gnathion points. Gnathion is the most inferior

point on the chin in the mid-sagittal plane. The mouth should be closed and the teeth in full

occlusion. The distance between the nasion and gnathion points is measured with a sliding

caliper.

 Upper face height (Anthropometer)

It is the vertical distance between the highest point on head when it is held in Frankfort-

horizontal plane and the point of contact of two lips in the mid-sagittal plane. The head of the
subject is held in the Frankfort-horizontal plane and the counter-weighted headboard is allowed to

rest on the head. With the anthropometer the vertical distance between the headboard and the

union of lips in mid-sagittal plane is measured.

 Ear length (Sliding caliper)

It is the maximum length of the ear between the uppermost and lowermost points of the

ear and is measured with a sliding caliper.

 Head height (Anthropometer and Stadiometer)

It is the vertical distance from the highest point on head when it is in Frankfort-horizontal

plane and the external auditory meatus. The counter-weighted headboard of stadiometer is

brought in contact with the top of head of the subject. The vertical distance between the

headboard and the external auditory meatus is measured with the anthropometer.

2.5.3 Diameters or Breadths of Various Body Parts

The breadths of the body reflect the frame size and the robustness of the skeletal frame. These

find their utility in techniques of assessing body physique like that of Heath and Carter

Somatotype and in projecting the gains in lean body mass in the special groups including athletes

and patients of anorexia nervosa.

The breadth measurements are taken with the help of anthropometer compass, sliding calipers and

spreading calipers. In case of larger measurements including shoulder width and hip width, the

anthropometer compass can be conveniently used. For measuring smaller width as those of wrist

and ankle, elbow and knee, the small sliding caliper serve the purpose better. There are certain

measurements which would include curved surface of the body. It is convenient to use the

spreading caliper in those cases. The instruments are generally calibrated to the nearest

millimeter. The calibration of the scale is of actual size in all the instruments used for breadth

measurements except for spreading calipers. In this case the calibration is displayed on a scale

near the joint of the two spreading arms of the calipers and is made in such a way as to conform
to the actual reading between the tips of the two arms of the caliper which are farther away from

the scale.

 Biacromial diameter or shoulder width (Anthropometer)

It is the maximum width of shoulders when the shoulders are relaxed and slumping

forward. The subject should stand erect and the shoulders drooping a little forward. The

measurement is taken between the outside edges of both the acromion processes, from the

backside of the subject.

 Bi-iliocristal diameter or hip width (Anthropometer)

It is the maximum width between the iliac crests of both sides. The subject should stand

erect, and the investigator behind him. The bars of the anthropometer are applied to the iliac

crests so as it gives the maximum width. The overlying soft tissue should be pressed hard in order

to obtain the real measurement which represents the development of the bone.

 Transverse chest (Anthropometer)

This is the transverse diameter of chest at the level of the union of 3rd and 4th sternebrae

at the end of a normal expiration. The subject should stand erect. Apply the arms of

anthropometer at the lateral sides of the chest at the marked level and measure it by exerting

slight pressure when the subject has ended the normal expiration.

 Antero-posterior chest (Spreading caliper)

This is the antero-posterior diameter of the chest between the point of union of 3rd and

4th sternebrae on the anterior side and the tip of a spine on the posterior side, perpendicular to the

axis of the body. The arms of the caliper rest on the two above mentioned points and the

measurement is taken at the end of a normal expiration Slight pressure is also exerted while

taking the measurement.

 Head breadth (Spreading caliper)

 This is the maximum breadth of the head in transverse plane. The two arms of the caliper

are placed on the most lateral points and are moved in order to obtain the maximum breadth.

Slight pressure is exerted before noting the measurement.

 Bizygomatic diameter (Spreading caliper)

This is the maximum breadth between the two zygomatic arches. Spreading caliper is

applied to the two zygomatic arches and the maximum diameter is recorded by moving the

spreading caliper in all directions.

 Nose breadth (Sliding caliper)

The maximum breadth of the nose is measured from the outsides of the two nares. The

arms of the caliper are brought in contact with the outside of the nares of the nose while keeping

the instrument horizontal.

 Bigonial diameter (Spreading caliper)

It is the maximum diameter between the angles of the mandible. Arms of the caliper are

brought in contact with the outside of the angles of mandible and pressure is applied to compress

the soft tissue beneath.

 Mouth width (Sliding caliper)

It is the distance between the corners of the mouth when it is normally closed. The arms

of the caliper are placed at the corners of the mouth taking care that the mouth is normally closed.

 Lip thickness (Sliding caliper)

It is the maximum thickness of the lips. The caliper is held vertically, the upper arm of

the caliper is placed on the medial point on the tangent of the highest points of the upper lip and

the other is brought to the medial point on the tangent of the lowest points on the lower lip.

 Minimum frontal diameter (Spreading caliper)

It is the minimum horizontal diameter between the temporal crests at the points of

maximum inward depression. The caliper is allowed to touch the bony crests and not the temporal
muscles.

 Ear breadth (Sliding caliper)

It measures the maximum breadth of the ear. The breadth of the ear is measured by keeping the

two arms of the sliding caliper parallel to the long axis of the ear.

 Bicondylar femur or knee width (Sliding caliper)

It is the maximum diameter across the outermost points or condyles on the lower end of

the femur bone. The subject should be sitting with his knee bent at right angle. Arms of the

caliper are applied to the outermost poil1t on the lower end of femur and pressure is applied to

compress the soft tissue in order to obtain the bony diameter.

 Bicondylar humerus or elbow width (Sliding caliper)

It is the maximum diameter across the outermost points on the condyles of lower end of

humerus. The arm of the subject should be bent at right angles. The arms of the caliper are

applied to the outermost points on the lower end of humerus. There is a need to exert pressure in

order to obtain the bony measurements. Since the inner condyle is lower than the outer one, so

while taking the measurement, the position of the instrument is oblique and not perpendicular to

the long axis of upper arm (Fig. 2.8).

Insert Fig. 2.8 somewhere here

 Wrist breadth (Sliding Caliper)

It is the maximum width between the two lateral styloid processes of radius and ulna. Strong

pressure is applied to compress the soft tissue before noting the measurement. Usually the caliper

is oblique and not perpendicular to the long axis of the bone.

 Hand breadth {Sliding Caliper)

It is the breadth of band across the distal tips of second and, fifth metacarpals. The hand of
the subject should rest on a flat surface, palm facing it, fingers together and in line with the axis

of the forearm. The caliper arms are applied to the outside of distal tips of second and fifth

metacarpals.

 Ankle breadth (Sliding Caliper)

It is the breadth of the ankle across the two malleoli. The subject should sit on a table with

legs hanging freely. The caliper arms are placed on two malleoli and pressure is exerted before

taking the measurement.

2.5.4 CIRCUMFERENCES

The circumferences of the body and those of the limbs provide vital information about the growth

and development of a child. The assessment of nutritional status during early years of life can be

conveniently done with the help of mid arm circumference, chest and head circumference, etc.

The amounts of musculo-skeletal structures and the lean tissue assessments can also be made

from the circumferences along with the use of skin and subcutaneous tissue fold thicknesses at

various body sites. Assuming the limbs as cylindrical entities, the cross-sectional areas of muscles

plus bone and fatty tissue can be easily calculated. The assessment of general obesity, the deep

adipose tissue and masculine-feminine type of distribution of body fat can also be assessed with

the help of certain circumferential measures.

The circumferences can be measured with flexible but non-stretchable tapes especially made of

steel. The tape must wrap around the body part snuggly without compressing the soft tissues

underneath and must be touching all along. In cases where the gaps between the body and the

tape persist, tape should not be compressed to reduce the gap. For example in case of a thin

subject, the measurement of chest circumference would involve a gap between the body and the

tape especially in the area of the back between the shoulder blades.

In case of the measurements of circumferences, the position of the tape is to be kept

perpendicular to the axis of the body or the body part being measured. The position of the tape is
generally horizontal to the ground. Only in the case of neck circumference does it show a

variation as the axis of the neck is variable and show a marked variation in its tilt.

 Chest circumference (Steel tape)

It is the circumference of the chest measured at the level of the union of 3rd and 4th

sternebrae. The measurement should be taken at right angles to the body axis at the end of a

normal expiation. Make sure the tape is in contact with the body throughout and it should be

gently touching it.

 Upper arm circumference-relaxed (Steel tape)

It is the circumference of the upper arm taken mid-way while the arm is hanging down

freely by the side. Mark the midpoint of the upper arm between the inferior border of acromion

process and the superior border of the head of radius. The measurement is taken at the marked

level keeping the tape horizontal (Fig.2.9).

Insert Fig. 2.9 somewhere here

Upper arm circumference-flexed (Steel tape)

It is the maximum circumference of the upper arm when it biceps muscle is fully flexed or

contracted. Ask the subject to flex his biceps muscle fully by bending the arm at the elbow. The

measurement is taken at right angles to the long axis of the upper arm where the maximum girth

is affected.

Calf circumference (Steel tape)

It is the maximum circumference of the lower leg when the calf muscle is relaxed. Ask the

subject to sit so that his knee is bent at right angles and his lower leg hanging freely. The

measurement is taken at right angles to the axis of the lower leg where it is registers a maximum

development.
Thigh circumference (Steel tape)

It is the circumference of the thigh just beneath the gluteal fold with the body weight

equally supported by the two legs. It is measured horizontally.

 Head circumference (Steel tape)

It is the maximum circumference of the head, taken just above the brow ridges. The

subject is asked to sit. The tape is placed around the head, above the brow ridges and adjusted on

the back of the head in such a way as it gives the maximum circumference.

 Neck circumference (Steel tape)

It is the circumference of the neck slightly above the thyroid cartilage. The tape is placed

around the neck and is kept horizontal while taking the measurement.

 Abdominal circumference (Steel tape)

It is the circumference of the abdomen at the level of the umbilicus when the abdominal

muscles are relaxed. Wrap the tape around the abdomen at the middle of the umbilicus

horizontally asking the subject to keep his abdominal muscles relaxed.

 Forearm circumference (Steel tape)

It is the maximum circumference of the forearm usually recorded proximal to the elbow

joint. The arm of the subject should be hanging normally and relaxed and the measurement is

taken at the level of maximum development.

 Wrist circumference (Steel tape)

It is the minimum circumference of the wrist taken slightly proximal to the styloid process

of ulna. The tape is so placed around wrist just proximal to the styloid process of ulna as it gives

the minimum circumference of the wrist.

 Ankle circumference (Steel tape)

It is the minimum circumference of the leg taken above the two malleoli. The tape s

wrapped around the legs above the malleoli where the minimum circumference is obtained.
2.5.5 Skinfolds

Skin and subcutaneous tissue fold thicknesses reflect the development of adipose tissue

(fatty tissue) overlying the body as well as the general obesity. The tissue is compressible and

hence there is a need to apply some standardized pressure for measuring it. There is general

agreement on taking the measurement at a standard pressure of 10 g/mm square. The standard

skinfold caliper is available which exert a pressure of 10g/mm square while taking the

measurements. These measurements involve a fold of the adipose tissue and the skin. Usually the

fold of the adipose tissue can be picked up very easily between the forefinger and the thumb,

though in obese cases, there is some difficulty in taking the skinfold measurement. The jaws of

the caliper should be applied to the already marked point and the reading be noted after two

seconds of the applying the full pressure.

 Biceps skinfold (Skinfold caliper)

The biceps skinfold is measured over the biceps muscle in the middle of the upper arm.

Pick the skin and subcutaneous tissue fold over the biceps muscle about one cm above the marked

level (mid point of the distance between the inferior border of the acromion process and the

external superior border of the head of radius), in line with the cubital fossa. Apply jaws of the

caliper at the marked level. Precaution must be taken to pick up all the subcutaneous adipose

tissue. The measurement is noted two seconds after applying the full pressure.

 Triceps skinfold (Skinfold caliper)

The triceps skinfold is measured over the triceps muscle in the middle of the arm at the

level of the upper arm circumference or the biceps skinfold, in line with the olecranon process.

Mark the mid – point of the landmarks acromiale and radiale over the triceps muscle at the back

of the upper arm and pick up skinfold about one cm above the marked level. Apply the jaws of

the caliper to the fold at the marked level and note the value after two seconds (Fig.2.10).
 Insert Fig. 2.10 somewhere here

 Subscapular skinfold (Skinfold caliper)

The subscapular skinfold is measured below the angle of the scapula. Pick up the skinfold

a little below the angle of the scapula, pointing downwards and outwards. Apply the jaws of the

skinfold caliper to the fold and take the value after two seconds.

 Suprailiac skinfold (Skinfold caliper)

The suprailiac skinfold is taken about one cm above and two cm medical to the anterior

superior iliac spine. Pick up the skinfold at the abovementioned site and measure with a skinfold

caliper.

 Forearm skinfold (Skinfold caliper)

Forearm skinfold is measured midway between the superior border of the head of radius

and its styloid process at the wrist. The skinfold is picked up the lateral side and in line with the

long axis of the forearm at the marked and point of the radius bone.

 Thigh skinfold (Skinfold caliper)

The thigh skinfold is measured in the middle of the mid-inguinal point and the proximal

line of the patella when the knee is bent at right angle. The skinfold is picked over the quadriceps

muscle, i.e. on the anterior aspect of the thigh and the fold should be pointing downwards.

 Medial skinfold (Skinfold caliper)

The medial calf skinfold is measured at the level of maximum development of the calf

muscle on the medial side. The fold is picked up medially and in line with the long axis of the leg

and measured with a skinfold caliper.

 Chest skinfold or Juxta Nipple skinfold (Skinfold caliper)

The chest skinfold is measured just lateral to the nipple. Pick a fold of the subcutaneous

tissue lateral to the nipple at the same level and apply the jaws of the caliper for measurement.
  Mid- axillary skinfold (Skinfold caliper)

The mid-axillary skinfold is measured on the mid-axillary line at the level of the xiphoid

process. Mark the level of the xiphoid bone on the mid-axillary line and pick up the skinfold at

this level fore measurement.

 Abdominal Skinfold (Skinfold caliper)

Abdominal skinfold is taken at the level of the umbilicus about five cm lateral to it. Pick

up the fold of the subcutaneous tissue at the given site and measure it with a skinfold caliper.

2.6 KINANTHROPOMETRIC MEASUREMENTS

The IBP techniques have been and are being employed by research workers in the fields of

auxology, human biology, anthropology, etc. So, the data which have been cumulating over the

last two decades in these fields are generally comparable and provide for opportunities to explore

geographical and temporal variations between groups of individuals.

In physically active groups, like sports and performing arts, the impetus of anthropometry

should be on the level of development of the musculo-skeletal structures. The human body which

is subjected to exercise may elicit bilateral differences; the side used more may show greater

development. Generally it is the right side which is of special significance. So, the experts in

sports sciences feel that the landmarks depending upon the laterality of the body should be

different in sportsmen from the other protocols because of the different types of objectives to be

achieved especially to know the maximum development of muscularity, as well as maintaining

uniformity with the techniques employed by sports scientists in the past, throughout the world.

One such agreement has been reached by a Leon and Thea Koerner Foundation Study

Group held at the University of British Columbia (1973). The group included authorities on

kinanthropometry such as Drs. J.E.L. Carter, William D. Ross, AR. Behnke Jr., S. Brown, M.

Hebbelinck and M.V. Savage. These experts have played the pivotal role in nurturing and
developing the field of kinanthropometry. Later research workers in this field have been using

these techniques and whatever future developments have taken place, these are mainly based on

these techniques. One major difference in the IBP and the above study group

recommendations is that the former suggested taking measurements on the left side whereas

the later have emphasized to take them on the right side of the body.

Various points on the body (landmarks) which are required for different body

measurements used in kinanthropometry have been described after Ross, Brown, Hebbelinck,

Faulkner (1978) and Ross, Karr and Carter (2000) which are given below. International Working

Group on Kinanthropometry (IWGK) which later on became the International Society for the

Advancement of Kinanthropometry (ISAK) has also endorsed these techniques and has been

imparting instructions to various study groups on these lines. .

Human body can take many postures; therefore before describing the points, it is necessary

to use some standard pose. Most commonly used standard anatomical posture is the one where

the subject stands erect, head in the Frankfort horizontal plane, feet together and arms hanging

down normally.

2.6.1 Landmarks on the body

Various points or landmarks which have been recommended by the kin anthropometric

study group and reported by Ross et al. (1978) for taking various measurements on the subjects

have been described below. Generally the techniques of taking body measurements are similar as

reported in the IBP protocol. The major difference is in the definition and position of these points

which may be different for certain measurements.

Vertex (v)

It is the superior most point on the skull in the midsagittal plane when head is held in

Frankfort horizontal plane (Figs 2.11, 2.16).

Gnathion (gn)
 This is the point which lies in the midsagittal plane on the inferior most border of the

mandible (Fig. 2.14, 2.15).

Insert Fig. 2.11 somewhere here

Suprasternale (sst)

It is the point which lies in the midsagittal plane on the superior border of sternal notch.

Mesosternale (mst)

The point is located at the intersection of midsagittal plane by the horizontal plane through

the middle of the IVth chondrosternal articulation.

Epigastrale (eg)

It is the point the horizontal plane where midsagittal plan is intersected by the horizontal

plane through the most inferior points on the tenth ribs.

Thelion (thl)

The point lies in the middle of the breast nipple of the right side.

Omphalion (om) .

The point is situated in the middle of the naval cavity.

Symphysion (sy)

The point is situated in the midsagittal plane on the superior border of the pubis symphysis.

Acromiale (a)

The point lies at the superior and external border of the acromion process of the right side of the

subject standing erect and shoulders relaxed. This definition of the acromiale point is different

from the IBP definition where it is the inferior most point on the external border of the acromion

process. While the biacromial width or the shoulder width by these two descriptions may be

similar, other measurements, e.g. those of the upper extremity and its parts which involve this
point, will be different. The definition in this section will result in larger measurements over the

IBP measurements.

Insert Fig. 2.12 somewhere here

Radial e (r)

The point lies on the superior and lateral border of the head of radius of the right side.

Stylion (sty)

It is the most distal point of the styloid process of the radius of the right side (2.12).

Dactylion (da)

The point lies most distally on the tip of the middle finger or any digit of the right hand when the

arm hangs down normally, fingers stretched and pointing downwards. In case any digit other than

the middle finger is longer, the point may be qualified by writing along with the digit number as

dactylion I, II, IV, V.

Metacarpale radiale (mr)

The point is the outermost or lateral on the distal head of IInd metacarpal of the right hand

when the hand is stretched (Fig. 2.17).

Metacarpale ulnare (mu)

The point is the outermost or medial on the distal head of ulna of the right side of the

stretched hand.

Iliocristale (ic)

The point lies most laterally on the iliac crest of the right side (Fig. 2.13).

Iliospinale (is)

The point lies on the tip of the right anterior superior iliac spine.
 Insert Fig. 2.13 somewhere here

Trochanterion (tro)

The point lies most superiorly on the greater trochanter of the femur of right side.

Tibiale (ti)

The point lies most proximally on the medial border of the head of tibia of right side.

Tibiale externum (te)

It is the most proximal point on the head of the tibia of the right side on the lateral side.

Sphyrion (sph)

It is the most distal point on the tip of the medial malleolus of right side.

Sphyrion fibulare (sphf)

It is the most distal point on the tip of the lateral malleolus of right side.

Pternion (pte)

The point is the most posterior on the heel of the right foot when the subject stands erect.

Insert Figs. 2.14, 2.15, 2.16 somewhere here

Akropodion or acropodion (ap)

The most anterior point on the toe of the right foot when the subject stands erect is called

akropodion (Fig. 2.18).

Insert Figs. 2.17, 2.18 somewhere here

Metatarsale tibiale (mtt)

It is the outermost point which is situated on the head of the 1st metatarsal of the right foot

when the subject stands erect.

Akropodion (ap)

It is the most anterior point on the toe of the right foot when the subject stands erect.

Metatarsale tibiale (mt t)

It is the outermost point which is situated on the head of the 1st metatarsal of the right foot

when the subject stands erect.

Metatarsale fibulare (mt f)

It is the outmost point which is situated on the head of the 5th metatarsal of the right foot

when the subject stands erect.

Cervicale (c)

The point is situated on the tip of the 7th cervical vertebra most posteriorly (on the mid-

sagittal plane).

Gluteale (g)

It is point in the mid-sagittal plane at the sacro-coccygeal fusion.

The following are the measurements recommended by Ross, Karr and Carter (2000) in

Anthropometry Illustrated.

2.6.2 Basic four measurements

 Stature (free standing stature; stature against a wall; stretch stature against a wall;

recumbent length) (Anthropometer).

Stretch stature reflects the maximum distance from the surface on which the subject stands to the

point vertex of the head, when the head is held in the Frankfort horizontal plane. It is desirable to

apply some gentle pressure upwards on the mastoid processes in order to help the subject

stretching him to the fullest.

 Sitting Height (Anthropometer)

Sitting height reflects the maximum distance from the surface on which the subject sits to the

point vertex of the head, when the head is held in the Frankfort horizontal plane and the subject

stretches his back to the maximum. It is desirable to apply some gentle pressure upwards on the

mastoid processes in order to help the subject stretching him to the fullest.

 Weight/Mass (Weighing scale)

It is the force of gravity acting on the mass of the body. Ideally it should be measured with a

beam balance up to the nearest 0.1 kg; however, in most cases a value nearer to 0.5 kg is also

acceptable.

 Span (Steel Tape)

It is the maximum distance between the two dactylion points of the left and right hands when the

arms are outstretched and are horizontal at the level of the shoulder with palms facing the wall.

The subject is positioned in front of the wall facing it.

2.6.3 The Lengths

 Acromiale – radiale length (Arm length) (Anthropometer compass)

The arm length or the upper arm length is the distance between points acromiale to radiale.

 Radiale – Stylion length (Forearm length)(Anthropometer compass)

The forearm length is the distance between points radiale and stylion.

 Mid-stylion – dactylion length (Hand length)(Sliding caliper)

The distance from the middle of two Stylion points on the wrist to the Dactylion point is

called hand length.

  Iliospinale height (Anthropometer)

This is the vertical distance of Iliospinale point from the ground.

 Trochanterion height (Anthropometer)

Trochanterion height represents the vertical distance from the point trochanterion to the

ground.

 Trochanterion – tibiale length (thigh length) (Anthropometer)

This is the straight distance between the points Trochanterion and tibiale.

 Tibiale laterale height (Leg length) (Anthropometer)

The leg length or tibiale laterale height is the vertical distance from the point tibiale laterale

to the ground

 Tibiale mediale – Sphyrion tibiale length (Tibial length) (Anthropometer)

The length of the tibia is represented as the straight distance between the points tibiale

mediale to sphyrion of the tibia.

 Foot length (Sliding caliper)

This is the distance between the points acropodion to pternion.

2.6.4 Breadths

 Biacromial Breadth (Anthropometer compass)

This is the distance between the acromiale points on each scapula which are the most lateral

points on the acromion processes with the subject in an erect posture and his arms hanging

down at the sides.

 Biiliocristal Breadth (Anthropometer compass)

The biiliocristal breadth is taken between the two most lateral points on the superior border of

each iliac crest.

 Transverse Chest Breadth (Anthropometer compass)

The transverse breadth of the chest is the breadth taken at the mesosternale level between the

two lateral aspects.

 Anterior-Posterior Chest Depth (Spreading caliper)

The chest depth is taken at the mesosternale level between the front and the back aspects of

the chest. The spreading calipers are used for taking this measurement.

 Biepicondylar Humerus Breadth (Sliding caliper)

Distance between the two epicondyles of the humerus when the arm is bent at a right angle at

the elbow.

 Wrist Breadth (Sliding caliper)

It is the width of the wrist taken between the two styloid processes when the hand is flexed at

the wrist to an angle of about 90 o.

  Hand Breadth (Sliding caliper)

It is the distance between the metacarpale mediale and metacarpale laterale. The

measurement is taken when the subject firmly holds a pencil in his hand.

 Biepicondylar Femur Breadth (Sliding caliper)

Biepicondylar femur breadth is the distance between medial and lateral condyles of the

femur. The subject is instructed to sit with the knee bent at a right angle.

 Ankle Breadth (Sliding caliper)

It is the distance between the two outermost projections of each ankle (malleoli).

 Foot Breadth (Sliding caliper)

Foot breadth is the distance between metatarsale tibiale and metatarsale fibulare.

2.6.5 The Girths

 Head Girth (Steel tape)

It is the maximum circumference of the head taken a little above the point glabella (the point

in the middle of the supra orbital ridges in the mid-sagittal plane). The tape should be kept

horizontal.

 Neck Girth (Steel tape)

It is the neck circumference taken slightly above the larynx.

  Arm Girth (Relaxed) (Steel tape)

It is the circumference of the upper arm taken at right angles to the long axis of the arm

midway between the points acromiale and radiale when the arm hangs down freely.

 Arm Girth (Flexed and Tensed) (Steel tape)

It is the circumference of the upper arm taken at the level of its maximum development when

the biceps muscles are fully contracted.

 Forearm Girth (Steel tape)

It is the circumference of the forearm at its maximal development.

 Wrist Girth (Steel tape)

It is the circumference of the wrist taken slightly away from the styloid processes.

 Chest Girth (Steel tape)

It is the circumference of the chest at the mesosternale level taken after the end of a normal

expiration.

 Waist Girth (Steel tape)

It is the circumference of the abdomen at the level of marked narrowing and is generally

located approximately mid way between the costal border and iliac crest.

 Omphalion Girth (Abdominal) (Steel tape)

It is the circumference of the abdomen taken at the mid-point of the naval or umbilicus.
  Gluteal Girth (Hip) (Steel tape)

It is the circumference of the hips at the level of the point symphysion where the buttocks

register the maximum development.

 Thigh Girth (Upper) (Steel tape)

It is the circumference of the thigh at the level where it joins the gluteus muscle. The subject

must support his weight equally on both the feet.

 Mid-Thigh Girth (Steel tape)

It is the circumference of the thigh taken mid-way between the points trochanterion and

tibiale.

 Calf Girth (Steel tape)

It represents the maximum circumference of the calf when the subject stands erect and weight

is equally distributed on both the feet.

 Ankle Girth (Steel tape)

It is the smallest circumference of the leg just above the point sphyrion tibiale.

2.6.6 Skinfolds

 Triceps skinfold (Skinfold caliper)

The skinfold is taken mid-way between the points radiale and acromiale over the triceps

muscle.
  Subscapular skinfold (Skinfold caliper)

The skinfold is picked up just below the inferior angle of scapula. The direction of the fold is

downwards and outwards.

 Biceps skinfold (Skinfold caliper)

The skinfold is taken mid-way between the points radiale and acromiale over the biceps

muscle.

 Iliac Crest skinfold (Skinfold caliper)

The skinfold is taken just above the iliac crest at the mid-axillary line. The fold should run

anteriorly downwards.

 Supra-Spinale (Heath-Carter referred to it as Supra-Iliac) skinfold (Skinfold

caliper)

The skinfold is picked about seven centimeters above the point Iliospinale at the level of

anterior axillary line. The fold runs inwards and downwards.

 Abdominal skinfold (Skinfold caliper)

The skinfold is picked up about 3 to 5 cm laterally towards the right side at the level of point

omphalion.

 Front Thigh skinfold (Skinfold caliper)

The skinfold site is mid-way between the inguinal line and the superior distal margin of

patella. The skinfold is taken when the subject sits with the leg is bent at right angle.
  Medial Calf skinfold (Skinfold caliper)

The skinfold is to be taken on the medial side of the calf where the maximum circumference

is noticed.

 Chest skinfold (Skinfold caliper)

The skinfold site is mid-way between the point thelion and the axilla.

2.7 Lohman et al. (1988) protocol of measurements

The above authors while recommending the techniques of these measurements have used

common names for the measurements wherever possible so that even those people who are not

familiar with anthropometry be able to use them. In most of the techniques the head is to be held

in Frankfurt Horizontal Plane. The inferior most point on the left eye orbital margin is to be held

at the same horizontal level as that of left tragion. Tragion can be defined as the deepest point in

the notch above the tragus of the ear.

2.7.1 Gross measurements

 Stature / Recumbent Length  Weight

2.7.2 Segmental Lengths

 Sitting height / Crown Rump Length  Calf Length

 Lower Extremity Length  Arm Span

 Thigh Length  Shoulder Elbow Length

  Elbow Wrist Length  Forearm Hand Length

 Hand Length

2.7.3 Body Breadths

 Chest Breadth  Knee Breadth

 Chest Depth  Ankle Breadth

 Biiliac Breadth  Elbow Breadth

 Bitrochanteric Breadth  Wrist Breadth

2.7.4 Circumferences

 Head Circumference  Thigh Circumference

 Minimum Neck Circumference  Calf Circumference

 Shoulder Circumference  Ankle Circumference

 Chest Circumference  Arm Circumference

 Waist Circumference  Forearm Circumference

 Abdominal Circumference  Wrist Circumference

 Buttocks Circumference

2.7.5 Skinfolds

 Subscapular Skinfold  Suprapatellar Skinfold

 Midaxillary Skinfold  Medial Calf Skinfold

 Pectoral (Chest) Skinfold  Triceps Skinfold

 Abdominal Skinfold  Biceps Skinfold

 Suprailiac Skinfold  Forearm Skinfold

 Thigh Skinfold
Techniques of all these measurements have been provided in great detail in the Anthropometric

Standardization Reference Manual by Lohman, Roche and Martorell (1988). The reader can

make comparisons between the measurements recommended by IBP versus this protocol in order

to find out which measurements are new in this protocol.

The IBP measurements are taken on the left side while those recommended by Lohman et al.

(1988) protocol are taken on the right side of the body wherever applicable.

The following is the description of only those measurements in this protocol which were not

given in the IBP protocol.

 Lower Extremity Length

The lower extremity length is the distance between the hip joint and the plane on which the

subject stands. In living subjects the exact location of hip joint cannot be determined. Therefore

the best alternative is to subtract sitting height from height for obtaining lower extremity length.

 Arm Span (Steel tape)

It the distance across the tips of the middle fingers of the laterally and maximally outstretched

hands at the level of the shoulders.

 Forearm Hand Length (Anthropometer compass)

It is the distance between the most posterior surface at the elbow overlying the olecranon process

and the tip of the middle finger when the arm is bent at right angle so that the upper arm is

vertical and the forearm is horizontal.

  Biiliac Breadth (Anthropometer compass)

It is the distance across the two iliac crests. The measurement is best taken from behind across the

two lateral aspects with a lot of pressure in order to press any overlying soft tissues including fat

and other tissues.

 Bitrochanteric Breadth (Anthropometer compass)

It is the distance across the most projecting points of the greater trochanters of the hip joints.

 Shoulder Circumference (Steel tape)

The shoulder circumference is taken at the level of the maximum development of deltoid muscles

slightly inferior to the acromion processes of the shoulder blades. The measurement should be

taken at the end of a normal expiration. The tape must touch the soft tissues on all sides but

should not be compressed. It shows the development of muscles of the shoulder and upper thorax

 Waist Circumference (Steel tape)

The waist circumference is measured at the smallest circumference of the torso which is the level

of the natural waist. The waist circumference is of immense value in assessing deep adipose

tissue. The ratio of waist to hip circumference is important in designating masculine type of fat

deposition which shows a greater susceptibility to adult onset o diabetes mellitus.

 Abdominal Circumference (Steel tape)

The abdominal circumference is taken at the level of the maximum bulging of the abdomen

which may be at the level of the naval but not always.

 Buttocks Circumference (Steel tape)

The circumference is taken at the level of maximum extensions of the buttocks without

compressing the soft tissues.

It reflects the adipose tissue in this region and also shows the size of the pelvic region.

 Pectoral (Chest) Skinfold (Skinfold caliper)

The skinfold is picked over the anterior axillary fold as high as possible.

 Suprapatellar skinfold (Skinfold caliper)

The skinfold is taken in the sagittal plane over the anterior aspect of the thigh about two cm above

the superior border of patella. It I take while the subject stands relaxed.

2.8 Accuracy and Reliability of Measurements

Anthropometric measurements are usually taken by a vast majority of scientists and professionals

from epidemiologists to sports scientists. The two most widely used measurements include height

and body mass and utilizing these two, an important index is calculated which is popularly known

as Body Mass Index (BMI). A wide variety of people engaged in taking measurements from

different disciplines calls for maintaining a high level of accuracy and reliability in taking these

measurements. Only then would it be possible to compare the values among different populations

enhancing the credibility of such measurements. Lots of variation and differences occur as a

result of measuring the same individual by many investigators or the same investigator over a

passage of time. This results in errors in the data. The ideal situation for measurements demands

for accuracy and reliability of different measurements.

2.8.1 Reliability (Reproducibility)

The difference in measurements conducted on the same subject on two occasions either by the

same investigator or by different investigators is an indicator of reliability. In other words,

reliability is the within-subject variability. According to Habicht et al. (1979), this within-subject
variability has two components:

 Imprecision or error originating due to the investigator taking measurements which are

different on two occasions. This is usually recorded from repeated measurements taken

consecutively over a very short span of time. Either the random errors in the measuring

instrument are responsible for imprecision or the investigator himself is to be held

responsible for being imperfect in measuring technique or recording it.

 Undependability which means that there are physiological measurements which cannot

be repeated by anybody howsoever an expert he may be and show inherent tendency to

fluctuate for example blood pressure body weight.

Thus any within-subject variation would be called unreliability and it has the above two

components and can be briefly expressed as:

Unreliability = imprecision + undependability

2.8.2 Accuracy

There is a real or true value of a measurement on a subject. The investigator strives to the best of

his ability to obtain that. How far is he successful in taking that determines his accuracy? The

only indicator of accuracy is the repeated measurements taken on a subject by an expert

investigator. Since an expert is a well trained professional, therefore his measurements taken on a

subject repeatedly will be very near to each other and it can be stated that these values

approximate each other. Such an expert is now referred to as a “criterion measurer or criterion

anthropometrist”.

In any anthropometric study, it is really important to be accurate. A training programme under an

expert is mandatory to achieve this. Measurement techniques have to be mastered and only when

the learner consistently achieves values very close to those of the criterion measurer can he

become a qualified measurer to start the job.

The differences between measurements taken on different subjects on two occasions by a trainee

would reflect his imprecision whereas the differences in measurements taken on different subjects

by a trainee and a criterion measurer would depict the inaccuracy of the former. Zerfas (1985) has

provided a protocol of repeat measurements where the differences can be judged as good, fair and

poor for a trainee and has been given in table 2.1. Comments on intra- and inter-observer error in

anthropometric measurements have been put forth by Ulijaszek and Lourie (1994).

One must strive hard to achieve the values of repeat measurements in the ‘good’ range; only then

one would have an acceptable level of reliability.

Insert table 2.1 somewhere here

The difference or variation in taking the repeat measurements by an investigator or those between

a trainee and a trainer is called the Technical Error of Measurement (TEM) and can be expressed

as follows:

TEM = (∑D2 / 2N)0.5

Where D represents the difference between measurements taken on two occasions

N is the number of subjects

Exercise 2.1. Calculate the TEM on the basis of the data given in Table 2.2 about the repeat

measurements taken by an investigator on ten subjects on two occasions.

The technical error of measurement (TEM) = (∑D2 / 2N) 0.5

= (0.49/2 x 10) 0.5

= 0.157 cm

Insert table 2.2 somewhere here

In case of height, the criterion for judging TEM as good is if its value is < 0.5 cm. Since in the
above cited example, the investigator’s TEM is 0.157 cm, this being within the stipulated value,

therefore it can be judged as ‘good’.

The coefficient of reliability ® can be calculated as follows and it ranges between 0 and 1, the

nearer the value is to 1 the better is its reliability:

R= 1 – [(TEM)2 / SD2]

Where TEM is the technical error of measurement

SD is the inter-individual variability

Ex. 2.2. Calculate the coefficient of reliability taking the values from Ex. 2.1 of TEM and SD.:

R= 1 – [(TEM)2 / SD2]

= 1 – [0.1572 / 4.2962]

= 1 – 0.001

= 0.999

The nearer the value of coefficient of reliability to unity the better it is and shows a consistency in

taking the measurements by the investigator. In the above example, the coefficient of reliability is

0.999 which is an excellent level of consistency by the investigator.

Ulijaszek has provided the upper limits of technical error of measurements (TEM) for males and

females modified from Zerfas (1985) which are presented in table 2.3.

Insert table 2.3 somewhere here

2.9 Which side to measure?

Majority of us are right handed and we show a great preference for hand use. People who use

their right or left arms for very strenuous jobs like the blacksmiths have a great tendency to

greatly develop their specific arms which would show wide bilateral differences in the muscle

mass between the left and the right arms. The most important point, however, is the quantum of

the differences between the measurements on the left and the right side and which measurements

are affected more by the laterality of the subjects.

A study on people with traditional occupations of Punjab conducted by Singh and Singh

(2007) indicates that the maximum percentage distribution of bilateral variations has been found

in biceps skinfold among carpenters, in femur bicondylar diameter, thigh circumference and hand

length among blacksmiths. Laubach and MacConville (1967) studied the bilateral differences in a

group of individuals for 21 anthropometric measurements. The results indicated that the right side

had significantly larger values for circumferences of upper arm at axilla and at mid-point (relaxed

as well as flexed), forearm and wrist circumferences. A similar type of findings have been

reported from the data of Health and Nutrition Examination Survey I (HANES I) where right side

measurements have been consistently larger than those on the left side. The arm circumference

and triceps skinfold are larger on the right side by 0.23 cm and 0.48 mm, respectively as

compared to those of the other side. The elbow width is larger on right side by 0.06 cm whereas

the subscapular skinfold is larger on the left side by 0.11mm than those of the respective sides.

According to Cohen (1977), if the differences between the right and left sides are converted into

the proportion of their Standard Deviation then all these four differences are just below one -

tenth value of their SD. These differences are very small and can be ignored very easily.

Asymmetry between the two sides can be quantified with the help of the following formula of

Relative Index of Asymmetry given by Wolanski (1972):

Relative Index of Asymmetry (RIA) = (2 D /[ X1 + X2]) x 100

Where D is the difference between the measurement on the right and the left side of the body,
X1 is the larger measurement of the two sides of the body,

X2 is the measurement on the opposite side of the body.

Ex. 2.3: Calculate the relative index of asymmetry if a person’s left arm length is 37.0 cm and

that of right arm is 38.5 cm.

RIA = (2 D / X1 + X2) x 100

= (2 X 1.5/ [37 + 38.5]) X 100

= (3/75.5) X 100

=3.97

The findings point out that there are differences between the right side and the left side for the

measurements of the arm where the values are larger on the right side. It has been pointed out by

Martorell et al. (1988) that these differences are smaller than those for measurement error.

It is also important to mention that the International Biological Programme has recommended that

all the bilaterally represented anthropometric measurements be taken on the left side of the body

(Weiner and Lourie 1981). The traditional anthropometry has also focused on the left side for

taking these measurements. Most of the developing world and the countries of Europe have

accumulated huge anthropometric data where the left side has been measured. On the other hand,

in the American continent the measurements were taken on the right side of the body. Keeping in

mind the small differences in anthropometric measurements between the left and the right side, it

is immaterial which side is measured and the decision about the choice of side may be left to the

investigators and the type of study they are undertaking.

2.10 Age assessment and Age Grouping

Chronological age is an important variable in growth studies which is often required while

dealing with children. Accurate ages can enhance the credibility of such studies. The ages can be
calculated from the date of birth and the date of examination. In case of literate subjects and their

parents, recall of the date of birth is not a problem. However, in case of illiterate people the exact

date of birth may not be known. Usually, they remember these dates in comparison with some

important festival or some historic event, etc. These reference points can come in quite handy to

assess the date of birth of the child.

In order to calculate the age of the child, the days and months are converted into the fraction of a

year and then the age can be obtained in decimal years by subtracting the date of birth from the

date of examination as follows.

Ex. 2.4. Calculate the age of the given child whose date of birth (DOB) and date of examination

(DOE) are December 25, 1994 and January 12, 2003, respectively.

DOE is January 12 = 12 days of the year =12/365 years

DOE = 0.033 years

DOB is December 25=360 days of the year = 360/365 years

DOB = 0.984 years

Age= DOE – DOB = 2003.033 –1994.984 years

= 8.049 years

Table 2.4 shows the conversion of days of specific months in decimal proportion of a year.

Insert Table 2.4 somewhere here

In sample surveys, a large number of subjects are measured and there is a need to make some

sort of groups. Groups according to ages can be made for the purpose of assessing growth and

development of children as given below. It is important to know how large a group should be in

terms of time, for example, a year, six months, three months, etc. While studying very young
children, the age groups should be small, say of three months or six months, however, in older

subjects, yearly age groups are usually attempted.

 If all the subjects have been studied on their birthdays, then the ages would be in precise

years, e. g. these can be exact 8.000 or 9.000 years, etc. Age groups based on the exact

whole year figures of all the subjects can be designated as 8.0, 9.0 years, etc.

 When the subjects are not studied on their birthdays, then their ages will be distributed

along time axis. Yearly age groups can be made in such a way so that the average age of

the group is depicted as a whole year figure, e.g. all subjects from 7.500 to 8.499 years

would be grouped on one year which can be designated as 8 ± years, from 8.500 to 9.499

years designated as 9± years.

 Another age grouping can also be attempted where the average age of the group tend to

be at a half year figure, e.g. all subjects from 8.0 0 to 8.999 years can be combined in one

year age group which is designated as 8+ years, from 9.000 to 9.999 years designated as

9+ years and so on.

2.11 Log Transformations

In general, body weight, skinfolds and circumferences have frequency distributions skewed to the

right side whereas the rest of the measurements exhibit normal distributions or Gaussian

distributions. Fig. 2.19 shows a diagrammatic representation of Gaussian distribution whereas

Fig. 2.20 displays the skewed distribution. The first step before analysis of those measurements

which show skewed distributions is to apply necessary transformation so that the distributions

become normal.

Insert Figs. 2.19, 2.20 somewhere here

Generally, log transformations to weight, skinfolds and circumferences are sufficient to achieve
this target. Edwards et al. (1955) gave a formula to transform the skinfold measurement as

follows.

Log skinfold =100 Log10 (skinfold in 0.1 mm–18)

So, it is recommended to transform weight, skinfold thicknesses and circumferences using

suitable formulae before statistical analysis is made. Table 2.5 presents the log transformed

values of skinfolds as given by Edwards et al. (1955).

Ex. 2.4. Using table 2.5 provide log transformed value to 12.5 mm triceps skinfold. Also assign

log transformed value to the sum of three skinfolds, viz., triceps as 12.5 mm, subscapular as 14

mm and suprailiac as 12 mm.

A triceps skinfold value of 12.5 mm would be assigned a log transformed value of 203 (table 2.5).

Triceps + subscapular + suprailiac skinfolds = 12.5 + 14 +12 = 38.5 mm

A skinfold value of 38.5 mm would correspond to a log transformed value of 256.

Insert Table 2.5 somewhere here

2.12 Human biological variations

The human beings successfully inhabit the globe from equator to the poles and from deserts to the

high altitude zones. These regions have drastically different climatic conditions and physical

properties of the environment. The populations living under these conditions have undergone

special changes in their bodies which provide them selective advantage for survival and

procreating. For example, to be successful in a desert climate, the body must evolve a strategy to

dissipate body heat which can be done by increasing the surface area. This seems to be the reason
for thin and elongated bodies of the inhabitants of the deserts. On the other hand, people of the

arctic have thick bodies which prevent heat loss. Similarly, the residents of the high altitude have

greater chest diameters in order to increase the pulmonary ventilation which provides them with

an opportunity to increase the availability of the oxygen which otherwise is less in the rarified

atmosphere of the altitude.

The populations of the world have lots of variations in body size and structure. There are very tall

populations measuring as much as 180 cm in comparison to the pygmies of central Africa who

are barely 130 cm in height. This range of averages of body height of the two extremes amply

point towards the need of having specific reference data for different populations.

Height and weight are the two most important measurements on the basis of which assessment

about the growth status of either the individual or that of the population can be assessed. In the

case of the individual child, his present status with respect to his percentile position in the given

reference standards can be assessed. If his position is significantly below 3 rd centile, his growth

performance is doubtful and needs monitoring. On the other hand, the status of groups in the

standards can provided and thus the performance of the group as a whole becomes clear.

Characteristic changes in height and weight take place during the growth period of children. The

pattern does not show a linear growth but witnesses many ups and downs. The period of

adolescence is of a special significance as the child witnesses dramatic changes in his physical

appearance. Abrupt increase in height and weight popularly known as adolescent growth spurt

transforms a boy into a man and girl into a woman. Besides during this period sexual maturity

takes place and the bones become fully mature by closing their epiphysis.

The body measurements are useful in studying different groups. The absolute and proportional

differences between groups can reveal a lot of information and throw light on the factors

responsible for effecting such a change. The same group migrated to an affluent setting can be

compared to the native group in order to gauge the effect of migration which might be

responsible for a drastic change in the life style as a result of acculturation. A comparison of the
body measurements between normal and abnormal group could reveal the differences and the

effect of such abnormality on human body.

The children usually follow a pre-destined growth curve and would try to follow them religiously.

Only during the period of adolescence can they wander slightly from these curves. This highly

organized characteristic of children’s growth opens new vistas in the field of prediction of adult

height. Usually the height achieved at any age is a good indicator of how tall a child would

become as an adult. Height of the child at any given age clubbed with a few more indicators as

the skeletal age, parental height and growth velocity during the preceding few years can be a

wonderful combination in the prediction of adult height. The accuracy of such predictions is very

high. Tanner et al. (1975, 1983) have provided equations for the prediction of adult height of

children on the basis of the above characteristics.

The body measurements of the child serve as a very good proxy measure of his nutritional

status. The child spends energy on growth, maintenance and play. If his energy intake is more

than these needs combined together he is stated to be in a positive energy balance and would

grow favorably and also runs the risk of becoming fat. If on the other hand, he maintains

equilibrium between the energy intake and the energy expenditure including all his needs of

growth as well, he is healthy and grows normally. But a situation where the energy balance is

negative which means the energy intake is lower than the energy expenditure, the child would be

undernourished. In this case, the growth of the child runs the risk of being affected. Nutritional

anthropometry which is based on various measurements like height, weight, fat folds and upper

arm circumference is considered to be a safe, easy and quite effective way of screening the

children whether they grow normally or not with a comment on their nutritional status.
Chapter 2 Exercises

Ex. 2. 1. The plane which divides the body into two parts, right and left is called ___ and the line
resulting from the intersection of frontal and sagittal planes is called____ , respectively.

Ex. 2.2. The skinfold calipers are generally designed with a standard pressure of ___ on the
measuring surfaces.

Ex.2. 3. Enumerate different protocols for taking body measurements given in this chapter?

Ex.2. 4. What is a Frankfort plane?

.
Ex.2. 5 Calculate the relative index of asymmetry (RIA) of the following measurements taken on
the two sides of a subject are as follows:
a. Humerus bicondylar diameter 6.7 cm and 6.9 cm.
b. Upper arm circumference 24.0 am and 27.2 cm.
c. Hand length 27.2 cm and 26.1 cm.
d. Forearm length 36.0 cm and 37.3 cm.

Ex.2.6. Calculate the TEM and the coefficient of reliability from the repeat measurements of
height (cm) given in the following table and if the SD is 10.125 cm.
Sr. No of the subject 1st occasion 2nd occasion

1 148.2 148.8

2 166.7 166.1

3 173.8 173.4

4 178.3 178.1

5 162.3. 162.0

6 163.6 163.9

7 178.5 178.8

8 168.5 168.1

9 176.3 176.5

10 184.2 184.0

Chapter 2 Answers

Ans 2.1: Sagittal plane or antero-posterior plane and longitudinal axis, respectively.

Ans 2.2. 10 g/mm2

Ans 2.3. IBP/HA, Kinanthropometric and Lohman et al. (1988).

Ans2.4 Frankfort plane is that plane which touches the inferior most point on the infraorbital crest
(lower border of the eye orbit) and the point situated in the ear notch above the tragus of the ear

Ans: 2.5
a. 2.94
b. 12.5
c. 4.13
d. 3.55

Ans. 2.6
TEM = 0.267
coefficient of reliability = 0.999
Table 2.1 The criteria for assessment of measurement error between a trainee and a trainer

Measurement Good Fair Poor

Height/length(cm) Up to 0.5 From 0.6 to 0.9 ≥1.0

Skinfolds (mm) Up to 0.9 From 1.0 to 1.9 ≥2.0

Arm circumference (cm) Up to 0.5 From 0.6 to 0.9 ≥1.0

Table 2.2 Repeat measurements of height (cm) of ten subjects by an investigator along with their

differences (D) and squared differences (D2)

Sr. No of the subject 1st occasion 2nd occasion D D2

1 160.2 160.0 0.2 0.04

2 165.5 165.7 0.2 0.04

3 173.3 173.4 0.1 0.01

4 168.3 168.1 0.2 0.04

5 172.3 172.0 0.3 0.09

6 169.6 169.9 0.3 0.09

7 173.5 173.8 0.3 0.09

8 168.5 168.4 0.1 0.01

9 166.3 166.5 0.2 0.04

10 174.2 174.0 0.2 0.04

Total 1691.7 1691.8 2.1 0.49

Note: The standard deviation (SD) of above measurements of height on 1st occasion is 4.52 cm

and that on 2nd occasion is 4.42 cm.

Table 2.3 The acceptable differences in taking measurements on two occasions at different levels

of reliability (adapted from Zerfas 1985)

Age group Height Sitting height (cm) Arm circ. (cm) T Sub

(cm) ri sca

c pul

e ar

p ski

s nfol

s d

k (m

i m)

m
 )

Reliability 0.95 M F M F M F MF MF

1-4.9 1.0 1.0 0.4 0.3 0.3 0.3 0 0 0 0

. . . .

6 7 4 5

5-10.9 1.3 1.4 0.4 0.4 0.5 0.5 1 1 0 1

. . . .

0 1 9 1

11.17.9 1.7 1.5 0.3 0.3 0.8 0.8 1 1 1 1

. . . .

5 6 6 7

18-64.9 1.5 1.4 0.3 0.3 0.7 1.0 1 1 1 2

. . . .

4 9 8 4

65+ 1.5 1.4 0.3 0.3 0.7 1.0 1 1 1 2

. . . .

3 9 7 3

Reliability 0.99

1-4.9 0.5 0.5 0.2 0.2 0.1 0.1 0 0 0 0

. . . .

3 3 2 2

5-10.9 0.6 0.6 0.2 0.2 0.2 0.2 0 0 0 0

. . . .
 4 5 4 5

11-17.9 0.8 0.7 0.1 0.1 0.3 0.4 0 0 0 0

. . . .

7 7 7 8

18-64.9 0.7 0.6 0.1 0.1 0.3 0.4 0 0 0 1

. . . .

6 9 8 1

65+ 0.7 0.6 0.1 0.1 0.3 0.4 0 0 0 1

. . . .

6 8 9 0

M –male F – female
Table 2.4. The decimal age calendar for the calculation of exact ages.

JAN. FEB. MAR. APR. MAY JUNE JULY AUG. SEPT. OCT. NOV. DEC.
1 2 3 4 5 6 7 8 9 10 11 12
1 000 085 162 247 329 414 496 581 666 748 833 915
2 003 088 164 249 332 416 499 584 668 751 836 918
3 005 090 167 252 334 419 501 586 671 753 838 921
4 008 093 170 255 337 422 504 589 674 756 841 923
5 011 096 173 258 340 425 507 592 677 759 844 926
6 014 099 175 260 342 427 510 595 679 762 847 929
7 016 l01 178 263 345 430 512 597 682 764 849 932
8 019 104 181 266 348 433 515 600 685 767 852 934
9 022 107 184 268 351 436 518 603 688 770 855 937
10 025 110 186 271 353 438 521 605 690 773 858 940
11 027 112 189 274 356 441 523 608 693 775 860 942
12 030 115 192 277 359 444 526 611 696 778 863 945
13 033 118 195 279 362 447 529 614 699 781 866 948
14 036 121 197 282 364 449 532 616 701 784 868 951
15 038 123 200 285 367 452 534 619 704 786 871 953
16 041 126 203 288 370 455 537 622 707 789 874 956
17 044 129 205 290 373 458 540 625 710 792 877 959
18 047 132 208 293 375 460 542 627 712 795 879 962
19 049 134 211 296 378 463 545 630 715 797 882 964
20 052 137 214 299 381 466 548 633 718 800 885 967
21 055 140 216 301 384 468 551 636 721 803 888 970
22 058 142 219 304 386 471 553 638 723 805 890 973
23 060 145 222 307 389 474 556 641 726 808 893 975
24 063 148 225 310 392 477 559 644 729 811 896 978
25 066 151 227 312 395 479 562 647 731 814 899 981
26 068 153 230 315 397 482 564 649 734 816 901 984
27 071 156 233 318 400 485 567 652 737 819 904 986
28 074 159 236 321 403 488 570 655 740 822 907 989
29 077 238 323 405 490 573 658 742 825 910 992
30 079 241 326 408 493 575 660 745 827 912 995
31 082 244 411 578 663 830 997
Table 2.5 Log transformed values of skinfolds using the formula
(Log skinfold =100 Log10 (skinfold in 0.1 mm–18))
mm 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9
2 30 48 60 70 789 85 90 95 100 104
3 108 111 115 118 120 123 126 128 130 132
4 134 136 138 140 141 143 145 146 148 149
5 151 152 153 154 156 157 158 159 160 161
6 162 163 164 165 166 167 168 169 170 171
7 172 173 174 175 176 176 176 177 178 179
8 189 180 181 181 182 183 183 184 185 185
9 186 186 187 188 188 189 189 190 190 191
10 191 192 192 193 193 194 194 195 195 196
11 196 197 197 198 198 199 199 200 200 200
12 201 201 202 202 203 203 203 204 204 205
13 205 205 206 206 206 207 207 208 208 208
14 209 209 209 210 210 210 211 211 211 212
15 212 212 213 213 213 214 214 214 215 215
16 215 216 216 216 216 217 217 217 218 218
17 218 218 219 219 219 220 220 220 220 221
18 221 221 221 222 222 222 223 223 223 223
19 224 224 224 224 225 225 225 225 226 226
20 226 226 226 227 227 227 227 228 228 228
21 228 229 229 229 229 229 230 230 230 230
22 231 231 231 231 231 232 232 232 232 232
23 233 233 233 233 233 234 234 234 234 234
24 235 235 235 235 235 236 236 236 236 236
25 237 237 237 237 237 238 238 238 238 238
26 238 239 239 239 239 239 239 240 240 240
27 240 240 240 241 241 241 241 241 241 242
28 242 242 242 242 243 243 243 243 243 243
29 243 244 244 244 244 244 244 245 245 245
30 245 245 245 245 246 246 246 246 246 246
31 247 247 247 247 247 247 248 248 248 248
32 248 248 248 249 249 249 249 249 249 249
33 249 250 250 250 250 250 250 250 251 251
34 251 251 251 251 251 251 252 252 252 252
35 252 252 252 253 253 253 253 253 253 253
36 253 254 254 254 254 254 254 254 254 255
37 255 255 255 255 255 255 255 256 256 256
38 256 256 256 256 256 256 257 257 257 257
39 257 257 257 257 258 258 258 258 258 258
 3. BODY PROPORTIONS

Chapter details

Body Proportions
The phantom stratagem
The O-scale system

Large and small individuals may look different from each other but it may happen that some of

them have similar bodily shapes. In other words if both the subjects are scaled to equal height

then the similarities in their body shapes would become more explicit. Shape of the body can be

judged with the help of body proportions. It has been noticed that some persons have very long

legs compared to their trunks whereas there are also those persons in whom trunk is relatively

much bigger than the legs. Studying one measurement with respect to another provides clues

about the shape of the body. Such ratios of different body parts are called body proportions. Body

proportions are useful in various fields such as human biology, anthropology, sports sciences,

auxology, etc., however, some inherent difficulties are encountered in interpreting the body

proportions. There are other approaches like that of the phantom which are now used to define

and interpret body proportions. The phantom is an imaginary human model which is based on the

male and female data taken from different groups and is said to represent all people of the globe.

It is only a comparative device with the help of which the bodily proportions are judged and

comparisons are made between individuals and populations. The phantom is used to derive z-

scores of differences in body proportions which are easy to interpret and these also dxprovide

good information.

3.1 Body Proportions

Traditionally, body proportions of one body measurement to another have usually been

attempted to know the variations in one body measurement by keeping the other constant in the

subjects to be compared. Virtually any two measurements can be taken for such proportions
depending upon the objectives of the study.

A few of such body indices which are often used are provided below:

 (Sitting height/height) x 100

 (Lower extremity length/height ) x 100

 (Sitting height/lower extremity length)x 100

 (Thoracic trunk/ abdominal trunk) x 100

 (Head breadth/ head length) x 100

 (Bicristal diameter/biacromial diameter)x 100

 (Chest depth/chest breadth)x 100

 (Upper arm length/ forearm length)x 100

 (Thigh length/leg length)x 100

 (Hand breadth/ hand length)x 100

 (Foot breath/ foot length )x 100

If two people differ in their sitting height but are also different in their heights then a simple

comparison of their sitting height would not yield much information. However, if sitting height in

relation to height is compared, it would be giving a better picture.

Ex.3.1 Calculate the simple proportional sitting height vis-à-vis that of height of the following

two subjects:

Subject 1, Sitting height = 76.0 cm, height = 170.0 cm

Subject 2, Sitting height = 75.0 cm, height = 165.0 cm

The proportional sitting height of Subject 1 = (76 x 100) /170 = 44.71 % of height

The proportional sitting height of Subject 2 = (75 x 100) /165 = 45.45 % of height

A comparison of sitting height/ height ratio between the two subjects reveals that the subject

no.2 has relatively longer trunk or sitting height compared to the subject no.1 whereas a

comparison of absolute values of their sitting height would have yielded the opposite results.
 Body Mass Index (BMI)

Body mass index (BMI) which is also known as Quetelet's index can be expressed as

follows:

BMI= Weight/Height2

Ex. 3.2 Calculate the BMI of a person if his height and weight are 170 cm and 66 kg,

respectively.

BMI = 66/(1.7)2

= 22.84

Here weight is taken in kg whereas height is taken in meters.

Body weight is a three dimensional entity whereas height is one-dimensional. According to

the dimensional rules, the best representation of weight vis-à-vis height would be to take the cube

root of weight or calculate the cube of height as follows.

Height/Weight0 33

Or Height3/ Weight

Much work has been done on body mass index and it has also been used in assessing

adiposity of children. According to Rolland-Cachera et al. (1982), a good weight/height index

meant for adiposity monitoring should be one which should be independent of height, highly

correlated with fat mass and body weight. Body mass index according to them fulfils these

conditions in growing children and they have suggested using it in determining the adiposity

among children (Rolland-Cachera et al. 1991). However, many scientists feel that body mass

index as an indicator of adiposity is neither as simple nor informative as it seems to be (Ross and

Ward 1982). The variations in body weight are not simply due to the variations in adiposity but

due to other factors as well. Therefore its utility in adiposity profiling of various groups may not

be as useful as it is made out to be. But in case of groups which have extensively been studied for

BMI with good results; the use of BMI in them can not be ignored.
  Androgyny score

The human males have typical broad shoulders whereas the females have relatively large hips. A

relationship of these two measures to a large extent can reveal the sexual dimorphism between the

sexes. There are certain males who possess some characteristics of females and the vice versa. To

what extent these features are present in either the males or the females can be known with the

help of “androgyny score”. This score is calculated as follows:”

Androgyny score = 3 X Biacromial diameter – 1 X Bi-iliac diameter

Ex. 3.3. Calculate the androgyny score of a person who has biacromial diameter as 36 cm and

bi-iliac diameter as 27 cm.

Androgyny score = 3 X 36 – 27 = 81

The higher values of this score denote masculinity whereas the lower scores indicate femininity

thus making a good discrimination among individuals of either sex about the masculine and

feminine features in their physiques..

This androgyny score has been extensively used by Tanner (1964) to discriminate between

different players of the various sports for their physiques during 1960 Rome Olympics.

 Conicity Index

Waist circumference for a given height and weight can be used as a predictor of central obesity.

Valdez et al. (1993) described an index on the basis of waist circumference and named it as

conicity index which can be calculated as follows:

Conicity Index = waist circumference/ (0.109 x (weight)/height)0.5

Here waist circumference and height are expressed in metres whereas weight is taken in kg.

Ex.3.4 Calculate the conicity index of the subject with following measurements:

Height 150 cm = 1.5 m

Waist circumference 50 cm = 0.50 m

Weight = 50 kg

Conicity index = 0.50 / (0.109 X (50/ 1.5) 0.5)

= 0.79

The principle implied is that if the abdomen is assumed to be a cylindrical entity, any deviation

on the higher side in the size of the cylinder for a given height and weight from that of the

standard is an indicator of central obesity.

3.2. The phantom stratagem

Relationships of one measurement to another are informative in comparing individuals who

otherwise differ in size or various other body measurements. Ross and Wilson (1974) have

proposed the concept of a theoretical reference human which they prefer to call as phantom to be

used as a reference standard for such comparison. According to them

"the phantom is a conceptual unisex, bilaterally symmetrical model derived from reference

male and female data".

The phantom height is 170.18 cm and body weight is 64. 58 kg. The phantom specifications for

various body measurements with their standard deviations are presented in tables 3.1 to 3.7. It is

important to mention here that means values and SD’s of various body measurements of phantom

can be used to study proportional differences in various populations, age and sex for comparative

purposes. The values of the phantom specifications have been systematically given in the form of

different tables as gross measurements (Table 3.1), projected heights (Table 3.2), derived and

direct lengths (Table 3.3), body girths (Table 3.4), breadths (Table 3.5), skinfolds (Table 3.6),

measurements of the heads and face (Table 3.7).

The phantom stratagem has been used by many authors to study body composition, human

physique and proportionality in general population of different age groups and also in case of

elite athletes (Ross and Ward 1984a, Ross et al. 1986, 1987).

Fig. 3.1 shows a sketch of the phantom along with a typical male and a female physique.
 Insert figure 3.1 somewhere here

The phantom values have been obtained on the basis of the measurements and landmarks defined

in the second chapter on body measurements (recommendations of kinanthropometry group).

There is no need, however, to absolutely adhere to the techniques of the phantom

measurements for calculating the differences. If the subjects or groups compared have been

studied following a uniform procedure and if that differs from the phantom techniques, even then

the differences in z-scores can be calculated and safely interpreted. But if different techniques are

employed in the subjects to be compared, then it has been advised not to attempt this procedure

for z-scores.

3.2.1 The z-scores

The body measurement of any subject is first adjusted to the phantom height or size and its

difference from the phantom reference value of the given variable is calculated. This difference is

then represented in terms of phantom SD of the given variable and is known as z-scores. The z-

scores are calculated as follows:

Z =(1/s)[v(170.18/h)d-p]

Where z is a proportionality value of z-score

v is any variable

s is the phantom standard deviation for the given

variable

170.18 cm is the phantom height constant

h is the subject's height

d is a dimensional constant whose values are

1 for all heights, lengths, breadths, girths and

 skinfold thicknesses,

2 for all area values,

3 for all volumes and weights

p is the phantom value for the variable.

If the z-score is zero, it means that the particular subject has the same proportion of the given

variable as that of the phantom. The z-scores higher than zero (all positive values), indicate a

greater proportional development of the given variable in the subject and the z-score less then

zero (all negative values) indicate a lesser proportional development of the variable as compared

to those of the phantom values.

Insert tables 3.1 to 3.7 somewhere here

It should be borne in mind that the phantom values of various measurements do not suggest as to

what should be the most desirable values in the human beings but only serve the purpose of a

calculating device for comparing groups and individuals.

"The phantom is not a normative model but primarily used as a

calculation device for comparing individuals and groups"(Ross

and Ward 1982).

Ex. 3.5. Calculate of z-scores of bodyweight in proportion to height of two subject whose heights

and weights are provided below.

Subject 1, height = 150.0 cm, weight = 50.0 kg

Subject 2, height = 160.0 cm, weight = 60.0 kg

Z =(1/s)[v(170.18/h)d-p]

Since the proportional body weight is to be calculated therefore the value of d (dimensional

constant) in this case would be 3. The s is the SD of body weight of phantom (See table 3.1), v is
the weight of the subject, h is the height f the subject whereas P is the body weight of the phantom

(table 3.1).

z-score (1)= (1/8.60) [50 (170.18/150.0)3 – 64.58]

=0.981

z-score (2)= (1/8.60) [60 (170.18/160.0)3 – 64.58]

=0.886

The z-scores of body weights of the two subjects are 0.981 and 0.886, respectively, both the

values are greater than zero. It means both the subjects have proportionately greater body weight

in relation to height than that of the phantom. Also, the subject no.1 is proportionately heavier in

body weight for a given height than the subject no. 2.

Ex. 3.6 Calculate the proportional z-scores of sitting height in relation to span if the values of

sitting height and span are 80.2 cm and 161.0 cm, respectively.

Z - score =(1/SD of sitting height of phantom)[sitting height of subject (span of phantom/span of

the subject)d – sitting height of phantom]

Take the phantom values from table 3.2. The proportional value of sitting height is to be obtained

which is a uni-dimensional value therefore the value of d should be taken as 1.

z-score = (1/4.5) [80.2 (172.35/161.0) – 89.92]

= - 0.90

The above value of - 0.90 of Z-score indicates that this subject has proportionately smaller sitting

height in relation to span than that of the phantom.

Ex.3.7 Calculate the proportional z-scores of Abdominal Girth 1 (Waist) in relation to Chest

Girth (mesosternale, end tidal) if the values of Abdominal Girth 1 (Waist) and Chest Girth

(mesosternale, end tidal) are 82.2 cm and 71.50 cm, respectively. Values of phantom are taken

from table 3.4.

z-score = (1/4.45) [71.5 (87.86/82.2) – 71.91] = 1.01

Though the abdominal girth of the above subject is smaller than that of the phantom yet with a z-
score of 1.01 it has shown proportionately bigger abdominal girth in relation to chest girth when

compared with the phantom.

Ex.3.8 Calculate the proportional z-scores of biiliocristal diameter in relation tobiacromial

diameter if the values of biiliocristal and biacromial diameters are 29.2 cm and 37.5 cm,

respectively.Values of the phantom to be seen from table 3.5.

z-score = (1/1.75) [29.2 (38.04/37.5) – 28.84] = 0.45

Ex.3.9 Calculate the proportional z-scores of triceps skinfold in relation to arm girth (fully

flexed) if the values of triceps skinfold and upper arm girth flexed) are 14 mm and 27.5 cm,

respectively. Values of the phantom for skinfolds are taken from table 3.6 and those for arm girth

(fully flexed) are taken from table 3.4.

z-score = (1/4.47) [14 (29.41/27.5) – 15.4] = - 0.0.96

Ex.3.10. Calculate the proportional z-scores of head breadth in relation to head length if the

values of head breadth and head length are 14 cm and 18 cm, respectively. Values of the

phantom for these measurements are taken from table 3.7.

z-score = (1/0.58) [14 (19.15/18) – 15.4] = - 0.32.

Phantom stratagem is a useful device

 in evaluating the structural differences between the subjects for various measurements,

 for quantifying the sexual differences,

 in knowing the patterns of proportional growth in different phases of life,

 and in exploring the proportional fractional body masses.

The phantom stratagem can be used to scale any variable to any other variable and not

necessarily the phantom height.

3.3 The O-scale system

The O-scale system for assessing the adiposity and proportional weight has been invented by

Ross and Ward (1984b). The concept of O-scale is similar to that of the growth norms/standards
but different in the sense that the proportionally projected values to the universal means are used

instead of the absolute values. According to this system, for assessing adiposity (A), the sum of

six skinfolds is first scaled to the standard height of 170.18 cm. Then the adjusted sum of

skinfolds is compared with the STANdard nINE scores (STANINE scores). The stanine scores

are standard nine scores having divisions at 4%, 11%, 23%, 40%, 60%, 77%, 89% and 96% of

the population for a given variable. The eight divisions have nine groups of frequencies, i.e., from

0 to 4%, 5 to 11%, 12 to 23%, 24 to 40%, 41 to 60%, 61 to 77%, 78 to 89%, 90 to 96% and 97 to

100%, which have been designated with the stanine scores from 1 to 9, respectively. The O-scale

stanine scores for proportional weight (w) and adiposity (A) have been given in Tables 3.8 and

3.9, respectively. These standards were constructed by Ross and Ward (1984b) on the basis of a

large data bank of 1236 children and young adults and 19000 adults of Canada. Since the O-scale

stanine scores are based on population specific standards, therefore it is advisable to construct the

O-scales for different populations. The adiposity and proportional weight of a person can be

judged with respect to the O-scales for his population. A point of contrast between the z-scores

and the stanine scores is that the former is sample independent whereas the latter is sample

dependent.

Insert tables 3.8 and 3.9 somewhere here

For the adiposity (A) assessment, six skinfolds at triceps, subscapular, suprailiac, abdominal,

front thigh and medial calf are taken. The techniques for these measurements have also been

described by Ross and Ward (1984b). The measurements are so chosen as they may account for

any regional variations in fat patterning and dysplasia in various parts of the body. Generally the

measurement techniques resemble the kin anthropometric group measurements given in the

previous chapter.
The O-scale proportional weight (w) can be calculated as follows:

Proportional weight (w) = Weight x (170.18/height)3

Now this value of proportional weight is checked to obtain the O-scale score or STANINE scores

for weight from table 3.8 for the given age and the sex of the subject.

The O-scale adiposity (A) rating can be calculated as follows:

O-scale for adiposity (A) = Sum of skinfolds x (170.18/height)

Now this value of adiposity is checked to obtain the O-scale score or STANINE scores for

adiposity from table 3.9 for the given age and the sex of the subject.

Ex.3.11. Calculate the O-scale score or STANINE score for adiposity of the given subject

Sex = Female

Age = 19 Years

Height = 160.0 cm

Weight = 60.0 kg

Sum of 6 skinfolds = 100 mm

The O-scale proportional weight (w) = 60.0 x (170.18/160.0)3

= 72.20 kg

Table 3.8 provides the values of proportional weight for conversion into their STANINE score.

The top row indicates the STANINE scores which are placed in between the columns representing

the values of proportional weights at different ages. A value of a proportional body weight of

72.2 kg of a 19 year old female would be checked from the row of 18-19 year age group and falls

in between the values of 71.0 and 77.8 kg. The two columns in which these two values are located

represent a STANINE score of 8. The design of table 3.9 for obtaining O-scale scores or

STANINE scores is also similar to that of the weight.

A value of 72.2 kg of proportional weight at 19 years in females corresponds to an O-scale

score or STANINE scores of 8 for proportional weight (Table 3.8).

O-scale adiposity (A) =100 x (170.18/160.0)

= 106.36 mm

A value of 106.36 mm at 19 years in females corresponds to an O-scale score or STANINE

scores of 6 for adiposity (Table 3.9).

The O-scale has a good practical utility in the follow up studies on the same individual to

monitor the effects of exercise and dietary changes. In case of vigorous exercise and dietary

constraints, the adiposity (A) is likely to decrease in greater proportion as compared to body

weight. This can be illustrated with the help of following example:

Ex. 3.12. The same female undergoes rigorous physical training for short durations and sheds a

lot of her body weight and the skinfolds. Let her measurements after the training programme be

as follows :

Weight = 55.0

Sum of skinfolds = 60 mm

O-scale adiposity (A) for 60 mm = 60 x (170.18/160.0) = 63.82 mm

This corresponds to a STANINE score of 2 for O-scale adiposity (A).

O-scale proportional weight (w) = 55.0 x (170.18/160.0)3 = 62.22 kg

This corresponds to a STANINE score of 5 for O-scale weight (w).

There is a difference of 4 stanine scores before and after exercise in the above subject in

adiposity (from 6 stanine score to 2) as compared to 3 for proportional weight (from 8 stanine

scores to 5). Thus the adiposity loss is proportionally greater than that of the body weight (Fig.

3.2).
Insert figure 3.2 somewhere here
Chapter 3 Exercises

Ex. 3.1. Calculate the proportion of head breadth to head length in the following cases:
a. head breadth = 15cm head length= 18.3 cm
b. head breadth = 13.4cm head length= 19.5cm
c. head breadth = 14.4cm head length= 18.2 cm
d. head breadth = 12.8cm head length= 17.3 cm

Ex.3. 2. Calculate the BMI of the following cases whose respective height and eight values are
given below:
a. 155 cm, 52 kg
b. 1.66 m, 61 kg
c. 159 cm, 65.2 kg
d. 1.78 m, 71 kg
e. 165.1 cm, 62 kg

Ex 3.3. Calculate the z-scores of bodyweight in proportion to height of following cases:

a. Weight 63 kg Height 166 cm
b. Weight 54 kg Height 170 cm
c. Weight 22 kg Height 110 cm
d. Weight 36 kg Height 120 cm
e. Weight 46 kg Height 140 cm

Ex.3. 4 Calculate the proportional z-scores of sitting height in relation to span of the following:
a. sitting height 67 cm span 140 cm
b. sitting height 78 cm span 148 cm
c. sitting height 75 cm span 157 cm
d. sitting height 70 cm span 156 cm
e. sitting height 80 cm span 164 cm

Ex. 3.5. Calculate the proportional z-scores of Abdominal Girth 1 (Waist) in relation to height in
the following:
a. Abdominal Girth 1 (Waist) 67 cm Height 158 cm
b. Abdominal Girth 1 (Waist) 60 cm Height 157 cm
c. Abdominal Girth 1 (Waist) 77 cm Height 160 cm
d. Abdominal Girth 1 (Waist) 88 cm Height 175 cm
e. Abdominal Girth 1 (Waist) 72 cm Height 183 cm

Ex.3.6. Calculate the proportional z-scores of triceps skinfold in relation to height in the
following:
a. triceps skinfold 18 mm height 167 cm
b. triceps skinfold 15 mm height 173 cm
c. triceps skinfold 22 mm height 177 cm
d. triceps skinfold 26 mm height 186 cm
e. triceps skinfold 13 mm height 167 cm

Ex. 3.7 Calculate the proportional z-scores of head breadth in relation to head length of the
following:
a. head breadth 14 cm head length 19 cm
b. head breadth 10 cm head length 17 cm
c. head breadth 13 cm head length 18 cm
d. head breadth 15 cm head length 21 cm
e. head breadth 17 cm head length 21 cm

Ex.3. 8. Calculate the conicity index of the following

a. waist circ. 65 cm Height 151 cm weight 50 kg
b. waist circ. 67 cm Height 165 cm weight 54 kg
c. waist circ. 72 cm Height 170 cm weight 61 kg
d. waist circ. 70 cm Height 168 cm weight 58 kg
e. waist circ. 75 cm Height 176 cm weight 67 kg

Ex. 3.9. Find out the O-scale score for proportional weight and adiposity of the following subject:
Male, age 26 years
Weight 75 kg
The sum of six skinfolds (triceps, subscapular, suprailiac, abdominal, front thigh and medial calf)
is 72 mm.
Chapter 3. Answers

Ans. 3.1.
a. 81.97
b. 68.72
c. 79.12.
d. 73.99

Ans.3.2 BMI of the subjects.

Hint – the height of the subjects must be converted into meters before putting it in the equations.
a. 21.64
b. 22.14
c. 25.79
d. 22.41
e. 22.75

Ans: 3.3
a. 0.3837
b. -1.2102
c. 1.9633
d. 4.4301
e. 2.0979

Ans: 3.4
a. – 1.65
b. 0.20
c. – 1.69
d. – 2. 80
e. – 1.30

Ans. 3.5
a. 0.06
b. – 1.54
c. 2.24
d. 3.07
e. – 1.11

Ans: 3.6
a. 0.66
b – 0.14
c. 1.29
d. 1.88
e. – 0.48

Ans. 3.7
a. – 1.67
b. – 6.58
c. – 2.15
d. – 2.42
e. 0.73
Ans. 3.8.
a. 1.036
b. 1.074
c. 1.103
d. 1.093
e. 1.115

Ans: 3.9.
O-scale score for weight 7
O-scale score for adiposity 5
 Table 3.1 Gross phantom specification (After Ross and Ward 1982)

Variable Mean SD

______________________________________________________________________________

Stature (cm) 170.18 6.29

Body mass (kg) 64.58 8.60

Lean body mass (kg) 52.45 6.4

Fat mass (kg) 12.13 3.25

Percent fat 18.78 5.20

Density (gm/cc) 1.056 0.011

Bone mass (kg) 10.49 1.57

Muscle mass (kg) 25.55 2.99

Residual body mass (kg) 16.41 1.90

Ht (in)/cube root of wt lb 12.83

Ht (cm)/cube root of wt kg 42.41

[Cube root of wt (kg)/ht (cm)] x 10 23.58

Somatotype 5-4-2.5
 Table 3.2 Phantom height projected (cm) (After Ross and Ward (1982)

Variable Mean SD

______________________________________________________________________________

Height vertex or stature 170.18 6.29

Height Gnathion 148.81 5.65
Height Suprasternale 138.31 5.46

Height Infrasternale 119.50 4.96

Height Symphysion 87.05 4.35
Height Acromiale 139.37 5.43

Height Radial 107.25 5.36

Height Stylion 82.68 4.13
Height Dactylion 63.83 3.38

Height Iliospinale 94.11 4.71

Height Trochanteric 86.40 4.32
Height Tibial (lateral or medial) 44.82 2.56

Height Sphyrion (fibular) 7.10 0.85

Height Sphyrion (tibial) 8.01 0.96
Height Cervical 144.15 5.58

Height Gluteal arch 88.33 4.41

Sitting height 89.92 4.50
Span (dactylion to dactylion) 172.35 7.41
 Table 3.3 Phantom lengths derived and direct (cm) (After Ross and Ward 1982)

Length Mean SD

______________________________________________________________________________

Head height (vertex-gnathion) 27.27 1.02

Neck (gnathion-suprasternale) 9.48 1.71
Trunk (suprasternale-symphysion) 51.26 2.56

Back (cervicale-gluteal arch) 56.83 2.84

Upper extremity (acromiale-dactylion) 75.95 3.64
Upper extremity (acromiale-stylion) 57.10 2.74

Arm (acromiale-radiale) 32.53 1.77

Forearm (radiale-stylion) 24.57 1.37
Hand (stylion-dactylion) 18.85 0.85

Lower extremity (Stature-sitting ht) 81.06 4.05

Thigh 1(stature-sitting ht tibiale) 35.44 2.12
Thigh 2 (iliospinale-tibiale) 49.29 2.96

Thigh 3 (trochanterion-tibiale) 41.37 2.48

Tibia (tibiale mediale-t. sphyrion) 36.81 2.10
Lower Leg (tibiale lateral-f. sphyrion) 37.72 2.15

Foot length (standing

akropodion-pternion) 25.50 1.16
Foot length (Flat unweighted
akropodion-pternion) 24.81 1.15
 Table 3.4 Phantom girths (cm) (After Ross and Ward 1982)

Girth Mean SD

______________________________________________________________________________

Head Girth 56.00 1.44

Neck Girth 34.91 1.73
Shoulders Girth 104.86 6.23

Chest Girth (mesosternale, end tidal) 87.86 5.18

Abdominal Girth 1 (Waist) 71.91 4.45
Abdominal Girth 2 (umbilical) 79.06 6.95

Abdominal Girth Av (mean 1and 2) 75.48 5.74

Hips Girth 94.67 5.58
Thigh Girth (1 cm distal, gluteal line) 55.82 4.23

Knee Girth 36.04 2.17

Calf Girth (standing) 35.25 2.30
Ankle Girth 21.71 1.33

Arm Girth (fully flexed, tensed) 29.41 2.37

Forearm Girth (relaxed) 25.13 1.41
Wrist Girth 1 (distal styloid) 16.35 0.72

Wrist Girth 2 (Proximal styloid) 16.38 0.72

Arm girth relaxed (-22/7 x triceps skf) 22.05 1.91
Chest girth (-22/7 x subscapular skf) 82.46 4.86

Thigh girth (-22/7 x front thigh skf) 47.34 3.59

Calf girth (-22/7 x medial calf skf) 30.22 1.97
 Table 3.5 Phantom breadths (cm) (After Ross and Ward 1982)

Breadth Mean SD

______________________________________________________________________________

Biacromial 38.04 1.92

Bideltoid 43.50 2.40
Transverse chest (mesosternale) 27.92 1.74

Biiliocristal 28.84 1.75

Bitrochanteric 32.66 1.80
Chest depth (AP, mesosternale) 17.50 1.38

Biepicondylar humerus 6.48 0.35

Wrist (max., stylion-ulnare) 5.21 0.28
Hand (distal II-V metacarpals) 8.28 0.50

Biepicondylar femur 9.52 0.48

Transverse tibia 9.12 0.47
Bimalleolare 6.68 0.36

Transverse foot (standing) 9.61 0.60

Transverse foot (flat, unweighted) 8.96 0.56
Foot (standing, distal I-V metatarsals) 10.34 0.65
 Table 3.6 Phantom skinfolds (mm) (After Ross and Ward 1982)

Skinfold Mean SD

______________________________________________________________________________

Triceps 15.4 4.47

Subscapular (diagonal) 17.2 5.07
Subscapular (vertical) 17.5 5.17

Chest 11.8 3.27

Biceps 8.0 2.00
Suprailiac 15.4 4.47

Abdominal 25.4 7.78

Iliac crest 22.4 6.80
Front thigh 27.0 8.33

Rear thigh 31.1 9.69

Medial calf 16.0 4.67
 Table 3.7 Phantom head and face measurements (cm) (After Ross and Ward 1982)

Measurement Mean SD

______________________________________________________________________________

Classic head ht (Vertex-gnathion) 27.27 1.01

Head length (glabella-occiput) 19.15 0.68
Head breadth (transverse parietal) 15.08 0.58

Head height (vertex-tragion) 13.31 0.75

Bizygomatic breadth 13.66 0.57
Bigonial breadth 10.59 0.58

Morphological face ht (nasion-gnathion) 11.94 0.69

Nose length (nasion-subnasale) 5.21 0.48
Table 3.8 O-scale proportional weight (kg) ratings for females and males (After Ross and Ward

1984b)

O-scale STANINE scores for body weight

Age ____________________________________________________________

(yr) 1 2 3 4 5 6 7 8 9

______________________________________________________________________________

Females

6 53.1 54.4 55.4 60.2 63.8 66.7 71.3 72.9

9 49.9 52.0 54.4 56.5 69.7 63.2 67.7 72.2

12 46.2 49.2 51.8 54.8 59.6 63.9 72.8 80.2

15 47.2 50.3 54.2 57.2 60.5 64.3 71.0 76.3

18-19 51.8 54.8 57.5 60.4 63.5 66.8 71.0 77.8

20-24 52.2 55.2 57.6 60.9 64.2 68.3 72.9 80.0

25-29 52.5 55.2 57.7 61.0 64.8 68.9 74.8 83.0

Males

6 55.2 56.8 59.9 62.6 64.8 67.7 69.6 73.9

9 49.4 53.3 55.1 57.4 59.7 62.5 66.1 69.1

12 46.3 50.6 52.8 54.9 58.3 62.2 67.3 74.4

15 46.8 49.2 51.4 54.3 57.5 61.2 66.8 71.7

18-19 49.5 52.8 56.4 59.0 62.5 64.5 67.8 70.8

20-24 51.3 54.8 57.8 61.8 65.6 67.4 74.6 80.1

25-29 53.1 56.2 59.8 63.2 67.5 71.4 76.4 84.3

Table 3.9 O-scale proportional adiposity (mm) ratings for males and females (After Ross and

Ward 1984b)

O-scale STANINE scores for adiposity

Age _________________________________________________________

(yr) 1 2 3 4 5 6 7 8 9

______________________________________________________________________________

Females

6 46.8 56.1 61.7 69.5 77.9 96.7 128.6 144.0

9 45.5 53.4 66.1 73.2 87.7 98.6 111.7 143.3

12 53.0 59.3 66.5 77.8 98.7 111.4 153.0 175.6

15 49.4 62.6 72.4 85.4 99.6 113.2 145.3 162.1

18-19 63.4 70.5 78.5 90.2 103.4 118.2 135.9 155.7

20-24 64.0 72.5 81.2 92.0 104.2 118.9 138.0 164.0

25-29 65.2 74.1 82.2 93.0 107.9 122.9 141.0 169.2

Males

6 43.0 47.4 57.4 63.0 70.0 80.9 92.7 121.0

9 43.6 47.1 50.9 55.9 64.2 77.7 105.2 172.4

12 37.6 43.1 47.0 53.4 65.7 89.3 129.6 188.9

15 33.4 35.7 42.1 47.0 55.9 69.0 100.8 146.1

18-19 31.5 34.3 41.7 47.6 57.0 70.3 87.3 109.3

20-24 35.0 40.9 48.1 57.8 71.5 89.0 109.0 130.0

25-29 38.3 45.5 54.5 66.8 81.8 99.5 119.3 144.0

 Fig. 3.2 Effect of exercise on adiposity and proportional weight in a female

% 4 11 [ 23 40 60 77 89 96

______________________________________________________________________________

O-scale 1 2 3 4 5 6 7 8 9

______________________________________________________________________________

Adiposity *......................................................#

Weight *.....................................#

* After exercise

# Before exercise
4. BODY COMPOSITION
 Chapter details

 Historical perspective
 Conceptual models of body composition
 Five level model of body composition
 The ‘Reference’ Man and a ‘Reference’ Woman
 Hydration of body compartments and body fat
 Densities of body components
 Cadaver analysis for revalidation of body composition
 Densitometric determination of body composition
 Anthropometric determination of body composition
 Adipo-muscular relationship
 Matiegka’s method
 Drinkwater tactic for estimating fractional body masses
 Roentgenogrammetry
 Hydrometry
 Dual Energy X-ray Absorptiometry (DXA)
 Neutron Activation

Human body is composed of various tissues and numerous body cavities filled with body fluids.

The composition of the human body creates a natural interest in every body. Earliest studies on

body composition were conducted on animals with a view to analyzing the quality of meat and

describing its composition. Changes in body fat and lean body mass as a result of feeding the

animals have been studied and it was also noticed that the amount of fat varied inversely with the

amount of body water. The greater the fat in the body the lesser would be the body water. Human

cadavers were dissected and studied for water content and other components only during the

beginning of the 20th century. It was increasingly being appreciated at that time that fat holds little

water and whatever water is present in the human body is equally distributed in all other tissues.

Thus the concept of fat and fat free mass was developed and this forms a formidable concept in

body composition analysis even today.

4.1 Historical Perspective

Albert Behnke (1942) made pioneering efforts at distinguishing overweight from obesity. It was

earlier understood that anybody whose weight is beyond certain defined limits is overweight and

hence has unwanted amounts of fat. Since the densities of fat and the lean body mass differ,

therefore it was possible to differentiate their relative amounts if the density of the body could be

measured. Behnke applied Archimedes’s principle to evaluate body density and then to convert it

into the amounts of fat and lean body mass. This was followed by a fervent activity at

standardizing the techniques for assessing the body density by underwater weighing and by water

displacement methods. Detailed experimentations were conducted by Keys and Brozek (1953) to

measure the body density, correct it for residual lung volumes and to devise formulae for the

calculation of percentage of fat and lean body mass. The works of these authors is still held in

great esteem and used in the studies of body composition analysis.

Weight for height standards were being used by the insurance companies and the military

authorities to assess the desirable weight of the persons during the first half of the twentieth

century. However Professor Behnke (1942) exposed the fallacy of such weight for height

standards in designating overweight and fatty subjects. From the body composition studies of

elite football players who were designated as too fat and overweight on the basis of height-weight

standards, Behnke (1942) found them highly muscular and extremely fit individuals with very

little amounts of fat. Terming them as physically non-fit simply for being overweight was a cruel

joke on them as they were the best by virtue of their body composition analysis. This landmark

study opened new vistas in body composition research which later found wide applications in the

fields of physical fitness, sports science and medicine.

The various techniques for estimating body composition include densitometry,

hydrometry, roentgenogrammetry, ultrasound, photon absorptiometry, neutron activation,

bioelectrical impedance, total body water by dilution, CAT scanning, total body potassium,

anthropometry, creatinine excretion, etc. (Mettau et al. 1977, Baumrind 1986, Hodgdon &

Fitzgerald 1987, Harrison 1987, Forsyth et al. 1988). While some of these methods are highly
invasive others are very costly, time consuming and need lots of equipment. Anthropometry is the

easiest of all, it is non-invasive, very economical and even the subject can be persuaded for the

measurements easily.

4.2 Conceptual models of body composition

The human body mass may be conceptually divided into numerous fractional masses by assuming

the different qualities of body tissues, water holding qualities and differential densities of various

tissues. On the basis of these qualities, the models may be conceived as a range from a single-

compartment to multi-compartment models. The division of the body mass can be made by

considering the major components of the body, e.g., fatty tissue, muscular tissue, skeletal tissue

and connective tissue. The studies on body composition would therefore assess quantitatively the

amounts of these tissues. For the study of body composition there are numerous methods which

are available these days. Human cadavers and animals can become the subjects for the direct

analysis of body composition; however, indirect methods are required to obtain information about

the body composition in living persons. The following is the nomenclature of different conceptual

body masses as suggested by Jebb and Elia (1995) a summary of which has been given in the

tabular form (Table 4.1).

Insert Table 4.1 somewhere here

 Single Compartment model – Body Mass

 Two Compartment model - Fat and Fat Free Mass

 Three Compartment model – Fat, Water and protein and mineral

 Four compartment model – Fat, Water, Mineral, Fat free soft tissue
4.3 Five-level model of body composition

The classical organizational levels of the body were used by Wang et al. (1995) who proposed a

five-level model of body composition. These levels started with the atomic or elemental level and

proceeded on to molecular, cellular and tissue level and culminated with the whole body. These

levels have been explained as follows:

Level 1. Elemental level or atomic level

It states the elements or different types of atoms present in the human body and their quantitative

study. The body is composed of oxygen, hydrogen, carbon, nitrogen, calcium, phosphorus, sulfur,

potassium, sodium and chlorine. Besides these, very small quantities of numerous other elements

are also present in the human body which include magnesium, silicon, iron, fluorine, zinc, copper,

manganese, iodine, rubidium, strontium, bromine, lead, aluminum, cadmium, boron, barium, tin,

nickel, gold, molybdenum and many others. The following table (Table 4.2) shows the amounts

of various elements in the human body in a reference man of 70 kg of body weight (Forbes 1987),

however, these values would be different in different individuals and the study of such elements

and their quantities would be of great importance.

Insert Table 4.2 somewhere here

Level 2. Molecular level

This level explains the composition of the body in terms of different molecules assembling

together to give it a complete form. These include water, proteins, fat, carbohydrates, and other

molecules (Table 4.3).

 Insert Table 4.3 somewhere here

Level 3. Cellular level

In the cellular level, the contents of the cell become the focus of study of body composition. The

cell solids and cytoplasm which forms all the cell mass along with the extra-cellular fluid and

extra-cellular solids are to be measured in this level.

The human bodies contain about sixty percent of water, however, factors like age, degree

of fatness, sex, populations or races influence this proportion. An average person of 170 cm. of

height and 70 kg of body mass would have 42 kg of water and 28 kg of the rest of the mass. The

adipose cells contain very little amount of water (about 10 to 30 %) as compared to the other

tissues (about 70%). Therefore it is the amount of body fat which determines to a major extent the

hydration of the body and its water content with respect to body weight. During childhood the

water content of the body is very high about 70 %. An average man has about 60 % of his body

mass as water as compared to 50 % of that of an average woman. An obese man may have 50 %

of his body mass as water which is just equal to that of an average woman. This is because of the

fact that the normal females have in addition some amounts of sex specific fat besides the normal

amount of fat and hence have a reduced water content of the body. Obese females may have as

little as 40 % of body weight due to body water. The proportion of body water and cell solids

stays relatively constant in normal as well as obese subjects in their fat free mass compartment,

though these would be quite variable if expressed in terms of total body mass. Table 4.4 shows

the percentage of total body water in children, average adult male and female and in obese

individuals of both the sexes.

 Insert Table 4.4 somewhere here

The water content of the body is distributed either within the cells or outside the cells and hence

two compartments of fluid distribution inside the body are made. The fluid present within the

cells is called intra-cellular fluid whereas that present outside the cells is referred to as extra-

cellular fluid. The extra-cellular fluid is further distributed either in interstitial fluid spaces or as

part of the blood plasma. The intra-cellular fluid constitute about two-thirds of the total body

water as compared to one-third in case of extra-cellular fluid. The relationship between interstitial

fluid and blood plasma within the extra-cellular fluid is three to one, respectively. Since the total

body water constitutes 60 % of the total body mass, and two-third of this is the intra-cellular fluid

which amounts to 40 % of that of the body mass. Similarly, one third of total body water is the

amount of extra-cellular fluid which would be equal to 20 % of the total body mass. This extra-

cellular fluid can be further fractionated as interstitial fluid and blood plasma in the ratio of three

to one and in terms of the ratios of total body weight, the interstitial compartment constitute 15 %

and the blood plasma constitutes 5% of the total body mass.

Quantities of intra-cellular fluid, interstitial fluid and plasma in an average individual of 70 kg

body mass and 42 litres of total body water are 28 litre or 40%, 10.5 litre or 15% and 3.5 litre or

5%, respectively.

The composition of intra and extra-cellular fluids is also different. The extra cellular fluid has a

very high concentration of sodium, chloride and bicarbonate ions (mmol/litre) whereas the

potassium ions and protein is the mainstay of intra-cellular fluid (Table 4.5).

Insert Table 4.5 somewhere here

Level 4. Tissue level

The study of major tissues of the body and their amounts is included in this level of body

composition analysis. Classical studies on body composition which include anthropometry,

densitometry, roentgenogrammetry, hydrometry, etc., have focused on these tissues which

include, fat, muscle, bone, blood, connective tissue, etc. A reference adult man of 70 kg body

mass has about 28 kg muscles, 15 kg of adipose tissue and 10 kg of skeletal mass. The amount of

skin in the reference man is about 5 kg (Forbes 1987).

Insert Table 4.6 somewhere here

Level 5. Whole body

The whole body and analyzing its composition externally is the final or fifth level o the study of

body composition. The body measurements and estimating body density are important in the

study of body composition.

It is important to note that inter-connections exist between components at various levels. As an

example, a common factor of fatness can be explained at different levels in the form of total body

carbon (level 1), lipid or fat content (level 2), the contents of adipocytes or fat cells (level 3),

amount of adipose tissue (level 4), thicknesses of skinfolds (level 5). All these are explicit

examples of different expressions of fatness at different levels but these are linked by common

factors. Heymsfield and Wang (1995) term these factors as steady-state relations which have the

potential to be mathematically illustrated. In estimating the body composition, numerous

assumptions about these steady-state relations are made. It is assumed that some components are

independent of age, sex and population and are related to each other in a rather stable and

predictable manner. Many assumptions about these steady state relations were indeed developed
in the past which could only be validated with the help of cadaver studies then. But now

sophisticated techniques have evolved which can in vivo estimate these components and hence

test these assumptions. Some examples are quoted from Heymsfield and Wang (1995):

Fat Free Mass (FFM) is considered to be a homogeneous entity in the classical body composition

studies. The different constituents of FFM at the molecular level (level 2) are assumed to be

similar in young and old people. A controlled study on weight and height matched young and old

was conducted by Heymsfield and Wang (1995) to find out the constituents of FFM at the

molecular level to find out similarities between the old and young. The in vivo studies revealed

that the TBW per unit of FFM and density of the FFM is similar in old and the young whereas

there is a marked reduction of TBK per unit of FFM in the old when compared to that of the

young.

4.4 The ‘Reference’ man and a ‘Reference’ woman

The ‘Reference’ man and a ‘Reference’ woman are conceptual man and woman whose

physical measurements and body composition are derived from very large samples of

men and women. Such standard values can be assigned to body components such as height,

weight, fat mass and percentage of fat, bone mineral and non osseous material, etc. for a

theoretical man and a woman. Brozek et al. (1963) and McArdale et al. (1989) have provided

such values on the basis of their own studies as well on the basis of data already existing. These

values serve the purpose of standards in a ‘reference man’ and a ‘reference woman’ (Tables 4.8

and 4.9). Reference standards of body composition of males and females have been devised from

large sets of data. These theoretical values of body composition are given for a reference man

and a reference woman by McArdale et al. (1989) and are given in Table 4.7.

Insert Table 4.7 somewhere here

The amounts of water, fat, protein, bone minerals and non-osseous materials per kg of body mass

along with their densities have been provide in Table 4.8. These are the values as obtainable in a

reference male and a female.

Insert Table 4.8 somewhere here

4.5 Hydration of body compartments and body fat

Body fluid volumes are generally set into two compartments. The intra cellular fluid (ICF) is

present in side the cells and the extra cellular fluid (ECF) is present in blood plasma and

interstitium. Besides this, there is trans cellular fluid which includes synovial fliud, intraocular

and cerebro-spinal fluid and that in the lumen of the intestine. Intracellular fluid is connected to

the blood plasma and interstitial fluid and there is adequate transfer of materials. Orally

administered substance reaches equilibrium with all compartments of the body and the amount of

body fluid compartments can be assessed by the dilution principle.

Fat or lipids generally do not hold water and therefore are referred to as being anhydrous. All the

water of the body is located in the lean tissue. On the basis of body fluids, the two-compartment

model of body composition can be made which would be fat mass and fat free mass (or lean body

mass). Studies on the water content of lean body mass (LBM) of human subjects have indicated

that it ranged between 69.4 to 73.2% (Widdowson & Dickerson 1964). Forbes (1962) found an

average factor of 72.4% of the human lean tissues. Other mammals like cat, dog, rat, rabbit,

monkey, etc., show a range of the water in their LBM between 72.0 to 78.0% (Widdowson &

Dickerson 1964). Table 4.9 provides values of hydration of lean body mass among humans and

mammals.
The lipids are heterogeneous substances which are soluble in organic solvents but insoluble in

water. In blood they are generally bound to plasma proteins and hence are called lipoproteins.

The plasma lipoproteins facilitate the transport of water insoluble lipids. After a fatty meal, a

large number of microscopic globular molecules appear in the blood which are known as

chilomicrons. Major human plasma lipoproteins include chilomicrons, very low density lipids

(VLDL), low density lipids (LDL) and high density lipids (HDL). Composition of various

lipoproteins varies greatly and is shown in table 4.10.

Insert Table 4.10 somewhere here

The cellular lipids are of two main types: neutral fat, stored in the adipose tissue as fat depots and

structural lipids which are an integral part of the membranes and other parts. It is generally

believed that neutral fat is utilized during starvation and is an adaptation to nutritional stresses.

A special type of adipose tissue which is very small in percentage to the total body fat is brown

fat and performs a great thermogenic function especially in infants. In them it is quite abundant

and is located around clavicles, towards axillla, around kidneys and in the posterior peritoneum.

Brown fat is different in being multilocular and in having abundant mitochondria. Sympathetic

nerve endings are very elaborate in brown fat and get easily stimulated by cold exposure which

results in heat production when its triglycerides are oxidized in situ (Forbes 1987). After the age

of 10 years it reduces greatly and is quite minimal in adulthood, however, the mammals and their

young ones have abundant stores of brown fat. Merklin (1974) studied the growth and distribution of

human brown fat during different periods of the foetal life.. White fat is the storage fat which is pressed

into service to meet the metabolic needs of the body. It has nothing to do with respect to the heat

generation in response to cold stimuli.

The total body fat is generally divided into 2 depots, viz.: ‘essential fat’ and the ‘fat in the adipose

tissue’. The essential fat is absolutely necessary for the normal physiological functioning of the

body. It is stored in the central nervous system, and is present in the bone marrow, heart, liver,

spleen, lungs, muscles, kidneys & intestines. In females essential fat also includes the fat in the

mammary glands and the pelvic region. This is called the sex-specific fat of the females.

Therefore the essential fat contains the lipid content of CNS, bone marrow and (in the females)

the mammary glands. In males, of the total body mass it constitutes 3% whereas it amounts to

about 20% of the total body fat. In case of females, it is 30% of the body fat and about 9% of the

body mass (Lohman 1981). The second depot of fat is the adipose tissue which seems to have a

dual function, the protection of the internal organs from injury and also serves the purpose of

nutritional reserve. Table 4.11 provides an insight into the amounts of different types of fat in a

reference male and a reference female.

Insert Table 4.11 somewhere here

The division of body weight into various components can well be conceived of by

considering the major tissues of the body, e.g. fatty tissue, muscular tissue, skeletal tissue. The

studies on body composition would therefore assess quantitatively the amounts or proportions of

these tissues of the body. How much is the contribution of each tissue to the body mass? The

scientific research in this field is based on direct and indirect methods of assessing the body

composition. Human cadavers and animals can become the subjects for direct analysis of body

composition, but in living beings the indirect methods have to be applied to find out body

composition. The direct methods serve as the basis of standardizing various methods. The

division of body weight can begin from a minimum of two compartments (fat and non fat) to a

maximum of as many as possible entities (fat, muscle, bone, water minerals, etc. The
fractionation must depend upon how accurately various assessments can be made and what is to

be achieved by the study.

The indirect methods of body composition analysis include surface anthropometry,

hygrometry, densitometry, roentgenogrammetry, CAT scanning (Computer Axial Tomography)

bioelectrical impedance magnetic resonance imaging, ultrasound, etc.

Body fat can be divided into two parts, storage fat and the essential fat. The essential fat is

stored in lungs, bon marrow, heart, liver, muscles, kidney, spleen, intestine and the nervous

system. This essential fat is important in normal functioning of the body and its parts. Apart from

this, there is another chunk of fat in females which is sex specific fat and this is mainly stored in

the breasts and the pelvic region.

The storage fat is that which comprises the adipose tissue or adipocytes. The number of

adipocytes generally stabilizes around 9 to 12 months after the birth of the child. Later on it is the

size of the adipocytes which changes. The function of the storage fat is to provide energy reserves

and to protect the internal organs from injury.

The adipose tissue is of two types – white and brown. The brown adipose tissue is a

specialized tissue which produces heat in response to cold stimulation. Heaton (1972) gave a

detailed account of the distribution of brown adipose tissue in the humans. It is stored in the

arteries of the neck below the clavicle towards the axilla, around the kidneys and in the posterior

peritoneum. Brown adipose tissue only produces heat and does not take part in the formation

storage and supply of fatty acids. On the other hand, heat produced by the white adipose tissue is

a by-product of its metabolic activity. It does not produce any heat in response to cold stimuli.

The heat producing activity of the brown adipose tissue declines with age, however, it plays an

important thermogenic role in the newborn.

The subcutaneous tissue is that which lies beneath the skin. It contains mainly the adipocytes

or fat cells. Major part other fat cells or adipocytes is constituted by the inert storage fat called

triglyceride and in normal man the cytoplasm in the adipocytes may be less than 5% of the
adipocytes volume.

The essential fat in females is generally about four times the amount in males because in

females it includes the sex specific fat also, which is presumably required in their child bearing

process.

The amount of essential fat in a reference man in 2.09 kg compared to 6.80 kg in a reference

woman (McArdale et al. 1989). The lean body mass in males is equivalent to the body weight

minus the storage fat. It should be kept in mind that the essential fat is a part of the lean body

mass and any attempt to lower or reduce the lean body mass or the essential fat would be at the

cost of the normal functioning of the body.

Minimal body weight in females, is a term which is an equivalent to lean body mass in

males, and includes the essential fat (about 12%) and the sex specific fat in the adipose tissue, i.e.,

over the breasts and the pelvic region (about 3%). It is generally considered that even the leanest

women do not have body fat levels lower than 10-12% of the body weight. So, this 10-12% limit

can be thought of as the lowest limit for fatness for all women in normal health.

4.6 Densities of body components

 Fat

Earlier studies on the density of ether extractable fat at a temperature of 37º C have prescribed a

general figure of 0.9000 g/cm³ to it (Fidanza et al. 1953). However, studies by Mendez et al.

(1960) have reported variations in the densities of fat which range from 0.9000 g/cm³ to 1.03

g/cm³. They have also reported an increase in fat density from 0.9000 to 0.9007 g/cm³ for

temperature decrease of only 1ºC. Taking into account the typical combination of all types of fat

in a reference person, the density of fat has been calculated as 0.915 g/cm³ (Brozek et al. 1963)

and 0.9168 g/cm³ (Leonard et al. 1983) (Table 4.12).

 Insert Table 4.12 somewhere here

 Muscle and Lean Body Mass

The muscles have a peculiar characteristic in the sense that they have a relatively constant density

at various sites and also at different ages. Mostly reported mean value for the muscle density is

1.05 g/cm³. On the other hand, the lean compartment of the body exhibit changes in density due

to the changes in the hydration of this compartment. According to a study by Lohman (1986), the

density of lean compartment of the body was 1.08 g/cm³ at the age of 10 years which increases in

density to 1.10 g/cm³ in the adults.

 Bone

Bone is the hardest and the densest of the body parts. The mean values for the density of human

bone is 1.236 g/cm³ as reported by Ross et al. (1986). A most pragmatic estimate puts the range

of the densities of human bones between 1.15 to 1.6 g/cm³. Osteoporosis which is the result of

bone resorption during old age cleaves the bone density approximately at the rate of 0.020 g/cm³

per decade.

An overview of different methods for assessing body composition is presented in the table 4.13

as adapted from Norgan (1995).

Insert Table 4.13 somewhere here

4.7 Cadaver analysis for revalidation of body composition

Studies on the human dead bodies are an integral part of the direct analysis of human body

composition. It provides accurate insights into the body compartmentalization and also serves the
purpose of validation of equations derived through indirect methods. The cadavers can be studied

through two methods – the anatomical dissection and the chemical analysis.

 Chemical analysis

The chemical analysis of the cadavers is done to obtain water, fat and mineral residue contents.

The water content is determined by desiccation or by drying. The amount of body fat is extracted

with the help of ether and the mineral residue by burning it to ashes.

 Anatomical analysis

The anatomical dissections for body composition analysis are conducted on persons who have

died accidentally or suddenly without a previous history of disease or illness. It can be assumed

that they have minimum ante-mortem change in body composition. Quick dissection

immediately following death also insures minimum post-mortem change and thus leads to

excellent results. However, enormous amount of labour is involved in the dissections of the whole

body cadavers, besides obtaining necessary legal permissions. Therefore this is one of the most

tedious and cumbersome processes, nevertheless, most precious and indispensable because it

serves the purpose of validation of equations for indirect estimation of body composition.

4.8 Densitometric determination of body composition

The study pertaining to the measurement of body density is called densitometry. With this

method, it is possible to assess the body fat and lean body mass because of the fact that the two

body compartments generally have different densities. It is assumed that the densities of fat and

lean body mass stay relatively constant (density of fat is 0.91 g/ml and density of lean body mass

is 1.10 g/ml). A proportion of the densities of these two body compartments is utilized in the

calculation of body fat of a given body density.

 Relationship between body density and Percentage of Fat

The most widely accepted mean values of densities of fat free mass and fat are 1.1 g/cm³ and 0.90

g/cm³, respectively. The greater the body density the lesser the amount of fat and vice versa. On

the basis of this principle, many equations are available which transform the density of body into

percentage of body fat. Siri (1961) assumed the above densities and gave the following equation:

Fat (%) = (4.95/Density – 4.50)100

Ex. 4.1 Calculate the % amount of body fat with the formula of Siri (1961) if the body density is

1.08 g/cm³.

Fat (%) = (4.95/1.08 – 4.50)100

= 8.33%

However, Brozek et al. (1963) assumed an average density of the human body as 1.064g/cm³ and

the density of fat as 0.9007g/cm³ which resulted in the following equation:

Fat (%) = (4.57/Density – 4.142)100

Ex. 4.2 Calculate the % amount of body fat with the formula of Brozek et al. (1963) if the body

density is the same as above 1.08 g/cm³.

Fat (%) = (4.57/1.08 – 4.142)100

= 8.95 %

Another equation by Behnke & Wilmore (1974) which takes due care of fatty subjects can be

represented as follows:

Fat (%) = (5.053/D - 4.614)100

Ex. 4.3 Calculate the % amount of body fat with the formula of Behnke & Wilmore (1974) if the

body density is the same as above 1.08 g/cm³.

Fat (%) = (5.053/1.08- 4.614)100

= 6.47 %

The sources of error and discrepancy in assessing fat from these equations emanate from the fact

that the bones of children, women and old subjects are less dense than those of adults and tend to

be overestimated. Conversely, in athletes the bones being the densest, these equations are likely

to yield underestimated fat amounts.

Density = Mass/Volume

Body mass or weight can be easily determined on a weighing machine, however, it is

relatively difficult to assess the body volume accurately.

The principle of Archimedes can be applied to find the body volume either by water

displacement or underwater/hydrostatic weighing methods.

4.8.1. Water displacement method

Specially designed water tank is used to measure the volume displaced by the body

immersed in it. A thin accurately calibrated tube is attached to the side of this tank for noting the

volume of water displaced. The subject goes totally under water and the amount of water

displaced can be noted from the finely calibrated tube. It is worth mentioning here that the air in

the lungs will interfere in the assessment of exact volume of the body. The subject is instructed to

expel all air. The residual lung volume is noted before the experiment and should be subtracted

while noting the exact volume of the body.

4.8.2. Under water weighing

Body volume is equal to the reduction of body weight in water. For example, if the body

weight is 60 kg and the underwater or hydrostatic body weight is 3 kg, then body volume would

be equal to (60kg – 3kg) 57 kg of water. Since it is already known that 1 g of water is equal to 1

ml at 39.2 degrees F, therefore 57,000 g of water in weight is equivalent to 57,000 ml in volume

provided the temperature of water is 39.2 degrees F. It the temperature of water is different, then

necessary correction is applied to obtain the volume of water which is equivalent to the volume of

the subject under study.

Under water or hydrostatic weighing is also performed in a water tank. An automatic chair is

provided in the tank in which the subject has to sit. The subject is tied to the chair with a belt and

it is suspended in water so that the subject goes completely under water. The chair is attached to

the weighing machine from which the under water body weight is recorded. Certain precautions

are taken which includes the wearing of very thin and light under garments by the subject.

Subject performs maximum forcible exhalation while he is being lowered in water. The subject is

asked to hold his breath for at least 5 seconds and the weight is recorded after that. It is advised to

repeat the under water weighing about 10 time because this weighing depends on the cooperation

and ability of the subjects to expel air maximally from his lungs and to ensure that he has put in

his maximum effort, it is necessary to repeat it a number of times. Even after maximal exhalation

some residual volume still remains which can interfere in the overall determination of body

volume. So, it is desirable to record the residual lung volume of the subject before taking his

under water weight and its buoyancy effect is subtracted from the body volume. The calculations

of percentage body fat and lean body mass can be done as given below:

Body density = Body weight in air/Body volume

Body volume = [ (Body weight in air – Body weight under water)/water temperature

correction] – Residual lung volume

Ex.4.4 Calculate the % of body fat and LBM and also the absolute amount of body fat and

LBM of the given subject with Body weight as 60 kg, Body weight under water as 3 kg, residual

lung volume as 1 litre and water temperature as 39.20F.

Body volume = [(60–3)/1] –1

=56 kg of water

=56,000 ml
 Body density = Body weight in air/Body volume

Body density = 60,000/56,000

=1.0714 g/ml

Percent body fat (Siri 1961) =(495/1.0714–450)

=12.0123 %

Percent of lean body mass (LBM) = 100 – 12.0123

= 87.9877 %

Absolute mass of body fat = (Percent body fat x body weight/100)

= 12.0123 x 60/100 kg

= 7.20738 kg

Absolute lean body mass = 60 –7.20738 kg

= 52.7926 kg

The densitometric method is a good method for assessing the body fat content and

consequently the lean body mass but it encounters many difficulties and sometimes gross errors

due to unknown reasons may be recorded. Since the requirement in this method is that of a water

tank and the under water weighing equipment, therefore its availability is quite scarce. It cannot

be taken to the field. Some subjects may not like to go under water for the experiment. Thus its

practical utility is greatly impaired and it cannot be applied to certain groups of human subjects.

4.9 Anthropometric determination of body composition

In the absence of densitometric assessment, the skin and the subcutaneous tissue fold thicknesses

as well as body girths can be used to indirectly estimate body density to be converted into body

fat and lean body mass or can be directly used in equations to reach at the values of different

body components. The research employing skinfolds in determining body composition has been

getting the top priority because it is easier to take these on any group of subject and moreover its

equipment is inexpensive and is also available easily.

 Over the last quarter of twentieth century, innumerable prediction equations have been

generated to assess body fat from the skinfolds. These prediction equations were constructed by

actually measuring the body density by under water/hydrostatic weighing and correlating the

density to the skinfolds. The major limitation of these prediction equations is that they are highly

specific for sex, age and population group. Cross-validation of a few of these equations has been

attempted which boast of generality. Large variations have been found when these equations are

used for estimating densities in different groups. The specificity of various equations may be due

to various factors which are assumed similar to all the groups. For example, the lean body mass is

comprised of bone, muscles and the rest of the mass. It is possible that there exist significant

differences in the proportions and densities of these constituents of lean body mass among

different sites and any differences in the general pattern of distribution of the subcutaneous tissue

among different groups can lead to biased results. Some authors have questioned the uniform

compressibility of the fatty tissue which may be affected by sex, age, fitness and fatness of the

individual.

Skin and subcutaneous tissue fold thicknesses

The measurement of skinfold is often used in bringing out differences with respect to age, sex and

population group. It includes a fold of skin as well as the underlying adipose tissue. That equals

two layers of these tissues. The adipose tissue is almost lacking in the eyelids, at the back of the

hands, scrotum and nose. The thickness of the skin alone is not uniform throughout the body but

show striking variations. According to a study of the cadavers it is the least over the biceps in the

upper arm and the maximum in the soles of the feet (Clarys et al. 1987). The skin is thicker in

males as compared to the females. The values of thickness of the skin over the biceps are 0.8 mm

in men and 0.5 mm in women. The corresponding values of skin thickness over the trunk are 2.1

mm and 1.7 mm, respectively in males and females.

 Perhaps the stresses of the hard physical labour are responsible for the sexual differences

in the thickness of the skin. Typically the skinfolds have 60-85% of the fat content of its volume,

however the ranges have been reported between 5-94%. The differences in skinfold thickness not

only reflect the differences in the amounts of subcutaneous tissue but also the water content of the

adipose tissue. Edema, which is sometimes associated with malnutrition is a condition when the

water content of the tissues increases and may result in increased values of skinfolds as well.

Compressibility of skinfolds

The subcutaneous tissue has an inherent quality of compressibility. This is the reason why skin

fold measurements should be taken at some standard pressure which is universally accepted as 10

g/mm². Variations in skinfold compressibility not only exist from site-to-site but also with age

and sex (Clarys et al. 1987). Compression of skinfolds continues from the time of application of

the pressure (applying the calipers) till the reading is taken. In neonates it is compressed a lot

which may continue up to 60 seconds. The compressibility of thigh and calf skinfolds is about

30% whereas that of biceps and supraspinale it is about 60% nearly double of the former (Becque

et al. 1986).

Skinfold sites

The skin and subcutaneous tissue can be measured from different sites of the body so that

regional variations are duly taken care of. The International Biological Programme/Human

Adaptability (Weiner & Lourie 1969) has recommended the following sites for taking skinfold

measurements – biceps, triceps, subscapular, suprailiac, thoracic front, midaxillary, abdominal,

thigh and calf. Needless to say that many new skinfold sites can be invented depending on the

need of the research proposal.

Instruments and Standardization for Measuring Skinfolds

There are numerous skinfold calipers which are in use for measuring skinfolds which are

Harpenden, Best, Lange, etc. The most widely accepted pressure is 10 g/mm² at a face area of 35
mm² and the reading is to be noted after two seconds. Edwards et al. (1955) have not only

recommended this pressure but also gave formulae for the log transformations of skinfolds before

obtaining descriptive statistics. It is not surprising to find variations in literature on the exerted

pressure for taking skinfolds. Parizkova and Goldstein (1970) made studies on the skinfolds with

the help of Best calipers exerting a pressure of 30 g/ mm² whereas Leger et al. (1982) found that

even the much acclaimed Harpenden calipers can exert a little lower pressure than the

recommended 10 g/mm². However, this variation in the exerted pressure may not actually be a

real cause for concern as many authors have found that between the pressures of 9 to 20 g/mm²,

there is not much difference in the measured skinfold values but an upper limit of 15 g/mm²

pressure is recommended (Keys & Brozek 1953, Behnke & Wilmore 1974). Harrison (1988) has

dealt with the skinfolds in details at various sites and suggested the techniques for taking these

measurements

Anthropometric Equations for obtaining fat mass

For the interest of the readers, few prediction equations derived from skinfolds and other body

measurements on different populations of the world are provided here. These can be applied to

monitor changes in the fatness in the same individual over a span of time and to compare groups

of subjects who otherwise do not form a heterogeneous group. The absolute values of fatness and

other body masses may not be very accurate when applied to any group but these can be quite

useful for comparative purposes.

 Equations using skinfold thicknesses

Most of the authors have devised various equations to calculate the body density from the

skinfolds. There are hundreds of such equations on different populations generated by different

authors to predict body density of the subjects. One of the most widely used equations on adults

and which was developed for the International Biological Programme (IBP) by Durnin and

Womersley (1974) is the following one:

 Density = 1.1765 – 0.0744 (log10 ∑S4) (males 20-69 years)

Density = 1.1567 – 0.0717 (log10 ∑S4) (females 20-69 years)

where ∑S4 is the sum of four skinfolds at biceps, triceps, subscapular and suprailiac.

Ex. 4.5 Calculate the body density in males and females using the above equation of Durnin and

Womersley (1974) if the sum of four skinfolds at biceps, triceps, subscapular and suprailiac is 40

mm in both the sexes.

Density (male) = 1.1765 – 0.0744 (log10 40) = 1.0573

Density (female) = 1.1567 – 0.0717 (log10 40) = 1.0418

The number of sites of skinfolds to be used for obtaining the density is a debatable point. Some

authors have used a minimal of even one while others have used as many as even 10 skinfolds.

Considering all this, what should be the ideal number of skinfolds and the best sites/locations? A

study conducted by Lohman (1981) indicated that using three or more skinfolds for calculating

density does not improve much the prediction if it is done only from 2 skinfolds. The three

skinfolds used by him for developing the following quadratic equation included the sum of chest,

abdominal and thigh skinfolds(∑S3):

Density = 1.0982 – 0.000815 (∑S3) + 0.0000084 (∑S3)2

Ex.4.6 Calculate the body densityusing the above equation of Lohman (1981) if the sum of three

skinfolds (chest, abdominal and thigh) is 40 mm.

Density = 1.0982 – 0.000815 (40) + 0.0000084 (40)2

= 1.05216

Cadaver validation of many equations by Martin et al. (1985) revealed that skinfolds from lower

limb should also be included in the equations to provide better results.

Equations of Jackson et al. (1978) fulfill the above criteria which have included seven skinfolds at

chest, abdomen, thigh, axilla, triceps, subscapular and suprailiac (∑S7) and obtained direct %age

of fat as follows:
 Fat (%) = 0.197 (∑S7) – 0.00024 (∑S7)² – 2.2

Ex. 4.7 Calculate the % of body fat using equation of Jackson et al. (1978) if the sum of seven

skinfolds at chest, abdomen, thigh, axilla, triceps, subscapular and suprailiac is 70 mm.

Fat (%) = 0.197 (70) – 0.00024 (70)² – 2.2 = 10.414

How much accurate is the prediction of body fat from skinfolds? The equations which consider

the age, sex and population are relatively better and can be considered quite accurate. Beddoe et

al. (1984) and Mazess et al. (1984) found that body fat and fat free mass are highly correlated

with skinfolds therefore very useful. The main sources of error in skinfold prediction of body fat

according to Lohman (1981) are biological variations in the proportion of subcutaneous fat and

technical measurement errors among investigators.

 Equations using various measurements

The inherent difficulty in taking accurate measurements of skinfold has prompted many scientists

to look for alternative measurements for predicting body components. Circumferences have

been used by some authors to calculate body fat (Best et al. 1953, Noppa et al. 1979, Pollock &

Jackson 1984, Murray & Shephard 1988). Some of the equations are reproduced below:

Equation given by Best et al. (1953) .

Body fat (%) = - 47.4 + 0.579(A) + 0.252(B) + 0.214(I) + 0.356(M)

Where (A) is abdominal circumference,

(B) is buttocks circumference,

(I) is iliac circumference, and

(M) is body mass.

Equation of Noppa et al. (1979)

Fat (kg) = 0.37(M) + 0.13(B) + 0.10 (∑S2) – 21.1

where (M) is body mass,

(B) is buttocks circumference,

(∑S2) is the sum of triceps and subscapular skinfolds.

Ex.4.8 Calculate the amount of fat using equation of Noppa et al. (1979) when body mass is 60

kg, buttocks circumference is 80 cm and the sum of triceps and subscapular skinfolds is 20 mm.

Fat (kg) = 0.37(60) + 0.13(80) + 0.10 (20) – 21.1 = 13.5 kg

% body fat =( fat/body wt)100 = (13.5/60 )100 = 22.5%

Anthropometric assessment of Lean body Mass

Martin (1984) pooled the data on bone densities of men and women to obtain equations

separately which are as follows:

Skeletal mass (men) = 28.0(A) + 0.482(B) + 1.38(C) + 4265 r² = 0.98

Skeletal mass (women) = 0.182(D) – 6.42(E) + 1.15(F) +787 r² = 0.79

where A = (wrist dia)² * ankle width

B = head girth * humerus width * biacromial width

C = head girth * humerus width * femur width

D = head girth * stature * wrist width

E = (femur width)² * wrist width

F = (humerus width)² * ankle width

The lean body mass assessed was made by Bugyi (1972) in children with the following equation:

LBM = 2.514(sum of two styloid dia. at two wrists) * Height (metres)

The LBM prediction in case of adults has been proposed by Crenier (1966) as follows:

LBM (men) = 0.846(T) + 0.469(H) + 1.44(A) – 0.394(B) – 109.50

LBM (women) = 0.935(T) + 0.173 (H) – 27.73

where (T) is lean (corrected for skinfold) thigh girth

(H) is the height

(A) is the lean arm girth

(B) is the biacromial dia

Multiple regression equations were proposed by Steinkamp et al. (1965) for the assessment of

LBM in adults:

LBM(men) = M – [ 0.894W + 2.53S + 1.003C – 0.353A – 35.69]

LBM(women) = M – [0.675B – 5.687D + 1.85A – 39.36]

where M is body mass (kg)

W is waist girth(cm)

S is the arm skinfold (cm)

C is the girth at iliac crest (cm)

A is the arm length (cm)

B is the Biacromial diameter (cm)

D is the wrist girth (cm)

Fuchs et al. (1978) devised another equation for the assessment of LBM from flexed arm girth

and height as follow:

LBM = 0.514(height-cm) + 0.0178 (flexed arm girth)² - 49.7

For Adult Men

Sloan (1967)

Density (kg/m3) = 1104.3 – 1.327 (Thigh skf) – 1.310 (Subscapular skf)

Jackson and Pollock (1978)

Density (kg/m3) = 1109.38 - 0.8267 (chest + abdominal + thigh skf) + 0.0016 (chest

+abdominal + thigh skf)2 – 0.2574 (Age)

Durnin and Womersley (1974)

Density (kg/m3) = 1176.5 – 74.4 log10 (Sum of biceps + triceps + Subscapular + suprailiac)

Weltman and Katch (1978)

Density (kg/m3) = [Body weight/ (0.8719 Weight + 0.2629 Thigh circumference) – 7.795] x

103
Lohman (1981)

Density (kg/m3) = 1098.2 - 0.815 (triceps + subscapular + abdominal) + (0.0084 (triceps +

subscapular + suprailiac)2

Norgan and Ferro-Luzzi (1985)

Density (kg/m3) = 1145.5 – 59.69 (log sum of thorax + triceps skf) – 0.529 (Age)

Vickery et al. (1988)

Density (kg/m3) (Blacks) = 1109.63 – 0.302492 (X) + 0.000550467 (X)2 – 0.503617 (Age)

Where X is the sum of triceps, subscapular, chest, midaxillary, suprailiac, abdomen and thigh

skinfolds

For adult women

Satwanti et al. (1978)

Density (g/ml)=1.1963 – 0.0019 (Thigh girth) – 0.0016 (chest skf) – 0.0012 (iliac crest girth)

+ 0.0023 (biiliac diameter)

For children and youth

Slaughter et al. (1988)

Around 10 years (White) boys

Percent fat = 1.21 (triceps + subscapular)-0.008 (triceps + subscapular)2-1.7

Around 10years (Black) boys

Percent fat = 1.21 (triceps + subscapular)-0.008 (triceps + subscapular)2-3.2

Pubescent (White) boys

Percent fat = 1.21 (triceps + subscapular)-0.008 (triceps + subscapular)2-3.4

Pubescent (Black) boys

Percent fat = 1.21(triceps + subscapular)- 0.008 (triceps+ subscapular)2 -5.2

All girls

Percent fat = 1.33 (triceps +subscapular)- 0.013 (triceps +subscapular)2-2.5

In the above equations of Slaughter et al. (1988), if the sum of triceps and subscapular
skinfolds

exceeds 35mm the following equations should be used:

Percent fat (Males) = 0.783 (triceps + subscapular) + 1.6

Percent fat (Females) = 0.546 (triceps + subscapular) +9.7

4.10 Adipo-muscular relationship

Vague et al. (1971) devised formulae to estimate adipose mass (mass of the total adipocytes) from

body measurements by the following procedure:

Fat-muscle ratio in the arm

This is also referred to as brachial adipo-muscular ration (BAMR). The circumference at the

proximal part of the upper arm is taken along with the skinfolds at that level. The adipose and

muscular cross-sectional areas are calculated from the circumference and the skinfolds as follows:

Circumference = 2 x (22/7) x r

or r = Circumference/2 x (22/7)

Utilizing this value of 'r', cross-sectional area of the total upper arm is calculated assuming

the limb as a circular entity at that plane as follows:

Cross-sectional area= (22/7) x r2

Now cross-sectional area of muscle-bone is calculated by correcting 'r' for the adipose tissue

thickness. The adipose or skinfold thickness is taken at four sites, i.e. anterior, posterior, lateral

and medial at the level of the circumference. The average of these skinfolds is calculated and

used in the adipose correction of muscle-bone

Radius of upper arm corrected for adipose tissue = r – (1/2) average skinfold

Cross-sectional area of upper arm corrected for the adipose tissue = (22/7) x (corrected

radius)2

Given the cross-sectional area of the total upper arm and that corrected for the adipose tissue,
the cross-sectional area of the adipose tissue can be obtained by subtracting the cross-sectional

area of muscle-bone from the total cross-sectional area of upper arm and the ratio of adipose

muscular tissue is calculated as follows:

Fat muscle ratio in the thigh

This is usually called femoral adipo-muscular ratio (FAMR) The circumference of the thigh

is taken at the level of the gluteal fold. Four skinfolds are taken at the level of the circumference,

viz. anterior, medial and the cross-sectional areas of the thigh are calculated as described for the

upper arm. The femoral adipo-muscular ratio is then obtained as follows:

Femoral adipo-muscular ratio (FAMR) = (Area of adipose tissue/area of muscular tissue)

Mean of the brachial and the femoral adipo-muscular ratios (MAMR) is calculated and used in

the assessment of adipose mass:

The percent of adipose mass = MAMR x Mean percentage of fat in adipose tissue (0.80) x

density of adipose mass (0.92) x 100

The absolute amount of adipose mass = MAMR x 0.80 x 0.92 x body weight

Brachial-Femoral adipo-muscular ratio (BAMR/FAMR)

In order to get a picture of distributional pattern of adipose tissue in various groups, it is

desirable to calculate the adipo-muscular ratios for arm and thigh. Relative development of the

two tissues at these two body parts can be evaluated from the following ratio:

Ex. 4.9 Calculate the Brachial-Femoral adipo-muscular ratio in the following person

Body weight =50.0 kg

Circumference of the upper arm = 22.0 cm

Skinfolds at the upper arm,

Anterior =8 mm

Posterior = 12mm

Media l= 8mm

Lateral = 12mm
 Mean skinfold of the upper arm = (8+12+8+12) mm = 40/4 mm = 10mm or 1.0 cm.

Thigh circumference = 45.0 cm

Skinfolds of the thigh,

anterior =18mm

Posterior=20mm

Medial =22mm

Lateral =20mm

Mean skinfold of thigh = 20mm or 2.0 cm

Brachial adipo-muscular ratio (BAMR)

Radius of upper arm=22.0/(2x22/7) = 3.5cm

Corrected radius = 3.5-(1/2) skinfold = 3.0cm

Cross-sectional area of upper arm = (22/7) x (3.5)2 = 38.5 cm2

Cross-sectional area of muscle = (22/7) x (3.0)2 = 28.28 cm2

Cross-sectional area of adipose tissue = 38.5-28.28cm2 = 10.22cm2

Brachial adipo-muscular ratio (BAMR) = 10.22/28.28 = 0.361

Femoral adipo-muscular ratio (FAMR)

Radius of thigh = 45.0 (2x22/7) = 7.159cm

Corrected radius of thigh = 7.159 - ½ skinfold = 6.159 cm

Cross-sectional area of thigh = 161.08cm2

Cross-sectional area of the muscles of thigh = 119.22 cm2

Cross-sectional area of adipose tissue of thigh

=161.08-119.22 cm2

= 41.86 cm2

Femoral adipo-muscular ratio

= 41.86/119.22

=0.351
 Mean adipo-muscular ratio (MAMR)

= (0.361+0.351)/2

= 0.365

Percentage of adipose mass

= 0.365 x 0.80 x 0.92 x 100.0

= 26.20%

The absolute adipose mass

= 0.356 x 0.80 x 0.92 x 50

=13.10 kg

4.11 Matiegka's method (1921)

Jindrich Matiegka (1921) has been quite fascinated by anthropometry that he felt the need of

developing a method to determine the physical efficiency of a given subject simply by taking

body measurements of the individuals in much the same way as psychologists test the mental

faculties of a person on the basis of intelligence tests.

The physical efficiency of a person depends on various factors such as the quantities or

amounts of various tissues (bone, muscle and subcutaneous fat0, the physiological qualities of

various organs like the reaction time, fatigue, and the state of health. Matiegka concentrated on

body measurements of extremities and thought that these represent the whole of the body well,

just as the brain is a representative of the mentality of a person. The method which he developed

is called somatotechnique by which quantitative analysis of various compartments of the body is

made. His method of finding the amounts of various body masses is given below:

W= O+D+M+R

where W= body weight

O= weight of bones

D= weight of derma or fat

 M= weight of skeletal muscles

R = remainder weight

The above component masses can be calculated by using the following equations:

1. Weight of bones or Ossa

Ossa = O2 x L x K1

Where L is the height of the subject

K1 = 1.2 (constant)

O= (O1+O2+O3+O4)/4

O1 is the maximum diameter of humerus bicondylar (cm)

O2 is the maximum diameter of femur bicondylar (cm)

O3 is the maximum diameter of wrist (cm)

O4 is the maximum diameter of ankle (cm)

2. D or derma

D=d x S x K2

d = ½ of the mean skinfold

d = (½) (d1+d2+d3+d4+d5+d6/6) (mm)

Where d1= skinfold at biceps muscle.

d2= skinfold of forearm, at maximum development, over the planter side

d3= skinfold of thigh over quadriceps muscle in the middle of inguinal and knee

d4= skinfold over the calf muscle

d 5= skinfold over thorax in the middle of mammary gland and umbilicus

d6 = skinfold over abdomen, in the middle of naval and the anterior superior iliac spine

The science of anthropometry was in infancy in the time of Matiegka and there was no

instrument for measuring skinfold thickness. So, the skinfold measurement was taken with a

sliding caliper by picking up the fat fold with mild pressure. The readers can make out how

inaccurate the measurements can be if there is no way of checking the pressure with which to
measure the skinfold thickness.

S = surface area in cm2

= Wt0.425 x Ht0.725 x 71.84

Weight in kg and height in cm should be taken.

K2= 0.13 (constant)

3. M or skeletal muscle

M= r2 x Lx K3

R= (r1+r2+ r3 +r4)/4

Where L= height (cm)

r1= corrected radius of upper are (flexed)

r2= corrected radius of fore arm (maximum)

r3 = corrected radius of thigh between trochanter and lateral epicondyle

r4= corrected radius of calf

K3= 6.5 (constant)

The corrected radii can be calculated as follows assuming the limb as a cylindrical entry:

Circumference = 2 x (22/7) x r

or r = c/2 x (22/7)

Corrected r = [c/2 x ( 22/7)] - ½ skinfold

The units of skinfolds should be the same as for circumference or radius while subtracting it.

4. R or remainder mass

R= W – (O+D+M)

In the purpose of development of this method, Matiegka studied the corpses of 12 boys of

16-17 year of age, all in good health. The constants were calculated, however, he felt that these

constants must be finely

tuned by conducting further studies on large groups of cadavers.

Concerning the physical efficiency, he found a good correlation between the amount of

muscles and the dynamometric strength of persons, however, the correlation was not complete.

Further improvements in the method can help in forming the basis for comparisons of

various subjects from which it can be easily determined whether a person having average skeleton

has feeble, medium or bulky muscles and insufficient, normal or excessive quantity of fat.

Matiegka suggested that the constants for the above equations be carefully calculated which

can be age, sex and height specific, on the basis of controls and the cadavers. The qualities of

different tissues and the results of physiological tests must be carefully studied. Mental influence

on muscular work also needs to be studied. Muscular work also depends on the state of mental

health. Other things like the tests of strength, influence of exercise, training, experience and

mental tone, all should be determined for a better understanding of a person’s physical efficiency.

A deeper understanding of person’s physical and mental faculties and efficiencies can be highly

useful in the choice of a suitable profession. A person can be happy and will be more satisfied if

he finds a profession to which he is mentally and physically most suitable.

Ex. 4.10 Calculate the amounts of fat, bone, muscle and remainder using Matiegka’s method

from the following measurements.

Height = 150gm

Weight = 50kg

Humerus bicondylar breadth = 6.8 cm

Femur bicondylar breadth = 6.8cm

Wrist breadth = 6.0cm

Ankle breadth = 6.5cm

Biceps skinfold = 5mm

Forearm skinfold = 6mm

Thigh skinfold = 10mm

Calf skinfold = 8mm

Thoracic = 12mm

Abdominal = 11mm

Upper arm girth (flexed)= 27.0 cm

Forearm girth = 25.0

Thigh girth = 45.0cm

Calf girth = 32cm

Ossa or mass of bones = O2 x L x K1

= (6.95) 2 x 150.0 x 1.2

= 8694 grams

= 8.694 kg.

B. Weight of derma or adipose tissue

D= d x S x K2

d = (½) [ 5+6+10+8+12+11)/6]

= 4.33 mm

S= 500.425 x 1500.725 x 71.84 cm2

= 14325 cm2

D= 4.33 x 14320 x 0.13

= 8063 grams

= 8.063kg

C. Weight of skeletal muscles

r1 = corrected radius of upper arm

= [Circumference of upper arm/ 2 x (22/7)]- ½ skinfold

= [ 27/2 x (22/7)] – 0.25

= 4.045 cm

Likewise corrected radius of upper arm r2 = 3.677 cm

 r3 = 6.659 cm

r4 = 4.691 cm

Mean corrected radius or r= (r1+r2+r3+r4)/4 cm

= (4.045 +3.667+6.659+4.691)/4 cm

= 4.768 cm

Mass of skeletal muscle (M) = r2 x L x K3

= (4.768)2 x 150.0 x 6.5

= 22165 grams

= 22.165 kg.

D Remainder mass

R= Body weight – (O+M+D)

= 50 – (8.6940 +8.061+22.1650) kg

= 50.0 – 38.920 kg

= 11.080 kg.

Extensions of Matiegka’s Method

Katch et al. (1979) suggested that for the calculation of fat mass, Matiegka’s formula can be

modified by introducing a dynamic constant which would vary with the sum of 11 body girths

and can be expressed as follows:

Fat Mass = Surface area* Sum of skinfolds * k

Deep fat and visceral mass can also be estimated directly from the total body mass with the

following equation (Shephard 1991):

Deep fat and visceral mass = 0.206 X Body mass

Drinkwater and Ross (1980) suggested an alternative in Matiegka’s remainder mass and gave a

formula to calculate the residual mass as follows:

Residual mass = 0.35 [{(a+b+c)/3 + d}/2]² X Height

 where a is biacromial diameter

b is transverse chest diameter

c is bicristal diameter

d is antero-posterior chest diameter

Drinkwater & Ross (1980) modified and revised the constants given by Matiegka was applied his

method to predict the masses of tissue components which surprisingly were accurate with an error

of only 0.8%.

In Brussels (Belgium), a team of anatomists conducted cadaver dissections in order to check the

validity of Matiegka’s equations. The findings of these dissections revealed some differences in

estimations of tissue masses from the one’s obtained through Matiegka’s method, which

underestimated the fat mass, muscle mass and visceral mass but overestimated the bone mass

(Drinkwater et al. 1986). It was, however, emphasized that sex-specific equations validated from

cadavers are required for greater accuracy of predictions of body masses.

4.12 Drinkwater tactic for estimating fractional masses

Various fractional body masses have been worked out from body measurement utilizing

phantom stratagem by Drinkwater and Ross (1980) and the procedure is referred to as

Drinkwater tactic for the calculation of fractional body masses.

The z-scores obtained from the phantom specifications represent the difference in phantom

standard deviation units. For example a z-score obtained of 0.981 of body weight of a subject

means that his body weight is proportionally 0.981 standard deviations more than that of the

phantom body weight when the height has been projected to the phantom height. Since we know

the phantom standard deviation of body weight is 8.60 (Table 3.1), therefore a z-score of 0.981

corresponds to a standard deviation of 8.44 (0.981 x 8.60 = 8.44). The given subject is

proportionally 8.44 kg heavier in body weight as compared to the phantom. Table 4.14 provides
the phantom specifications of various fractional masses and their subsets of measurements.

Insert Table 4.14 somewhere here

The Drinkwater tactic for calculation of fractional masses is based on the principle that

the deviation of the subject’s fat mass (or any other body mass) from that of the phantom is the

same as the deviation of the indicators of fat which are skinfold measurements. Same principle

will hold good for the other body masses.

Skinfold correction for muscle mass= [(22/7) x skinfold (cm)

The first step is to calculate z-scores for each of the various indicators of a given fractional

mass say fat mass whose indicators are six skinfolds. Then calculate the mean z-score of these six

indicators of fat. Now utilize this mean z-score to calculate the subject’s fat mass. The fat mass so

obtained is a result of the projection of subject’s height to the phantom height. The value of the

fat mass then has to be rescaled or adjusted to the actual height of the subject as follows:

Fat mass = [Obtained fat mass/ (170.18/ht) 3]

Similarly the other fractional masses can also be calculated.

The various subsets of measurements used for obtaining fat mass with the help[ of

Drinkwater tactic include triceps, subscapular, suprailiac, abdominal, front thigh and

medial calf skinfolds. The measurements required for fractional skeletal mass include humerus

bi-epicondylar width femur bi-epicondylar width, wrist girth and ankle girth. The fractional

muscle mass is obtained using relaxed arm girth and triceps skinfold, chest girth and subscapular

skinfold, thigh girth and front thigh skinfold, calf girth and medial calf skinfold and forearm girth

and forearm skinfold. The residual fractional mass is calculated with the help of biacromial width,

transverse chest width, bi-iliocristal breadth and antero-posterior chest depth

Ex. 4.11 Assume the following values of various subsets of measurements and obtain fractional
body masses in the subject:

Height =150.0 cm

Triceps skinfold =10 mm

Subscapular skinfold = 12 mm

Suprailiac skinfold = 12 mm

Abdominal skinfold = 12 mm

Front thigh skinfold = 20 mm

Medial calf skinfold = 5 mm

Humerus biepicondylar width = 6.0 cm

` Femur biepicondylar width = 8.9 cm

Wrist girth = 15.0 cm

Ankle girth = 20.2 cm

Relaxed arm girth =22.0 cm

Chest girth =75.0 cm

Thigh girth = 40.0 cm

Calf girth = 28.0 cm

Biacromial width =35.0 cm

Transverse chest width = 25.0 cm

Biiliocristal breadth =26.0 cm

Anterior posterior chest depth = 16.0 cm

Fat mass calculation (use the phantom values of skinfolds from table 3.6)

z (triceps) = (1/4.47) [10(170.18/150.0) –15.4] = – 0.907

z (subscapular) = (1/5.07) [12(170.18/150.0) – 17.2] = – 0.707

z (suprailiac) = (1/4.47) [12(170.18/150.0) – 15.4]= – 0.399

z (abdominal ) = (1/7.78) [20(170.18/150.0) –25.4]= – 0.348

z (thigh) = (1/8.33) [20(170.18/150.0) – 27.0]= – 0.507

z (calf)= (1/4.67) [15(170.18/150.0) – 16.0] = 0.218

Mean z – value of six skinfolds = – 0.4436

It means that the subject’s fat mass is 0.4436 SD less than that of the phantom’s fat mass.

Table 4.14 shows the phantom’s measurements for fractional masses. The fat mass of phantom is

12.13 kg with SD of 3.25. A z –value of 0.4336 for fat mass corresponds to an amount of 1.4417

kg (0.4431 x phantom SD for fat mass which is 3.25 = 1.4417).

Therefore the subject’s fat mass= 12.13 – 1.4417 kg = 10.6883 kg.

The above fat mass of the subject has been calculated assuming his height as 170.18 cm. It

is necessary to rescale this fat to his actual size which is 150.0 cm and can be done in the

following manner:

Actual fat mass = Obtained fat mass/ [170.18/height] 3

= 10.6883/ [170.18/150.0]3

= 7.319 kg

Utilizing the mean score, the fractional masses can be directly calculated with the following

formula:

M= [(z x s) + p]/ (170.18/h) d

Where M is the fractional mass

z is the mean phantom z-scores for the subset of variables

p is the phantom value for the given fractional mass

s is the standard deviation

h is the subject’s height

d is the dimensional constant and it’s value is 3 for all masses or volumes

The fat mass of the above subject can be calculated with the above formula.

Fat mass = [( - 0.4436 x 3.25) + 12.13]/(170.18/150.0)3

= 7. 319 kg

Skeletal mass
 z (humerus) =(1/0.35)[ 6.0 (170.18/150.0) –6.48] = 0.9349

z (femur) = (1/0.48)[8.9 (170.18/150.0)—9.52] = 1.2028

z (wrist) = (1/0.72) [15.0 (170.18/150.0)—16.35]=0.9278

z (ankle) = (1/1.33)[20.2(170.18/150.0)—21.71] = 0.9079

The mean z-score= 0.9933

M= [(0.9933 x 1.57) + 10.49] / (170.18/150.0) 3

M (Skeletal mass) = 8.251 kg

Muscle mass

For the calculation of muscle mass, four body girths, viz, upper arm (relaxed), chest, thigh

and calf are necessary. All these girths must be corrected for the subcutaneous tissue overlying

the body, in the following manner:

Corrected arm girth = Arm girth – [(22/7) x( triceps skinfold/ 10)]

= 22.0 – [(22/7) x (10/ 10)] = 18.86 cm

Corrected chest girth = Chest girth– [(22/7) x (subscapular skinfold /10)]

= 75.0 – [(22/7) x (12 /10)] = 71.29 cm

Corrected thigh girth = Thigh girth – [(22/7) x (front thigh skinfold/ 10)]

= 40.0 – [(22/7) x (20/10)] = 33.71 cm

Corrected calf girth = Calf girth – [(22/7) x (medial calf skinfold / 10)]

= 28.0 – [(22/7) x (15/10)] = 23.29 cm

These corrected body girths are utilized for the calculation of z – values. Since the body

girths are taken in centimeters and the skinfolds in millimeters, so, while making the above

corrections, all the skinfolds must be divided by a factor of 10 so as to convert them into

centimeters, as has been done in the above calculations.

z (arm) = (1/1.91) [ 18.86(170.18 /150.0) –22.05] = -0.3434

z (chest) = (1/4.86) [71.29 (170.18/ 150.0) – 82.46] = - 0.3393

 z (thigh) = (1/3.59)( = [33.71 (170.18/150.0) – 47.34] = - 2.5320

z (calf) = 1/1.97) = [ 23.29 (170.18/ 150.0) – 30.22 ]= - 1.9297

Mean z – value = –1.28612

Muscle mass = [(–1.28612 x 2.99 )+ 25.55]/170.18/ 150.0)3

= 14.863 kg

The residual mass

z (biacromial) = (1/1.92) [35.0 (170.18/ 150) – 38.04] = 0.8691

z (trans chest) = (1/ 1.74) [ 25.0(170.18/150) – 27.92) = 02548

z (bi- ilio) = (1/ 1.75) [26.0 (170. 18/150.0) – 28.84 ] = 0. 3759

z (ap- chest) = (1/ 1.38) [ 16.0 (170.18/ 150.0) –17.50]= 0.4728

The mean z-score is = 0.4932

The residual mass

= [(0.4932 x 1.90) + 16.14]/ (170.18 / 150.0)3

= 11.694 kg.

4.13 Roentgenogrammetry

The measurement of soft tissue on the X-ray photographs is generally called

roentgenogrammetry. The X-rays or roentgen rays are the electromagnetic rays of very short

wavelength which can penetrate matter opaque of light rays, produced when cathode rays

impinge upon matter which were first discovered in 1895 by Konard von Roentgen, a German

physicist.

The roentgenograms meticulously taken on extremities of the human subjects can be very

useful in differentiating the various tissues, viz., fat, muscle and bone which in turn can find their

applications in body composition studies.

The most important sites on the body for X- ray measurements are the upper arm, thigh and

calf. Tanner (1964) described in details the standardized techniques for taking these X- ray
photographs, which have been described below:

The upper arm should be placed in such a way that the two epicondyles of the humerus bone

be overlapping each other in the X- ray film. The lateral aspect of the arm should be facing the

source of the X-ray. The arm should be away from the film so that the central vertical plane of the

arm is at a distance of 5.0 cm from the film. The anode of X- ray machine is placed precisely at

1.5 meters from the film. This distance helps in checking the unusual distortion of various areas

on the X-ray film because the X- rays fall practically parallel on all areas.

For the X- ray of calf, the posterior side of the leg should face the film while the anterior

aspect should face the X- ray source. The distance of the film from the central vertical axis of the

calf should be 10.0 cm. The anode of the X-ray machine should be at a distance of 1.5 meters

from the film. The x- ray of the calf is taken at its maximum development.

The x- ray of the thigh should be taken with the lateral aspect facing the source of X- rays.

The lateral position can become more accurate if the two epicondyles of femur overlap each other

in the film. The distance between the central vertical plane of the thigh and the film be 10.0 cm.

The anode distance from the film is the same as for other regions, i.e. 1.5 metre.

Garn and Shamir (1958) have suggested a voltage from 35 to 75 kilovolts at 10 to 20

milliampere seconds while taking the X- rays. However, depending upon the mass to the X-

rayed, the appropriate alteration can be made in the voltage.

Suitable precautions must be taken to provide protection to various areas, especially the sex

glands. Specially designed leaded underwear or jockstrap or Armadillo (Tanner, et al. 1958) must

be worn by the subject before taking the X- rays.

It must be noted that the laterality of the body must be uniformly adhered to while taking the

X-rays. As in the case of IBP anthropometric measurements, the X- rays should also be taken

preferably on the left side of the body.

The measurements on the radiograph of the upper arm are taken midway between the points

acromiale and radiale. A line is first drawn along the axis of upper arm which should be passing
through the middle of the two skin borders. A perpendicular to this is drawn at the marked middle

of the arm which is used for measurements. Usually the perpendicular line cuts the axes of the fat

and muscle areas at right angles. But in the case of humerus bone, the perpendicular may not cut

the long axis of the humerus at right angles. But in the case of humerus bone, the perpendicular

may not cut the long axis of the humerus at right angles. Therefore, while the fat and muscle

measurements can be taken along the perpendicular, the bone measurement should be taken at

right angles to its own axis. The following widths are measured with finely calibrated calipers:

1.Bone width

2. Muscle width (Total with across the two muscle borders – bone width)

3. Fat width (Sum of two fat widths on either side).

5. Total width of the upper arm.

Fig. 4.1 is a diagrammatic representation of radiogram of the upper arm where AA is the

long axis of the limb, BB is perpendicular to it from which two fat widths (BC and B’C’) and the

total muscle and hone width (CC’) is taken. Since the axis of the bone EE’ in this case is different

from the limb, therefore a perpendicular to the bone axis (DD’) is measured for bone widths.

Insert Fig 4.1 somewhere here

Calf should be measured at the level of its maximum development. Long axis of the tibia bone is

drawn and a perpendicular to it at the level of maximum development should be used for the

measurements. The following widths are taken:

1.Total width of the calf

2. Fat width (Sum of two fat widths on either side)

3. Muscle width (total width across the two muscle/ fat borders—tibia width)

4. Bone Width

Fig. 4.2 is a diagrammatic representation of radiogram of the calf. AA represents the long

axis of the tibia upon which a perpendicular BB’ is drawn. All the measurements are taken on this
perpendicular.

The fat width = BC+ B’C’

The muscle width = Cc’ –DD’

Bone width = DD’

Width of the total calf = BB’

Insert Fig 4.2 somewhere here

Tanner (1964) included fibula as part of the muscle. However, this is a debatable question

whether to retain fibula as part of the bone width or in muscles. Logically, fibula should become a

part of the bone width, however, the difficulty may arise because many measurements of muscles

will have to be taken which may interfere with the accuracy of such measurements.

The measurements on the thigh radiograms have been recommended at a level which is

above the lower border of femoral condyles by an amount equal to one-third of the subischial

length. The subischial length is determined indirectly by subtracting sitting height from the height

measurements, If the height of a person is 150.0 cm and the sitting height is 80.0 cm, then his

subischial length would be 70.0 cm (150.0-80.0). One- third of subischial length would be 23.3

cm(70.0/3 cm= 23.3 cm). While determining the level for measurement a distance of 23.3 cm

upwards from the lower border of femoral condyles will be taken.

The measurements are taken at right angles to long axis of the femur bone. All measurements

of bone, fat the muscle are taken according to the procedure outlined for upper arm.

Fig. 4.3 shows the outline of thigh radiogram. Various widths on it are as follow:

The fat width = BC+B'C'

Muscle width = CC'- DD'

Bone width = DD'

Total width of the thigh = BB'

The fat widths can be utilized later for estimating the fat mass or percentage of body fat. The
body mass can be fractionated into fat mass and lean body mass. This fat mass of a group of

subjects can be determined first by hydrostatic weighting. Then linear regression equations can be

fit to derive regression coefficient from which fat mass or percentage of body fat can be estimated

by putting the values of fat widths obtained from the radiograms.

Insert Fig 4.3 somewhere here

Body mass = a + bX

Where 'a' is a constant representing lean body mass, 'b' is the slope of the regression line and

X is the total fat width on the radiograms. Then

Fat mass = bX

From the estimated hydrostatic fat mass the total fat width from the radiograms (X), the

value of 'b' can obtained.

By putting the value of fat mass derived from radiographic measurements and the body mass

in the equation.

Body mass = a+ bX

The lean body mass or 'a' mass or 'a' can be calculated. The above equation where the values of

constants are known for a group of individuals or population, the procedure is easy for fat mass

estimation from the radiographic measurements.

Katch and McArdale (1983) have described a technique through which the percentage of

body fat can be evaluated quite accurately from the radio-grams of the upper arm. Measurements

of fat are taken at three specific sites on the radio-grams on both the anterior and posterior sides

which are later used in fat calculation. They have found reasonably good agreement (r =0.90) in

the body fat obtaining from radiographic measurements and the hydrostatic weighting methods.

4.14 Hydrometry

The technique for the estimation of total body water and the extracellular volume has been
described after Graystone (1968).

Estimation of total body water is based on the simple principle of dilution. A chemical

substance is given orally and after it reaches an equilibrium in the body's its dilution in plasma or

urine is noted. From the proportion of actual concentration, the amount of total body water can

be estimated.

A specific amount of sodium bromide is dissolved in deuterium oxide (which should be

about 25 times the amount of sodium bromide). Deuterium oxide should be of 99.8 percent purity

and having a density of 1.105 g/ml at 250C. The recommended doses to the subjects are 80mg of

sodium bromide in 2 grams of deuterium oxide per kg of body weight. The subjects should

observe overnight fast.

Three to four hours after administering the above substances, the blood samples of about

20ml are taken out and the plasma is separated for analysis. Then the deuterium oxide

concentration in plasma is determined along with that of the plasma bromide.

The amounts of total body water and other spaces can be determined as follows as described

by Graystone (1968):

Total body water (litres)

= [Volume of deuterium oxide administered in ml /Deuterium oxide concentratio in plasma

water (ml/1)]

Corrected bromide space or Extracellular water (litres)

=[mEq sodium bromide administered – 10%]/[plasma bromide (mEq/1)/0.88]

Total body chloride (mEq)

=[mEq Sodium bromide/plasma bromide (mEq/1)] x plasma chloride (mEq/1)

Intracellular water = Total body water – Extracellular water

It is generally assumed that the fat mass is anhydrous, that it contains no water or very little

amount of water. So, whatever the total amount of body water is, that is mainly distributed in the

lean body mass.

 Thus total body water ∞ Lean body mass

or Total body water = C x Lean body mass

Where 'C' is a constant. It can be determined by calculating the lean body mass from the

hydrostatic weighing method and comparing it with its estimation from total body water.

After determining the lean body mass, the fat mass can also be determined:

Fat mass = Body mass – Lean Body mass

The total body mass, fat mass, total body water and the intracellular water can be utilized to

estimate the dry cell residue and the bone minerals, but it encompasses a lot of assumptions

including the equitable distribution of body water every where.

Body mass (M) can be fractionated as follows:

M = F+T+S+B

Where F = fat mass

T = total body water

S = dry cell residue

B = bone minerals

Intracellular water can be utilized in determining the dry cell residue and the bone minerals.

4.15 Dual Energy X-ray Absorptiometry (DXA)

The photon absorptiometric technique is used to assess the mineral content of the human body

especially that of skeleton. It started with Single Photon Absorptiometry (SPA) during the

nineteen sixties and later resulted in the adoption of the dual photon absorptiometry (DPA)

technique for the analysis of bone mineral density among humans.

The different names for absorptiometric techniques are as follows:

X-ray absorptiometry (XRA)

Quantitative digital radiography (QDR)

X-ray Spectrophotometry (DXA or DEXA)

In the case of dual energy absorptiometry, two sets of photon beams with different energies are

used for the quantification of bone mineral content where the soft tissues have different

compositions and also where the thickness of the bone does not remain constant.

The principle involves the measurement of ‘initial’ and ‘emerging’ intensities of both the beams

passing through the same volumes. Attenuation at two energy levels in the soft tissue provides

estimates of fat and lean body mass whereas in regions which contain bones the assessments yield

the amounts of bone mineral and soft tissues.

4.16 Neutron Activation

The technique is useful in estimating the amounts of various constituents of the body including

sodium, potassium, calcium, phosphorous and chlorine. The principle involves the bombardment

of the subject with a known dose of fast neutrons. These are captured by different elements in the

body which get transformed into unstable isotopes emitting gamma radiation. The amount of

gamma radiation can be measured with the help of whole-body counters. Whole body nitrogen

estimates can be made with this technique.

The International Commission on Radiological Protection has provided estimates of the amount

of nitrogen in lean tissues as 31.9g/kg. The estimates of nitrogen content of the muscle and in the

rest of the tissues given by Cohn et al. (1980) are 30 g/kg and 36 g/kg, respectively.

Standardization of amounts of nitrogen in various tissues is to be done. This may be used for the

estimation of amounts of different tissues in the body.

Chapter 4 Exercises

Ex 4.1. Calculate the %body fat with three equations of Siri, Brozek and Behnke & Wilmore if
the body density are as follows
a. 1.064
b. 1.043
c. 1.033
d. 1.055
e. 1.049

Ex. 4.2. Calculate the body density in males and females using the following equations
Density = 1.1765 – 0.0744 (log10 ∑S4) (males 20-69 years)
Density = 1.1567 – 0.0717 (log10 ∑S4) (females 20-69 years)
Considering the values of four skinfolds required in the equation similar in each sex which are as
follows:
a. 56 mm
b. 77 mm
c. 71 mm
d. 45 mm
e. 59 mm

Ex.4.3. Ex. Calculate the body density using the equation of Lohman (1981) if the sum of three
skinfolds (chest, abdominal and thigh) is :
a. 66 mm
b. 73 mm
c. 79 mm
d. 45 mm
e. 49 mm

Ex. 4.4. Calculate the % of body fat using equation of Jackson et al. (1978) if the sum of seven
skinfolds at chest, abdomen, thigh, axilla, triceps, subscapular and suprailiac is as follows:

a. 59 mm
b. 79 mm
c. 102 mm
d. 98 mm
e. 105 mm

Ex. 4.5 Calculate the amount of fat using equation of Noppa et al. (1979) in the following:where
buttock circ. is in cm, body weight in kg and skinfolds in mm.
a. buttock circ. 75 Body weight 59 Triceps +subscapular 23
b. buttock circ 85 Body weight 65 Triceps +subscapular 25
c. buttock circ 82 Body weight 64 Triceps +subscapular 24
d. buttock circ 77 Body weight 66 Triceps +subscapular 25
e. buttock circ 81 Body weight 67 Triceps +subscapular 28

Ex. 4.6. Calculate the bone mass using Matiegka’s method in the following:
a. Humerus dia. 6.6cm, femur dia 8.8cm, wrist dia 5.4 cm, ankle dia 6.8cm, height 167 cm
b. Humerus dia. 5.6cm, femur dia 7.8cm, wrist dia 5.4 cm, ankle dia 6.8cm, height 157 cm
c. Humerus dia. 7.6cm, femur dia 8.0cm, wrist dia 6.0 cm, ankle dia 6.0cm, height 185 cm
d. Humerus dia. 7.0cm, femur dia 8.0cm, wrist dia 5.0 cm, ankle dia 7.0cm, height 170 cm
e. Humerus dia. 6.8cm, femur dia 8.0cm, wrist dia 6.4 cm, ankle dia 7.8cm, height 178 cm

Ex. 4.7. Calculate the mass of skeletal muscles using Matiegka’s method in the following:
a. corrected mean radius 5.228 cm height 172 cm
b. corrected mean radius 4.238 cm height 184 cm
c. corrected mean radius 4.881 cm height 167 cm
d. corrected mean radius 5.190 cm height 174 cm
e. corrected mean radius 4.893cm height 179 cm

Ex. 4.8. Calculate the mass of derma (D) using Matiegka’s method and surface area (S) in the
following subjects:
Note: Obtain the surface area (S) using the equation: S (cm2) = Wt0.425 x Ht0.725 x 71.84

a. ½ mean skinfold 5.40 mm height 167cm weight 64 kg

b. ½ mean skinfold 6.23 mm height 163cm weight 66 kg
c. ½ mean skinfold 5.88 mm height 175cm weight 75 kg
d. ½ mean skinfold 6.21 mm height 184cm weight 73 kg
e. ½ mean skinfold 6.68 mm height 181cm weight 69 kg

Ex.4.9.
(X) Calculate the z-score of following skinfolds for fractional body masses (Drinkwater tactic) if
the height of the subject is 164.6 cm. Also calculate the mean z-score of all the skinfolds
a. Triceps 14 mm
b. Subscapular 16 mm
c. Suprailiac 18 mm
d. Abdominal 20 mm
e. thigh 19 mm
f. calf 12 mm

(Y) Use the above mean z-score to calculate the fat mass of the above individual.

Ex. 4.10. Calculate the z-scores of the following diameters and circumferences to be used for the
fractional skeletal mass when the height of the subject is 164.6 cm. Also obtain the mean z-score
of these measurements and the amount of skeletal mass.
a. humerus bicondylar dia. 7.2 cm
b femur bicondylar dia 9.6 cm
c wrist circumference 17.2 cm
d. ankle circumference 21.4 cm

Ex. 4.11. Calculate the z-scores of the following diameters to be used for the fractional residual
mass (Drinkwater tactic) when the height of the subject is 164.6 cm. Also obtain the mean z-score
of these measurements and the amount of residual mass.

a. biacromial width 35 cm
b. transverse chest width 28 cm
c. bi-iliocristal breadth 25 cm
d. antero-posterior chest depth 19 cm
Chapter 4 Answers

Ans.4.1 The %age of body fat is as follows:

a. Siri 15.23 Brozek 15.31 Behnke & Wilmore 13.51
b. Siri 24.59 Brozek 23.96 Behnke & Wilmore 23.07
c. Siri 29.19 Brozek 28.20 Behnke & Wilmore 27.76
d. Siri 19.19 Brozek 18.97 Behnke & Wilmore 17.56
e. Siri 21.88 Brozek 21.45 Behnke & Wilmore 20.30

Ans. 4.2. Densities are for male and female, respectively.

a. 1.0464 1.0313
b. 1.0361 1.0214
c. 1.0387 1.0239
d. 1.0535 1.0381
e. 1.0447 1.0297

Ans.4.3.
a. 1.0078
b. 0.9939
c. 0.9813
d. 1.0445
e. 1.0380

Ans. 4.4
a. 8.5875
b. 11.8651
c. 15.3970
d. 14.8010
e. 15.839

Ans. 4.5. Amount of body fat in Kg

a. 12.78
b. 16.5
c. 15.64
d. 15.83
e. 17.02

Ans. 4.6.
a. 9541 g or 9.541 kg
b. 7717 g, 7.717 kg
c. 10569 g or 10.569 kg
d. 9295 g or 9.295 kg
e. 11227 g or 11.227 kg
Ans. 4.7.
a. 30557 g
b. 21481 g
c. 25861 g
d. 30465 g
e. 27856 g

Ans. 4.8. mass of derma (D) and surface area (S) ,respectively are:

a. 12072 g or 12.072 kg 17197 cm2

b. 13866 g or 13.666 kg 17120 cm2
c. 14548 g or 14.548 kg 19031 cm2
d. 15751 g or 15.751 kg 19510 cm2
e. 16346 g or 16.346 kg 18823 cm2

Ans. 4.9
(X)
a. -0.207023467
b. -0.129702992
c. 0.718167016
d. -0.606939937
e. -0.883060393
f. -0.769420905
Mean z-score = - 0.313
(Y) Fat mass = 10.055 kg

Ans. 4.10
a. 2.754521784
b. 0.844673957
c. 1.990397597
d. 0.312381805
The mean z-score = 1.475494
Skeletal mass = 11.587 kg

Ans. 4.11
a. -0.965357938
b. 0.591500119
c. -1.709994793
d. 1.553700671

The mean z-score = -0.132537985

The residual mass = 14.375 kg
Table 4.1 Conceptual models of body composition (Adapted from Jebb and Elia 1995)

1 - compartment Body mass. More or less body mass than the

reference values. Being the only compartment, it
does not take into consideration factors of an
individual's physique.

2 - compartment Fat and Fat Free Mass (FFM). It is one of the

earliest attempted divisions of body weight made on
the assumptions of differential densities of the two
compartments, viz., fat = 0.9 g/cc and FFM =1.1
g/cc.

3 - compartment Fat, Total Body Water and protein +

mineral
Jebb and Elia (1995) suggest a constant ratio for
protein and mineral and hence have provided a
density of protein +mineral as 1.52 g/cc.
4 – compartment Fat, Total Body Water, protein, mineral
Protein bears a direct relationship with total body
nitrogen. Deuterium oxide provides estimates of total
body water.

More compartments Fat, Extra Cellular Water, Intra Cellular

Water, protein, mineral,
Numerous further divisions of body mass can be
made, e.g., amounts of different types of minerals,
glycogen and other molecules in the body.
Table 4.2 Different elements constituting human body and their amounts in a reference man of

70-kg body weight (Adapted from Forbes (1987)

Element Amount (kg). Amount (%)

Oxygen 43 .000 61.43
Carbon 16.000 22.86
Hydrogen 7.000 10

Nitrogen 1.800 2.57

Calcium 1.100 1.57
Phosphorus 0.500 0.71

Sulfur 0.140 0.2

Potassium 0.140 0.2
Sodium 0.100 0.14

Chlorine 0.095 0.14

Magnesium 0.019 0.027
Silicon 0.018 0.025

Iron 0.0042 0.006

Fluorine 0.0026 0.0037
Zinc 0.0023 0.0032
Table 4.3 Major organic molecules of the body
Category Elements % of
body wt

Proteins C,H,O,N 17

Lipids C,H 15

Nucleic acids C,H,O,N 2

Carbohydrates C,H,O 1
Table 4.4 Percentage of total body water in children, average adults and obese adults of

both the sexes

Individuals % Total Body Water

Children 70 %

Average man 60 %

Average woman 50 %

Obese man 50 %

Obese woman 40 %
Table 4.5 Amounts of various ions and proteins in Intra Cellular Fluid and Extra Cellular Fluid

Substance Plasma Intra-cellular fluid Extra-cellular fluid

Sodium ions (mmol/l) 140 10 145

Chloride ions (mmol/l) 100 3 115

Potassium ions (mmol/l) 4 160 4

Protein 16 55 10

Bicarbonate (mmol/l) 28 10 30
Table 4.6 The amounts of various tissue/organs in a reference adult man of 70 kg body weight

(International commission on radiological protection 1975)

Tissue/organ Amount (kg)

Weight 70.000
Skeletal muscles 28.000
Adipose tissue 15.000
Skeleton (total) 10.000
Table 4.7 Body composition values of a reference man and a reference woman (after McArdale et

al. 1989 and Ross and Ward 1982).

Variable Reference man Reference woman Phantom

Age (yr) 20-24 20-24 -

Height(cm) 174.0 163.8 170.18

Weight(kg) 69.9 56.7 64.58

Total fat (kg) 10.5 15.3 12.13

Percent fat 15.0 27.0 18.78

Table 4.8 Values of a reference man and a reference woman for amounts of water, protein, fat and

others (modified from Brozek et al. 1963)

Variable Weight (g/kg) Density

Water 624 0.9937

Fat 153 0.9007

Protein 164 1.34

Non osseous minerals 10.5 3.317

Bone minerals 47.4 2.982

Total 999 1.064

Table 4.9 Hydration of the Lean Body Mass (LBM) in humans and mammals

% of water Source
LBM in humans 69.4 – 73.2 % Widdowson & Dickerson (1964)

LBM in humans 72.4 % Forbes (1962)

LBM in mammals(cat, dog, rabbit, 72.0 – 78.0 % Widdowson & Dickerson (1964)

etc.)
Table 4.10 Structural components and densities of different

lipoproteins (adapted from Simons & Gibson 1980)

Feature Chilomicr VLDL LDL HDL

ons

Density(g/ml) 1.006 1.006 1.006- 1.063-

1.063 1.21

Triglycerides 87.5 52.78 8 4.5

Cholesterol ester 3.5 15 40 15

Unesterified cholesterol 2.5 7 10 3

Phospholipids 7 18 22.5 27.5

Protein 1.5 9 20 49.5

Table 4.11 The amounts of essential, intramuscular, thoracic-abdominal and inter-muscular fat

expressed as % age of total body fat (Adapted from Lohman 1981)

Variable Males Females

Essential fat 20% 30%

Intra-muscular fat 10% 4%

Thoracic-abdominal fat 12% 8%

Inter-muscular fat 30% 20%

Table 4.12 Densities of fat at different sites

Specific fat & location Density (g/cm³) Source

Adipose tissue 0.9000 Fidanza et al.(1953)

Cell & interstitial fat 0.93 Mendez et al.(1960)

Brain fat 1.03 Mendez et al. (1960)

‘Average’ fat 0.915 Brozek et al. (1963)

‘Average’ fat 0.9168 Leonard et al. (1983)

Table 4.13 A summary of different methods of body composition assessment (After Norgan

1995)
 Anatomical dissection and biochemical analysis of the cadavers
 Densitometry and Body density
 Hydrometry and Total body water
 Roentgenogrammetry and tissue widths
 Bioelectrical impedance analysis
 Magnetic resonance imaging
 Photon Absorptiometry
 Ultrasonography
 Near Infrared interactance (NIRI)
 Dual energy X-ray absorptiometry (DXA)
 Computer Axial Tomography (CAT)
 Anthropometry and skinfold thicknesses
Table 4.14 Phantom specifications of various fractional masses and their indicators or subsets of

measurements (After Drinkwater and Ross 1980).

Mass Subset indicators Mean

SD
FAT (kg) 12.13 3.25
triceps skinfold (mm) 15.4 4.47
subscapular skinfold (mm) 17.2 5.07
suprailiac skinfold (mm) 15.4 4.47
abdominal skinfold (mm) 25.4 7.78
front thigh skinfold (mm) 27.0 8.33
medial calf skinfold (mm) 16.0 4.67

MUSCLE (kg) 25.55 2.99

relaxed arm girth-triceps skf (cm) 22.05 1.91
chest girth-subscapular skf (cm) 82.46 4.86
thigh girth-front thigh skf (cm) 47.34 3.59
calf girth-medial calf skf (cm) 30.22 1.97
forearm girth (optional) (cm) 25.13 1.41

SKELETAL (kg) 10.49 1.57

humerus bi-epicondylar width (cm) 6.48 0.35
femur bi-epicondylar width (cm) 9.52 0.48
wrist girth (distal to styloids) (cm) 16.35 0.72
ankle girth (smallest) (cm) 21.71 1.33

RESIDUAL (kg) 16. 14 1.90

biacromial width (cm) 38.04 1.92
transverse chest width (cm) 27.92 1.74
bi-iliocristal breadth (cm) 28.84 1.75
antero-posterior chest depth (cm) 17.50 1.38
5. HUMAN PHYSIQUE

Chapter details

Viola’s classification
Kretschmer’s classification
Sheldon’s Method of Somatotyping
Somatotyping Criteria
Dominance of endomorphy
Dominance of mesomorphy
Dominance of ectomorphy
The trunk index and somatotype
The second order variables of human physique
Gynandromorphy
Dysplasia
Textural aspect
Hirsutism
Critical evaluation of Sheldon's method of Somatotyping
Parnell’s method of Somatotyping

The history of classification and analysis of human physique can be traced back to the very

ancient times when the people with strong bodies and who had the ability to fight, hunt and

organize must have achieved distinction and got noticed by the society. This seemed to have

impressed the rulers and administrators to look for cherished human bodies and thus the

foundations of visual classification of human physique might have started. Hippocrates a great

Greek philosopher and physician of the fifth century BC described two different types of people:

 Habitus phthisicus were thin and lean persons with long extremities. These

individuals had a greater susceptibility to tuberculosis.

  Habitus apoplecticus were short persons with thick and massive bodies who were

very much prone to the diseases of the cardiovascular system.

After Hippocrates not much advances took place in this field. The idea of Hippocrates was further

extended by many scientists in the beginning of the nineteenth century who described three

different types of physical constitution:

 Digestif type were the physiques with fatty characteristics

 Musculaire type were the physiques with strong muscular and athletic features

 Cerebrale type or brainy type was the physiques with lean and linear features.

It was as early as the seventeenth century that a luminary Elsholz at the University of Padua,

Italy, started studying the body morphology with the help of anthropometric measurements.

Lambert Adolphe Jacques Quételet (1796 –1874) was a Belgian scieintist. However, it was

much later during the nineteenth century that Quetelet started measuring the humans

anthropometrically and provided the desired statistical treatment. His famous ratio of body weight

to height called Quetelet’s index (Weight/height2) is now recognized the world over for assessing

obesity and under-nutrition and is now popularly known as Body Mass Index (BMI) has

withstood the test of time.

A German psychiatrist Kretschmer (1925), in the beginning of the twentieth century, gave a

detailed account of the characteristics of three categories of humans which were named as pyknic

or fatty, athletic or muscular and leptosome or lean. His method was based on making

anthroposcopic observations on the human subjects. Kretschmer also correlated the physique with

the characteristics including the temperament of the person. His method is still very much popular

with psychologists who aim at studying the behaviour and body constitution. But other scientists

who tried to use his method found it very difficult to apply because majority of the people did not

conform to the characteristics of any of these groups but fell in between. An Italian physician
Viola (1921) during the early part of the twentieth century devised a method of human physique

analysis by utilised body measurements. He grouped physique as a) longitype having relatively

long limbs compared to the trunk, massive thorax compared to the abdomen, and greater

transverse diameters relative to the antero-posterior ones; b) brachitype or broad type, having the

characteristics opposite to those of the longitype; c) normotype which fall in between the above

two categories and d) mixed type who show characteristics of different types in different parts of

the body, i.e. they may be brachitype in one part, longitype in the other and normotype in still

another, etc. Though the same objection of discrete types may be levelled against this system as

well, yet it provided an opportunity to classify humans in any of these categories without much

difficulty. The major objective of this system was to correlate differential susceptibilities to

various diseases in different types of physiques.

The interest in the study of human physique classification considerably increased during the

twentieth century. Numerous methods for the classification of human physique were invented or

modifications were suggested in the already existing methods. These include the methods of

Tucker and Lessa (1940), Sheldon et al.(1940), Bullen and Hardy (1946), Cureton (1947), Hooton

(1951), Parnell (1954), Damon et al. (1962), Clarke ( 1971), Heath and Carter (1967). The details

of some of these methods which have stood the test of time and which were in much use and are

still being used is provided here.

5.1 VIOLA’S classification

During the beginning of the twentieth century, an Italian scientists Viola presented a method for

the classification of human physique. Anthropometric measurements were taken for this purpose.

These measurements were combined with each other to derive certain indices and values which

were used for classifying humans. The list of measurements required is presented below:
 Upper extremity length

Lower extremity length

Thoracic length

Thoracic breadth

Thoracic depth

Upper abdominal breadth

Upper abdominal length

lower abdominal breadth

Lower abdominal length

Abdominal depth

The following indices were later calculated from different body measurements:

 Thoracic index = Thoracic length + Thoracic breadth + Thoracic depth

 Upper abdominal index = Upper abdominal breadth + Upper abdominal length

+ Abdominal depth

 Lower abdominal index = lower abdominal breadth + Lower abdominal length

+ Abdominal depth

The upper abdominal and lower abdominal indexes were combined together to obtain the total

abdominal index.

 Total abdominal index = Upper abdominal index + Lower abdominal index

These indexes were further combined together to get the values of trunk and extremities as

follows:

 Trunk value = Thoracic index + Total abdominal index

 Limb value = Upper extremity length + Lower extremity length

On the basis of these measurements, indices and values, four different types of human physiques

were identified which were longitype, brachitype, normotype and mixed type.
Longitype Physique:

The physique is characterized by long limbs and elongated body.

Relatively long limbs compared to the trunk

Relatively larger transverse diameters as compared to the antero-posterior ones

Relatively larger thorax compared to the abdomen

Brachitype Physique

This physique is characterized by massiveness and robustness of the body.

Relatively short limbs compared to the trunk

Relatively short transverse diameters as compared to the antero-posterior ones

Relatively short thorax compared to the abdomen

Normotype Physique

This is the physique which is normal and falls between the longitype and brachitype

Normally proportioned limbs versus trunk, thorax versus abdomen and transverse versus antero-

posterior widths

Mixed type Physique

This type of physique shows disproportions in the human body. It lacks uniformity in the

physique. It is longitype by way of certain characteristic, brachitype by the other and mixed type

by still another characteristic. All the indicators for judging the physique fail to reach a specific

conclusion about a physique. In the present day terminology this may be referred to as dysplasia.

5.2 KRETSCHMER’S (1925) classification

A German psychologist E. Kretschmer proposed a model of human physique analysis in which he

recognised three different types of physiques. Actually his interest was to discover psychoses of
different types and to find out if these types are related to specific types of physiques. The three

different types of human physique described by him are pyknic, asthenic (leptosome), and

athletic. A description of all these types is given below:

Pyknic: These are thick and short people. Mainly the massiveness of the human body is the

characteristic of this type. The massiveness may be because of fat or a combination of fat and

muscles. The people have characteristics where head is large and heavy, thorax and abdomen are

massive or more developed with respect to the extremities. Though the distinction between

muscled men and pyknic is very clear yet the latter may have some muscles. It can be stated that

the pyknic physique ranges from an all fat to a combination of fat and muscles. As can be found

in the studies on human physique by Sheldon, Kretschmer’s pyknic resemble mainly the

physiques ranging from endomorphs to endomorph-mesomorph where the muscles and fat are

equally expressed in a person.

Asthenic (leptosome)

The main characteristics of this type include long and thin features of the body. The people are

tall and very thin. The extremities are extremely long as compared to the trunk. It seems as is the

body lacks not only fat but muscles also. The transverse dimensions of the body relatively more

prominent than the antero-posterior ones. These people seem to lack body strength and thus can

be considered fragile. The physique can best be described as long and spidery. The body posture

cannot be maintained as strictly upright but some type of swaying and tilting may be represented.

Athletic

This type of human physique has the characteristics of typical athletes. Strong and heavily

muscled bodies is the mainstay of this type. Actually Kretschmer describes this physique as a

type between the pyknic and the asthenic. So these people have very less fat but have

considerable amounts of muscles. Thus they may not be as massive as the pyknic ones. All parts

of the body exhibit prominent muscles. Physical strength is natural outcome in these physiques.
Besides these three types of physiques, another type of body morphology was also noticed by

Kretschmer in which different parts of the body did not match. This was referred to as the

dysplastic type. This type of physique does not show uniformity and hence is disproportional.

Kretschmer was of the opinion that short and thick type of people show extraversion in their

personalities and that is why these were more susceptible to manic-depressive type of psychosis.

On the other hand, the asthenic type had introverted personalities which made them more prone to

schizophrenia.

5.3 Sheldon’s Method of Somatotyping

The morphological and structural differences among human beings are unique and that is why no

two humans are alike in body form. Even the identical twins (monozygotic) can be identified

from each other although they develop from the single ovum and share exactly similar genetic

information. These large differences in body form, morphology and physique in humans must

form the basis for any attempt at classification and analysis of human physique. It must be a

precondition that all these variations from one extreme to another cannot simply be divided into a

few discrete types or groups. The classification which is based on only the discrete types involves

the human physique at the extreme poles whereas the majority of the other physiques falling in

between the extremes remain unattended. So, a good classification must take care of the subtle

human morphological variations and must be able to classify human physique into a large number

of categories.

That the human physique is a continuously distributed characteristic was appreciated by

William H. Sheldon, S.S. Stevens and W.B Tucker, who successfully devised a method in 1940

to analyse and quantify human body form called Somatotyping. According to Sheldon et al.

(1954):

"Somatotypes are morphophenotypic ranges along continua of variation which possess

 constantly recognizable characteristics and are the functional end products of the whole

genetic and developmental complex".

The somatotype is aimed at providing some sort of identification tag to the subject and may be

regarded as an attempt towards general human taxonomy or classification. It may also be referred

to as something similar to the Mendeleyev’s periodic table of the elements in chemistry. Sheldon

recognised three basic components of physique, viz., endomorphy, mesomorphy, ectomorphy.

Each individual has varying degrees of development of these three components. The somatotype

is always written in three numerals: the first indicating the development of endomorphy, the

second the mesomorphy and the third the ectomorphy. Sheldon was perhaps the first scientist to

appreciate the continuity of human physique (not a few discrete types) and invented a workable

method to achieve this.

The existing methods of classification of human physique at that time, chiefly that of Viola’s

and Kretschmer’s, were tested by Sheldon and his associates and it was found that the majority of

the persons could not properly fit into any of the described types. Thus the ideas of grouping

human beings into numerous categories got a firm support. According to them any method based

on human measurements at best can take only a representative group of measurements which can

be segmental and fragmentary and hence have limited value. Contrary to this, photographs in

three standard poses can provide complete information about the human physique. Pictures taken

with great care can exhibit muscular relief, the folds of skin and subcutaneous fat and the bony

projections. So the nude photographs of the subjects were considered as the most desirable

records for judging the physique. Photographic technique must be standardized so as to avoid any

unnecessary distortion of certain body parts by keeping a respectable distance between the subject

and the camera. All three views (front, back and side) of the subject can be taken on a single film

by specially designing the camera where only one-third of the film is exposed.

A brief description of the three components of physique is given as follows:

Endomorphy

Endomorphy is a structural component which has some similarities to the pyknic type of

Kretschmer’s classification. Both denote massiveness, big, heavy and large. In Kretschmer’s

terminology, the pyknic represents a compact body which is a combination both of sturdy

musculo-skeletal frame along with a good degree of fatness. On the other hand, the endomorphy

does not represent or involve muscular development. It is the development or presence of soft

roundedness which accrues from the huge fat accumulation over the body and massiveness of the

internal organs. General softness and roundness of the body and its various parts, proximal parts

of the limbs relatively massive than the distal parts, tapering of the extremities, abdomen

predominating over thorax, soft body contours, hands and feet relatively short, etc. Endotonia is a

term used to denote a good level of development of endomorphy whereas endopenia is used to

denote the lack of endomorphy.

Mesomorphy

Similarities can be drawn between the athletic type of Kretschmer and the mesomorphy of this

system. Both rely on the predominance of muscle and the skeletal frame. In the former the

athletic are functionally defined. They perform physically better whereas the present system

projects mesomorphy mainly as a structural component. General massiveness and sturdiness of

the musculo-skeletal system of the body, highly developed muscles of the limbs, distal segments

of the extremities relatively more prominent, strong thorax and predominating over abdomen

which is highly muscular, antero-posterior diameters of the trunk smaller than the transverse

ones, etc. For mesomorphic component, extreme development is called mesotonia and a lack of it

is called mesopenia.
Ectomorphy

In Kretschmer’s terminology asthenic seems to be that type which resembles ectomorphy of

Sheldon’s concept. The former, however, denotes asthenic as weak or lacking in physical strength

whereas the latter refers to ectomorphy as linearity or a proportionally less development of

thicknesses of various body parts. The weak or lacking in strength may be due to the two

components, viz., endomorphy or ectomorphy. Thin and lean body, weak muscles, thin skeletal

diameters, pointed and sharp bony projections, long and slender extremities, little muscles, etc.

Ectotonia and ectompenia are used to denote a maximum and minimum development of

ectomorphy in a person.

A critical examination of Kretschmer’s types of human physique vis-à-vis that of the Sheldon’s

has revealed that though the three types superficially may give some idea of resembling each

other in the two systems yet in fact these are quite different. This is one of the reasons why the

authors did not retain the nomenclature of pyknic, athletic and asthenic and instead coined

endomorphy, mesomorphy and ectomorphy which are more meaningful and shows uniformity.

But at the same time, the authors were aware of the drawbacks of this nomenclature. These names

are polysyllabic and may be difficult to pronounce and comprehend. However, they left this

puzzle to the future scientists to explore. With the passage of time either the use of these terms

would get a firm footing or these would be revised. It is worth mentioning here that there has

been no attempt at re-designating these structural components. What the authors have designated

reluctantly as compromises on terminology has firmly been stabilized and accepted.

There are documented proofs which indicate the predominance of digestive viscera in

extreme endomorphs, those who have the maximum development of endomorphy in them. The

findings on the intestinal weights and lengths in male cadavers of various types are given in table

5.1 to highlight the point of predominance of digestive viscera in endomorphy.

Insert table 5.1 somewhere here

Many anatomists have also found similar types of results on visceral length and weight. Thus the

term endomorphy quite accurately reflects the component of physique which quite obviously is

derived from the innermost embryonic layer – the endoderm. The characteristic endomorphs who

exhibit fatty deposition and soft rounded features seem to be the result of the predominance of

digestive viscera. There are tendencies of overeating therefore the body assimilates more than

what is actually needed. This results in the excessive fat storage resulting in fatty deposits. The

middle embryonic layer or mesoderm produces bones, muscles and connective tissues. These

constituents are present in the second component of physique or mesomorphy. Relatively large

surface area of the body predominates in the ectomorph. The outer embryonic layer or ectoderm

forms the skin, nails and sensory organs. These features derived from ectodermic layer are most

prominent in ectomorphs.

5.4 Somatotyping CriteriA

Somatotyping is done by visual observations on nude photographs of the subjects taken in

three poses; front, side and back. Typical somatotypes of an endomorph, mesomorph and

ectomorph are given in Fig. 5.1.

Insert Fig. 5.1 somewhere here

The body is divided into 5 segments for the sake of somatotyping as follows:

Region I- Head and neck

Region II- Thoracic trunk above diaphragm

Region III- Arms and hands

Region IV- Abdominal trunk below diaphragm

Region V- Legs and feet

Somatotyping of each region is done independently of others, on the basis of 7 characteristics.

Endomorphy, mesomorphy and ectomorphy ratings are assigned to each characteristic and the

mean somatotypes of each region are calculated. The total somatotype is an average of the
somatotypes of the five regions.

Sheldon studied 4000 male college students in order to know the possible range of variations

in human physiques. He was able to recognise as many as 79 types of physiques from the above

sample. Among them there were three extremes, 711, 171 and 117 which were in a negligible

proportion in the whole series indicating that these extreme types are very rare. The

recommended scale for each component is from 1 to 7 where 1 represents the minimum possible

development and 7 the maximum. From 1 to 7 the ratings at each step represent equal-appearing

intervals, e.g. the magnitude of difference in characteristics for any component between the

ratings of 1and 2 is the same as between the ratings of 2 and 3 and so on. The reason why 1 was

retained as the minimum rating instead of a possible 0, was that no human exhibits a total lack of

any component of physique.

Any subject who is extreme in one component cannot be extreme in the other two

components. Sheldon found that a person cannot have a rating of more than 5 in two components.

Similarly, there cannot be anybody having somatotypes as 111 or 777. Since there is some

dependence of one component on another, hence the sum of three components is also limited

from 9 to 12 instead of a theoretical value of 3 to 21. The person who is fat may have muscles to

support it but he will not be linear then. In table 5.2 a list of all the somatotypes known to

Sheldon from his data available at that time are presented.

Insert table 5.2 somewhere here

Later on in 1954 Sheldon Published a book "Atlas of Men” based on a mammoth sample of

46,000 human subjects in the age range of 18 to 64 years which included people of all walks of

life including academicians, delinquents, patients, etc. Not only White but Negro and Jews also

got a place in this atlas. On the basis of this extensive data, tables of the distribution of height

over cube root of weight ratios at different ages were devised. Somatotyping procedure was made

less cumbersome and less subjective by utilising this distribution. Only a few somatotypes are
possible at any given height weight ratio First of all, the height weight ratio is obtained and the

possible somatotypes at that ratio are noted. Then the somatotype photograph of the subject is

compared with standard photographs available in an atlas, to make out with which it tallies most

and a final decision is made regarding his somatotype.

In order to make the designations of somatotypes quite lively and absorbing, Sheldon

attached animal totems to different somatotypes to which they resemble most. For example,

 711 was designated as an ‘American manatee-siren or mermaid’,

 171 as an ‘eagle’,

 117 as ‘walking sticks’,

 741 as an ‘Ancient hippopotamus’ and so on.

The somatotype, as conceived of a biological tag to the individual should remain unaltered

throughout life but in the absence of grossly disturbing pathology and malnutrition. The

subjectivity of this system is in a sense its strength in achieving the above aim. It is expected of

the experienced raters to possess the capacity to explore and judge deep inside the body for the

amount of different components. That mass of tissues which would remain static throughout life

and even under slight environmental insults. The person should also be experienced in the

knowledge of the normal age changes taking place in various tissues and the effect of various

factors impinging upon them. Sheldon perceived the usefulness of his method in constitutional

studies where the particular type of body build may have some associations with certain diseases,

behavioural characteristics, physical fitness and prowess.

The detailed criteria outlined here for the three components of physique are for the males and

are based on inspectional assessment of the photographs. The features are so described as would

be seen in those individuals having the extreme manifestations of a given component.

5.5 Dominance of Endomorphy

The general characteristics give the body a soft and round outlook as is humanly possible. The

thickness of the body tends towards equality to the breadths, throughout the body. The body mass

has a tendency to be centrally located. In a competition of thorax and abdomen, the latter excels

the former in dominance. Trunk or torso overshadows the limbs in volume. The proximal

segments of the extremities are well developed relative to the distal segments. The limbs

generally resemble more or less, the inverted pyramids; the proximal segments being similar to

the shape near the base and the distal segments being like the apex. There is a conspicuous

tapering of the extremities and considerable hamming of the thighs and upper arms. Shoulders are

soft and square. It is difficult to observe a neck which is usually short. Head attains a figure

nearly spherical. The face is equally proportional with upper and lower segments nearly matching

each other in size. Wide features of the face are generally noticed. There is no muscular relief in

any part of the body. Even the proximal muscles like the deltoid, gastrocnemius and trapezius do

not show themselves from underneath the skin and subcutaneous tissue.

The extremities are short and weak and with conspicuous taper. The hands and feet are generally

very short.

The skeletal frame supporting the body is small and weak. As can be seen in the X-ray, the cortex

is thin but the bony projections are nearly absent.

Instead of an S-shaped vertebral column or spinal column, it is usually straight. It may be so

because of heavy padding of fat and also due to the excessive centrally located mass.

The trunk is relatively massive and long. The chest is broad at the base and the waistline is high

and indistinguishable. The width of the body just above the iliac crest is the largest instead of that

at the trochanteric level. Since the lower chest is highly distended therefore the ribs exhibit a wide
angle with the vertebral column and the sternum. Breasts also show some development due to the

deposition of fatty tissue. Buttocks are round and without any dimpling.

The outer curve of the thigh is of a feminine character, a full sweeping curve which may extend

to the calf also.

The skin is generally soft and velvety. The pubic hair distribution has a feminine characteristic.

Generally, the hairs are distributed over scapula, deltoid and breasts but lesser in quantity. Thick

bushy chests are quite uncommon. A tendency towards baldness is often noticed even during

youth and it usually begins in the centre of the head extending peripherally later on.

The quality of the hair is generally fine. The genitalia are less developed. The penis is usually

small in size and lost in the hair. Generally the testes are un-descended and corona is small with

very long foreskin.

5.6 Dominance of mesomorphy

The general characteristics of the body include a hard and sturdy physique. The muscles are thick,

prominent and rippling with the maximum perceptible relief. The skeletal structures are thick and

very well developed. The breadths of the body at shoulders and of the forearm and calf being

exceptionally large and exceed the depths or antero-posterior diameters.

The trunk is massive and rugged with strong muscles. The extremities are massive; the distal

segments are relatively more developed. Hand and feet are usually strong and broad. In the trunk,

the thorax dominates over abdomen. Shoulders are heavy and broad. Hips are strong whereas the

waist is thin and small. The various segments of arms and legs seem to be equally developed or

proportionate. The head is strong and fully developed. Heavy muscles and thick bones of the head

are prominent features. All bones are well developed.

Neck is prominent and long with transverse diameters eclipsing the antero-posterior ones.

The muscles of the neck are so developed especially the trapezius that it gives the neck a shape resembling

a pyramid. In the thoracic region, the contour of the back or vertebral column is straight. But there is a
highly prominent lumbar lordosis or a sharp convexity forward. The buttocks are usually deeply dimpled

and heavily muscled. The abdominal muscles are prominent and show typical knotting.

The skin is usually thick with a better developed connective tissue. Thus the skin is tightly gripped by the

connective tissue to the adipose tissue and the creases or folds are heavy and deep.

The hair like the skin is coarse. The distribution of the hair around the body is highly variable.

Pubic hair are typically masculine along with upwards growth medially towards naval and on

lateral sides. The skin is light but elastic and has a tremendous capability of returning to its

original position when it is pinched lightly.

Genitalia and the scrotum are usually very well developed. They are firm and thick in

characteristic.

5.7 Dominance of ectomorphy

The ectomorphy is characterized by the fragility, linearity and the delicacy of the human body.

The whole of the body has very thin and thready muscles. The skeletal frame is usually fragile

and slightly built.

There is an impression of drooping shoulders. The upper and lower extremities are relatively very

long whereas trunk is short. The abdomen is flat and shallow. Lumbar lordosis and thoracic

kyphosis are prominent.

In trunk, the thoracic region is relatively long in comparison to the abdomen. There is lack of any

bulging of muscles anywhere in the body, no muscular relief. Usually the shoulders are carried

forward with the result that the arms hang in a plane anterior to the plane of the body.

In extremities, the distal segments are relatively mote prominent. The upper arms and thighs are

extremely weak. The ankles and wrists are usually small and fragile. If there is a prominence of

joints which is not due to the pathological conditions, then this is a prominence of mesomorphy.

Neck is thin but long with minimum muscles and projects forwards. The transverse diameter of

neck is equal to the antero-posterior diameter but these are small. The head is slightly built with
minimum fat and muscles. Cranial mass overshadows the facial mass. The features of face are

sharp, fragile and small. Usually the face presents a triangular outlook with sharp pointed chin.

The lower jaw is usually small and delicate.

5.8 The Trunk Index and Somatotype

In his later works, Sheldon et al. (1954) constructed somatotype-HWR tables to help the rater in

quickly doing the job of somatotyping. These tables would depict the possible somatotypes at a

given HWR value. It is easier to find out the best suitable somatotype from a limited range. In this

study (Atlas of Men) 1175 somatotype photographs were given which were based on men of all

ages beyond 18 years. The major objections of immutability of the somatotype along with a lot of

subjectivity in rating the subject persisted even in this study. Sheldon then devised a trunk index

and took its help in somatotyping procedure.

Trunk index is the ratio of the areas of thoracic trunk to the area of abdominal trunk of the

somatotype photograph of a given subject. The areas were calculated with the help of

planimeter (a simple geometrical instrument used to calculate the areas of non-uniform

figures). The new method of somatotyping was provided on the basis of trunk index

(Sheldon et al. 1969).

The following procedure was suggested to calculate the somatotype of a given subject:

 The trunk index is first obtained. This is done with the help of an instrument called

planimeter used to calculate the areas of thoracic trunk and that of the abdominal trunk

from the given photograph.

 The maximum and minimum values of body mass and height of a given subject as

recalled by the subject are to be taken into account

  Somatotyping Ponderal Index (SPI) of the subject is calculated. Ponderal Index is the
0.33
index of height/weight . If a person is more massive or has more weight for a given

height then his ratio would be lower whereas in the case of a person with low weight for a

given height, this ratio would be higher. Somatotyping Ponderal Index (SPI) of a given

subject is the value of his Ponderal Index (PI) at the greatest massiveness of the subject in

his life time.

 THE TABLES OF HWR AND TRUNK INDICES PROVIDED BY

SHELDON ARE USED FOR FURTHER EVALUATION.

 THE BASIC TABLES FOR SOMATOTYPING INCLUDE

TRUNK INDEX, MAXIMUM HEIGHT, SOMATOTYPING

PONDERAL INDEX (SPI). THE TABLES ARE MEANT

DIFFERENTLY FOR MEN AND WOMEN.

5.9 THE SECOND ORDER VARIABLES OF HUMAN PHYSIQUE

Needless to say that even with a continuous classification of physique which may include around

80 different body types, every type still may reflect lots of variations among the individuals

themselves. Sheldon thought of grading every somatotype on the basis of some other features so

that within a given somatotype further classification can be made and the individuals can be

distinguished from one another. The features he thought of included

 Gynandromorphy (mixing of male-female features),

 Dysplasia (disproportionate body),

 Textural aspect (quality of the texture of the skin) and

  Hirsutism (growth of body hair).

It is worth mentioning that all these characteristics could be used to differentiate individuals from

within a given somatotype. With the help of these features all the individuals within a given

somatotype can be judged and separate identities can be established. However, these

characteristics cannot be used to further differentiate different somatotypes. For example, if there

are numerous individuals of the same somatotype say 5-3-2, then all of them may be further

differentiated on the basis of second order variables including gynandromorphy, dysplasia,

textural, hirsutism. But if the individuals have different somatotypes say 5-3-2, 5-4-2, 5-3-4, etc.,

then it is not advisable to further classify them on the basis of gynandromorphy, dysplasia,

textural, hirsutism. Sheldon has very succinctly argued that the further gradations within the same

somatotype has to be attempted and not by mixing the different somatotypes. It would be like

grading a specific type of fruits like apples or oranges separately. But the apples and oranges

cannot be mixed together for the purpose of grading them and then comparing them on the basis

of these characteristics.

5.10 Gynandromorphy

During the development of the embryo the gonads are bipotential (have the potential of

developing into either male or female) and an interaction between genetic make-up and hormones

makes the sex organs of one type develop further. This is why the rudimentary structures of the

opposite sex are present in everybody. The males retain to some extent the female features and

the females the male features. This mixing of the male-female features which can be recognized

externally or morphologically is called gynandromorphy. The assessment of gynandromorphy

has been recommended by Sheldon who prefers to call it the g-index or g-aspect on the basis of

following criteria. These criteria are for males to judge the female features because Sheldon

studied only the males:

  It describes the extent to which features suggest femininity. The smallness of features,

soft round relief, small oval eyebrows, long eyelashes delicate alae of nostrils, small

mouth with full lips are some of the hallmarks of facial features.

 There is a rounded delicacy of shoulders with weak arm. Subjects have feminine type of

arms which are shorter and more delicate relative to legs.

 The hips are disproportionately large compared to the body.

 The structure is typically an hour glass figure or figure 8 appearance of the body as a

whole. A high waist, softly moulded shoulders, full sweep of the outer contour from

waist to knee, full pneumatic appearing buttocks are additional features. Groins and the

inner surfaces of the thighs are full of flesh and massive.

 There is a sparse distribution of secondary hair on the body with feminine distribution of

pubic hair.

 Feminine softness of subcutaneous finish of the entire body exists, which gives the body

a feeling of child-like soft cushioning of the external body fat.

 Presence of breast formation with lot of adipose tissue underneath and the tissue may

become functional in some cases which is called gynecomasty.

 Prominence of the outer curve of the lower leg as compared to the inner curve is

generally noticed.

5.11 Dysplasia

It is generally considered that the human body is bilaterally symmetrical and well proportioned.

However, in actual practice it can be seen that not only do the two sides of the body differ in a

given individual but show regional disproportions as well. It may be a massive thorax in a person

with well muscled shoulders but with weak arms and legs. Or in a person, the lower portion of the

body is more massive as compared to the upper parts of the body. Such types of disproportions
are quite often noticed. Sheldon has referred it to as ‘dysplasia’. In Indian mythology, a learned

legend with uncanny wisdom had as many as eight defects of body proportions and hence was

popularly known as ‘Ashtawakar’. An uneven mixing of body components in different parts of

the body is called dysplasia.

Dysplasia can also be measured and rated on a 7 – point scale. The minimum value of

dysplasia (a rating of 1) indicates a very well proportioned body whereas the maximum value (a

rating of 7) indicate a highly deformed and disproportionate body physique. For expressing

dysplasia in the form of above ratings, the following procedure has to be applied:

a) All the differences among different regional somatotypes component-wise are calculated and

then added up. This is done separately for endomorphy, mesomorphy and ectomorphy and then

all the differences are summed up. The procedure for calculating differences in a given

component is similar as to making all possible combinations in sports in case of league matches

of different teams. For example, in case of endomorphy it would involve all differences in this

component between 1st region versus 2nd, 3rd, 4th and 5th regions and 2nd versus 3rd, 4th and 5th

regions and 3rd versus 4th and 5th regions and 4th versus 5th regions. Thereafter all these

differences will be added up. In a similar fashion, the differences for mesomorphy and

ectomorphy can also be calculated.

Ex. 5.1 Calculate dysplasia assuming the following regional somatotypes of a given subject:

1st region 5–3-2

2nd region 4-3-2
3rd region 5-2-3
4th region 4-2-3
5th region 5-2-2

Differences for endomorphy = 1st vs. 2nd, 3rd, 4th, 5th regions = 1,0,1,0

= 2nd vs. 3rd, 4th, 5th regions = 1, 0, 1

= 3rd vs. 4th, 5th regions = 1, 0

= 4th vs. 5th regions =1

 Total difference for endomorphy = 6

Differences for Mesomorphy = 1st vs. 2nd, 3rd, 4th, 5th regions = 0,1,1,1

= 2nd vs. 3rd, 4th, 5th regions = 1, 1, 1

= 3rd vs. 4th, 5th regions = 0, 0

= 4th vs. 5th regions =0

Total difference for Mesomorphy = 6

Differences for Ectomorphy = 1st vs. 2nd, 3rd, 4th, 5th regions = 0,1,1,0

= 2nd vs. 3rd, 4th, 5th regions = 1, 1, 0

= 3rd vs. 4th, 5th regions = 0, 1

= 4th vs. 5th regions =1

Total difference for Ectomorphy = 6

The sum of all differences for endomorphy, mesomorphy, ectomorphy = 6 + 6 + 6 = 18

b) The total of all differences for the three components is taken and with the help of table 5.3, a

rating of dysplasia can be assigned.

Insert table 5.3 somewhere here

The rating for dysplasia in the above subject with a total difference as 18 would be 6.

So dysplasia rating = 6 units.

5.12 TEXTURAL ASPECT (t-index)

This second order variable of human physique can only be useful to further categorize the

individuals within a given somatotype. The texture of the human skin varies from a smooth finish
to a rough one. The evaluation of the quality of the texture of the skin was suggested by Sheldon.

Judging the quality of human skin somehow smells of a feeling of racism. According to Sheldon

there is a fairly clear gradation from very coarse to very fine physical texture or quality. If it is

possible to arrange a series of pictures in an ascending order of textural fineness, judging the

quality of the skin of a person becomes very easy. The rating scale for this variable has been

suggested from 1 to 7 where 1 indicates the coarsest texture and 7 indicates the finest texture of

the human skin. It is understood that the judgments on this variable in humans can lead to

discriminatory complications. It is strongly advised against using this characteristic for the

classification of human beings. Reference of textural aspect has been provided here in order to

acquaint the reader about all the aspects of somatotyping and human physique.

5.13 HIRSUTISM

The human beings have body hair all around. Some have dark pigmented and long hair all over

the body whereas others have barely visible body hair. During the course of human evolution and

with the wearing of clothes man started losing pigmentation of the body hair. Hirsutism is defined

as excessive and increased growth of coarse and pigmented hair on those body areas of women

where men generally have hair - like face, chest and back. The amount of body hair varies from

individual to individual which may provide a criterion of classifying humans on the basis of body

hair. Sheldon provided a scale of hirsutism from 1 to 5 where 1 indicated almost lack of

pigmented hair on the body with extremely sparse pubic hair and 5 indicated extreme

pigmentation and luxuriant growth of hair all over the body.

5.14 CRITICAL EVALUATION OF SHELDON’S METHOD OF SOMATOTYPING

 This is a subjective method; the rater should be highly specialized in the art and

techniques of somatotyping for the best results. Even the experienced raters may

differ to some extent in somatotype assignments and a rater may give different
 somatotypes to the same photograph if asked to rate at two different time intervals.

 The method has been developed from the white males of limited age range, hence the

complete variations in human physique are not known. The somatotypes of females

and other ethnic groups and their range of variations are also unknown. The extremes

which Sheldon has described in his work may not remain the extremes if whole of the

population of the world at different times is studied. One is bound to find more

extreme cases; but then they will be rated only 7 in the component in which they are

extremes.

 The system is based on the concept that the physique of an individual does not

change from birth to death and is unaltered by environmental factors, such as

malnutrition, disease, etc. It advocates the immutability of the physique throughout

life. However, many students of constitution and body build do not entirely accept

this viewpoint and consider that the changes do take place in body build with age.

 The gross size and weight of the subject does not get a place in the assignment of

somatotype. A six feet tall man and a five feet tall person both having the same

somatotype cannot be differentiated although both these physiques may have

different meanings.

On the whole, Sheldon's method of somatotyping is a useful tool for the students of human

constitution and body build.

5.15 PARNELL’S METHOD OF SOMATOTYPING

R.W. Parnell (1954) a British physician described a method to objectively somatotype human

subjects by physical anthropometry instead of by the visual inspection of photographs of the

subjects.

Sheldon’s method of somatotyping is based primarily on making visual observations on the nude

photographs. An alternative approach to the visual inspection of photographs is to take

measurements on the photographs and then derive ratios and indices which form the basis of

somatotype. According to Parnell’s experience, Sheldon’s photometric method which objectively

assesses the somatotype, takes a long time to somatotype a person, may be more than an hour.

Secondly, if the choice of dominance of the components in the beginning is wrong, the whole

process may result in wrong assessment of the somatotype.

There are certain inherent difficulties in Sheldon’s method which comes in the way of its wider

use. Parnell thinks that the major difficulties include:

 Subjectivity

 Nude photographs

 Cost, labour and time

Parnell’s attempt was to overcome these difficulties in the somatotype procedure and devise a

new technique which could be applied on every body with ease. Parnell’s effort was to describe a

short physical anthropometric method for obtaining somatotype with the following purposes:

 To provide objective guidance on the dominance of somatotype components in a healthy

person.

 To estimate the Sheldonian somatotype objectively and as accurately at least as the

agreement achieved between experts in photoscopic somatotyping.

 To make an estimate of women’s somatotype possible although in the absence of a

published reference somatotype data the estimate cannot be compared.

 To reduce on cost, labour and time while doing somatotypes.

Deviation chart profile of physique

The method of estimating dominance of somatotype components chiefly depends on Standard

Deviation Chart. This chart has been designed on the basis of following body measurements:

1. Height 3. Humerus bicondylar diameter

2. Weight 4. Femur bicondylar diameter

5. Upper arm circ. (biceps flexed)

6. Calf circumference

7. Subscapular skinfold

8. Suprailiac skinfold

9. Triceps skinfold

10. Biacromial diameter

11. Bi-iliac diameter

12. Chest width

13. Chest depth

For judging the somatotype, a Standard Deviation Chart was designed which is based upon the

anthropometric data obtained from 405 undergraduates at Oxford and Birmingham. The mean

values of all the measurements listed above were placed under one column which made the

standard column in designing the chart. Thereafter, columns on the left were generated by

subtracting one-half of the standard deviation from the mean value for each measurement. The

similar procedure was adopted for generating the column towards the right side by adding one –

half standard deviation to the mean value. The typical standard deviation chart as designed by

Parnell (1954) appears in Table 5.4

Insert table 5.4 somewhere here

The profile of the somatotype can be estimated on the basis of the position of various

measurements of a given subject in the deviation chart. In the following diagrams, “B” means the

average of two bony diameters, “M” means the average of two muscle girths, “H” means height

and “F” means sum of three fat folds (Fig. 5.3).

Insert Fig 5.3 somewhere here

In endomorphs and endomorphic mesomorphs, the direction of HF line is from top left to

bottom right in the deviation chart.

In ectomorphs and Ectomorphic mesomorphs, the direction of the HF line is from top

right to bottom left on the deviation chart.

In case of average somatotypes (444) and endomorph-ectomorphs, the direction of the

HF line is vertical.

Mesomorphic dominance is present when the BM average point lies to the right of the H

and also to the right of the HF line.

 Lack of mesomorphy (a value of less than 3) is denoted when the average of the BM

point lies to the left of the HF line.

An important point to be kept in mind in case of mesomorphy assessment is regarding the status of

height. In order to be rated higher on mesomorphy a subject’s bone and muscles must be so much

developed as to be placed ahead of the column for the height in the deviation chart.

Once the dominance status of the components is known from the deviation chart, a most suitable

somatotype can be assessed by using the subject’s ponderal index from the Sheldon’s set of tables.

Chapter 5 Exercises

Ex. 5.1 Answer the following questions.

a. How many regions of the body are made for the purpose of Sheldon’s method of
somatotyping?
b. Which component of somatotype represents relative fatness in the body?
c. What would be the somatotype of a person with extreme endomorphy but with the minimum
values of mesomorphy and ectomorphy?
d. What is the term used for uneven mixing of somatotype components in different regions of
the body?
e. What is Sheldon’s method of analysis of human physique referred to as?

Ex. 5.2. Calculate dysplasia in the subjects with following regional somatotypes

A.
1st region 6– 3 - 2
2nd region 3-4-2
3rd region 4-2-3
4th region 4 - 4- 3
5th region 6-2-2
B.
1st region 5–3-2
2nd region 5-2-2
3rd region 5-2-2
4th region 4-2-2
5th region 5-2-1
C.
1st region 2–4-5
2nd region 2-5-5
3rd region 3-4-5
4th region 3-5-3
5th region 2-5-4
D.
1st region 2–7-3
2nd region 2- 7 - 3
3rd region 2- 7- 3
4th region 2-7-3
5th region 1-7-3
E.
1st region 4–3-2
2nd region 4-3-2
3rd region 4-2-2
4th region 4-2-2
5th region 4-2-2

Chapter 5 Answers

Ans. 5.1
a. 5
b. endomorphy
c. 711
d. dysplasia
e. somatotyping

Ans. 5.2
A. total difference = 34, rating of dysplasia = 7
B. total difference = 12, rating of dysplasia = 4
C. total difference = 22, rating of dysplasia = 7
D. total difference = 4, rating of dysplasia = 2
E. total difference = 6, rating of dysplasia = 3
Table 5.1 The intestinal weights and lengths of cadavers who were extreme in endomorphy,

mesomorphy and ectomorphy (adapted from Sheldon et al. 1940).

Type N Intestinal Intestinal Ht(cm) Wt(kg)

Wt (kg) Length(m)

Extreme endomorph 10 1.5 11.2 168 81

Extreme mesomorph 13 1.1 9.6 174 74

Extreme ectomorph 11 0.8 8.7 177 64

 Table 5.2 Different types of somatotypes observed by Sheldon from his available data.

Endomorphy Somatotypes

rating

1 171, 172, 162, 163, 154, 145, 136, 127, 126, 117

2 271, 263, 262, 261, 254, 253, 252, 245, 244, 236, 235, 226, 225, 217, 216

3 371, 362, 361, 354, 353, 352, 344, 345, 343, 335, 334, 326, 325, 316

4 461, 453, 452, 451, 444, 443, 442, 435, 434, 433, 425, 424, 415

5 551, 543, 542, 541, 534, 533, 532, 524, 523, 522, 515, 514

6 641, 632, 631, 623, 622, 621, 613, 612

7 731, 721, 712, 711

 Table 5.3 Scale for conversion of differences into the rating of dysplasia

Difference Rating Percentage

0 1 5

2-4 2 16

6-8 3 23

10-12 4 26

14-16 5 18

18-20 6 8

>20 7 4

Table 5.4 Parnell’s M.4 Deviation Chart

Fig. 5.1 Typical somatotype of an endomorph, mesomorph and ectomorph
Endomorph Mesomorph Ectomorph
6. HEATH-CARTER METHOD OF SOMATOTYPING

Chapter details

Heath-Carter method of Somatotyping

Anthropometric Measurements
Technique of Heath-Carter Anthropometric Somatotype
First component or endomorphy rating
Second component or mesomorphy rating
Third component or ectomorphy rating
Somatochart and Somatoplot
Somatotype Distributions
Somatotyping Children
Critical Evaluation Of Heath-Carter Anthropometric Somatotype Method

Sheldon’s method of Somatotyping has provided new techniques for the analysis and

classification of human physique. However, there were numerous difficulties in applying this

technique to quantify the physique of a person. The main difficulty was to have the nude

photographs of the subject. Therefore, there have been many attempts to make it simpler, easily

executable and more objective. Several attempts were later made in this direction to somatotype

on the basis of anthropometric measurements (Cureton 1951, Parnell 1954, Damon et al. 1962);

however, these methods remained relatively unused because of certain discrepancies. The Heat-

Carter method of somatotyping is one such attempt which fulfils to a major extent these

requirements and is widely in use throughout the world during the last two decades. Its

application is immense in the fields of sports sciences, anthropology, human biology, child

growth, etc. It is based on anthropometric measurements which are easy to take on the subjects-

Heath (1963) critically examined the shortcomings in Sheldon's method and suggested alterations

and modifications in it. Later on, Heath and Carter in 1967 gave their own method of

somatotyping. Though this method differs from that of Sheldon's in the sense that it evaluates the

body form or physique at the given time compared to the unchanging somatotype of Sheldon. The

ratings of three primary components of physique are assigned from the tables on the basis of the
anthropometric measurements. Before going into the details of the method, it is necessary to

acquaint with their concepts of somatotype and the three components, Viz., endomorphy,

mesomorphy, ectomorphy.

Heath and Carter (1967) and Carter (1975, 1980), Carter et al. (1983), Carter and Heath

(1990) have defined these concepts as follows:

"A Somatotype is a description of the present morphological conformation. It is expressed in

a three numeral rating, consisting of three sequential numbers, always recorded in the same

manner. Each numeral represents the evaluation of three primary components of physique which

describe individual variations in human morphology and composition"

"First component (or endomorphy) refers to relative fatness in individual physiques; it also

refers to relative leanness. That is, first component ratings are evaluations or degrees of fatness

which lie on a continuum from the lowest recorded values to the highest recorded values".

"Second component (or mesomorphy) refers to relative musculo-skeletal development per

unit of height. Second component ratings are evaluations of musculo-skeletal development which

lie on a continuum from lowest to highest degrees recorded. The second component can be

thought of as Lean Body Mass relative to Height".

"Third component (or ectomorphy) refers to relative linearity or individual physiques. Third

component ratings are based largely, but not entirely on height/cube root of weight ratios.

Height/cube root of weight ratios and third component ratings are closely related, so that at the

low ends of their distributions both connote relative shortness of the several body segments, and

the high ends connote elongation or linearity of several body segments. Ectomorphy ratings

evaluate the form and degree of longitudinal distribution of the first and the second component".

6.1 Heath-Carter method of Somatotyping

The Heath-Carter method of somatotyping described below is "THE HEATH CARTER

ANTHROPOMETRIC SOMATOTYPE METHOD". It may be for the interest of the readers to

note that in the Heath-Carter method a photoscopic somatotype rating can be made which
evaluates the physique from the photographs by visual inspection as well as height/cube root of

weight ratios. The best estimate of physique or somatotype of an individual is a combination of

the photoscopic and anthropometric estimates of somatotypes and is the criterion method.

However, in the absence of trained raters and photographs, the anthropometric somatotype is a

very good estimate of the physique of an individual

6.2 Anthropometric Measurements

The following anthropometric measurements are required for obtaining the somatotype:

1. Height

2. Weight

3. Triceps skinfold

4. Subscapular skinfold

5. Supraspinale skinfold

6. Calf skinfold

7. Humerus biepicondylar diameter

8. Femur biepicondylar diameter

9. Biceps girth

10. Calf girth

 Height (Stadiometer or Anthropometer)

It is the erect body length from the soles of the feet to the vertex. Vertex is the most superior

or the highest point on the head when the head is in Frankfort horizontal plane (See chapter 2

for details).

 Body weight (Weighing machine)

It is the nude weight o the body when the bowels are empty and is taken on a weighing

machine or beam balance (details in chapter 2).

 Triceps skinfold (Harpenden skinfold calliper)

The subject stands erect, arms normally hanging down by the side. The skinfold is picked up

over the triceps muscle of the right arm midway between the acromion process and the

superior border of radius in line with the olecranon process. The fold should be parallel to the

long axis of the arm.

 Subscapular skinfold (Harpenden skinfold calliper)

The subject stands erect and his shoulders are relaxed. The skinfold is picked up slightly

below the most inferior angle of the right scapula. The skinfold should be pointing

downwards and outwards.

 Supraspinale skinfold (Harpenden skinfold calliper)

The subject stands erect and asked to inspire normally and hold his breath. The skinfold is

picked up about 2 to 5cm above the anterior superior iliac spine on the line to the anterior

axillary border of right side pointing forwards and downwards.

 Calf skinfold (Harpenden skinfold calliper)

The subject is asked to sit on a chair with his knee bent at right angle. The skinfold is picked

up on the medial side of the right calf slightly above the level of the maximum girth. The fold

should be parallel to the long axis of the leg.

 Humerus biepicondylar diameter (Sliding calliper)

 It is the maximum diameter across the outermost points on the epicondyles of the distal end

of humerus. The arm of the subject should be bent at right angle and the width across the two

points is taken with a sliding calliper. Measurements are taken on both the sides and the

larger value is recorded.

 Femur biepicondylar diameter (Sliding calliper)

It is the maximum width across the outermost points on the epicondyles of the distal end of

the femur. The subject sits on a chair with the knee bent at right angle. The calliper is applied

to the epicondyles of the femur. Measurements are taken on both the sides and the larger

value is recorded.

 Biceps muscle girth (Steel tape)

It is the maximum circumference of the upper arm when the biceps muscle is fully contracted

with elbow flexed. The tape is wrapped around the contracted upper arm taking care that it

remains at right angles to the long axis of the upper arm and the largest value is taken by

moving the tape in either direction where it is maximum. Measurements are taken on both the

arms and the larger value is recorded.

 Calf muscle girth (Steel tape)

The subject is asked to stand erect, both feet about 15 to 23 cm apart and body weight equally

supported on both the legs. The tape is passed around the leg at right angle to its long axis

and the maximum value is taken. Measurements on both the legs are taken and the larger

value is recorded.

The Heath-Carter anthropometric method is an objective one, i.e., any two raters who are

provided with the same body measurements ill assign the same somatotypes. However, the

accuracy to somatotype depends mainly upon how accurately the measurements are taken. So, the

investigator is advised to master the techniques of taking these measurements. Inter and intra

investigator comparisons of these measurements are necessary to make a check on the accuracy.

There are certain measurements like the skinfolds which show large variations when taken at two
different times and by different investigators.

It has been advocated by Tanner (1964) and recommended by Carter (1975) that the

differences between the same measurements taken independently by a measurer on two occasions

should not exceed 5%, So, on this basis, the recommendations are that the absolute differences for

bone diameters should not exceed 1mm and for girths not more than 2 mm.

6.3 Technique of Heath-Carter Anthropometric Somatotype

Table 6.1 is a typical Heath-Carter rating form which is required for obtaining the

somatotypes. The minimum ratings of first component reflect the minimum possible non-essential

fat, of second component of least development of musculo-skeletal structures and the third

component, the least linearity. Theoretically, the minimum rating can be zero but practically,

ratings less those 0.5 units are never assigned. Observed ratings so far for endomorphy,

mesomorphy and ectomorphy are from 1 to 15, from 1 to 12 and from 0.5 to 9 units, respectively.

The somatotype of 5-3-2 means a rating of 5 for endomorphy and 2 for ectomorphy. The

procedure for calculating the somatotype from anthropometric measurements is described below.

Insert table 6.1 somewhere here

6.3.1 First component or endomorphy rating

The measurements required for endomorphy ratings are skinfolds at triceps, subscapular and

supraspinale. Take the sum of these three skinfolds. Search the rating form for endomorphy

evaluation for the nearest value to the recorded sum of the skinfolds. Here a reference to the rows

and columns will be made quite often and the readers must acquaint themselves with these. The

rows are horizontal sets of values and the columns the vertical ones. There are three rows, viz.,

upper limit, mid-point and lower limit. Circle the nearest value (in some cases where the

difference is within a few millimetres, the values in the upper and the lower limit are circled
whereas in most of the cases the mid point is circled). Now deal with the columns and look in

which column this circled value falls. Directly below this column the value of endomorphy can be

seen (See appendix at the end of this chapter for easy and quick calculation of endomorphy,

mesomorphy and ectomorphy)

The endomorphy scale has been developed regardless of the height of the subject. If a subject

is 170.18 cm tall and the other is 150.0 cm and both have the same sum of the skinfolds, then

both of them will be assigned the same endomorphy rating. But in the real sense, a short person

will be fattier than the tall one.

Health- Carter has suggested a way out of this problem. The skinfolds are first corrected

before estimating the endomorphy. The subject's height is brought to the level of universal

average along with a modification in the sum of the three skinfolds in the following manner:

Corrected sum of skinfolds

= (Sum of skinfolds/ height) x 170.18

This corrected sum of skinfold is utilised for endomorphy assignments.

Example: Let us assume the values of height, triceps, subscapular and subscapular and

supraspinale skinfolds as 142.0 cm, 12mm, 10 mm and 8mm, respectively. The sum of skinfolds

is 30mm and a value of 29.0 be circled on the rating form for endomorphy determination. The

rating of endomorphy is 3 (Table 6.2). The corrected sum of skinfolds is 39.95 mm (30 x

170.18/142.0) which corresponds to a rating of 4 for endomorphy.

 Insert table 6.2 somewhere here

Exact decimal rating of endomorphy can be assigned from the measurements directly using

the following equation of Carter (1980):

Endomorphy= – 0.7182 + 0.1451(X) – 0.00068(X)2 + 0.0000014(X)3

Where X is the sum of triceps, subscapular and supraspinale skinfolds,

For obtaining height corrected endomorphy, X is multiplied by (170.18/ height in cm).

Ex. 6.1 Calculate the endomorphy with and without height correction with the help of

equation given by Carter (1980) if the sum of skinfolds = 30.0 and height is 142 cm.

Endomorphy (without height correction)= – 0.7182 + 0.1451(X) – 0.00068(X)2 + 0.0000014(X)3

= – 0.7182 + 0.1451(30) – 0.00068(30)2 + 0.0000014(30)3

= – 0.7182 + 4.353 – 0.612 + 0.0378

= 3.06

Corrected sum of skinfolds = 30 x (170.18 /142)

= 35.95 mm

Endomorphy (with height correction)= – 0.7182 + 0.1451(35.95) – 0.00068(35.95)2 +

0.0000014(35.95)3

= – 0.7182 + 5.216 – 0.8788 + 0.065

= 3.68

6.3.2 Second component or mesomorphy rating

Record the values of height and the bone diameters in their respective boxes on the rating
form. Before entering the values of biceps muscle girth in the rating form, subtract triceps

skinfold form it and similarly subtract calf skinfold from the calf muscle girth (since the triceps

and calf skinfold are taken in millimetres and the muscle girths in centimetres, before subtracting

the skinfolds from their respective muscle girths, it is necessary to divide them by 10, i.e. to

covert them to centimetres).

Circle the nearest height value of the height scale. Also put a height mark say an arrow (↑) at

a column or a space between columns which corresponds to the exact height of the subject. Circle

the nearest values of bone diameters and the muscle girths in their proper rows. In the case of

measurement falling exactly in the middle, the lower value be circled.

Next step is dealing only with columns and not the numerical values. Find the column or

space between the columns which is the average of the columns deviations for the bone diameters

and the muscle girths only (not height). This can be done in the following way:

a. The left most circled column be designated as zero column (remember only the

bone diameters and the muscle girths are taken).

b. From the zero column, add the total number of columns to each of the other

three circled values.

c. Divide this total by four.

d. Court this number of columns to the right of zero column and put some specific

mark for your reference this point way be put at a columns or a space as the case

may be.

This way the average columns of bone and muscles in estimated which can be indicated by

an asterisk (*). Again dealing with the columns only, count the number of columns and its

fraction between the column of height and the average column.

A rating of 4 for mesomorphy is taken as the standard value. If the average columns of bone

and muscles fall on the height column, i.e. when the difference is zero, the mesomorphy rating is

assigned as. If the average columns falls on the right of the height column, then the same number
of columns and fractions is moved to the right of 4 in the row of second component and if the

average column is towards the left of the height column then the same number of columns are

moved to the left of the columns of 4. If it lies exactly in the middle of the two ratings, then circle

the value closer to 4 on the scale. For example, if the point lies in the middle of the two ratings of

3 and 3.5, a rating of 3.5 is assigned (3.5 is closer to 4) and if the point lies in the middle of the

ratings 5 and 5.5, then a rating of 5 is assigned (5 being closer to 4)

An alternative procedure for mesomorphy calculation

The easiest way to calculate the mesomorphy rating is as given below. The circled height

column is taken as the standard or zero column and the deviations of bone diameters and muscle

girths from this column are noted. The difference of the columns which lie on the left side of the

height column be written with a negative sign and the difference of those on the right side of

height column with a positive sign. Then the algebraic sum of the four values is taken and written

as D alone with the negative or positive sign. The average deviation is calculated by dividing it by

4 and then 2 (i.e. divide by 8) to convert to component units.

The mesomorphy rating can then be directly calculated using the following formula:

Mesomorphy (second component) = (D/8) = 4.0

Where D is the algebraic sum of columns as described above.

Ex. 6.2 Calculate mesomorphy from the table of height, humerus biepicondylar, femur

biepicondylar, corrected arm and calf girths are 142.0 cm, 5.5cm, 8.3cm, 27.0cm and 32.1 cm,

respectively.

The deviations of bone diameters and muscle girths from the height column are noted. The

deviations are +1 for humerus biepicondylar,

+3 for femur biepicondylar,

+4 for biceps muscle girth and

+5 for calf muscles girth.

The algebraic sum of the deviations or D = 1+3+4+5=13

 Mesomorphy = (D/8) +4.0

= (13/8) +4.0

=5.63

Another way of calculating mesomorphy

With the following equation of Carter (1980) exact decimal rating mesomorphy can be easily

obtained from the measurements directly.

Mesomorphy= (0.858 x humerus width) + (0.601 x femur width) + (0.188 x corrected arm

girth) + (0.161 x corrected calf girth) – (height x 0.131) + 4.50

Here, corrected arm girth is taken as the upper arm girth when biceps muscles are fully flexed and

then subtracting triceps skinfold from it. Similarly corrected calf girth is calculated by

subtracting calf skinfold from calf girth.

Ex.6.3 Calculate mesomorphy rating if values of height, humerus biepicondylar, femur

biepicondylar, corrected arm girth and calf girths are 142.0 cm, 5.5cm, 8.3cm, 27.0cm and 32.1

cm, respectively

Mesomorphy = (0.858 x 5.5 + 0.601 x 8.3 + 0.188 x 27.0 + 0.161 x 32.1) – (142.0 x 0.131) +

4.50

= 5.85

There is some difference in the mesomorphy estimate by the above two methods (5.63 vs 5.85).

The equation is very precise in its calculation because every millimetre is accounted for.

However, in case of use of the table for calculation, lot of approximation is to be made for

knowing the deviation of a measurement.

6.3.3 Third Component or Ectomorphy Rating.

Height Weight Ratio (HWR) is calculated as follows:

HWR = height/ (weight)1/3. Circle the closest value in the height weight ratio scale meant for

determining ectomorphy. Assign the ectomorphy rating which falls below the column in which

height weight ratio is circled.

Ex. 6.4 Calculate the HWR if weight= 40.0 kg and height = 142.0 cm

HWR = 142/(40.0) 1/3

=41.52

A rating of 2 of ectomorphy will be assigned from the table.

The calculation of height-weight ratio (height/weight1/3) is quite difficult. It can be made easy

by consulting Appendix I, in which, 1/cube root of weight values are provided. Check the value

of this factor from the table for the given weight and multiply it with the height of the subject to

obtain this ratio as follows:

Ex. 6.5 Calculate HWR using Appendix I for values of 1/cuberoot of weight

Weight = 40.0kg, height = 142.0 cm

HWR = 142.0 x 0.2924

= 41.52

Ectomorphy rating can be directly calculated from height weight ratios employing the

following equation of Carter (1980):

Ectomorphy = HWR x 0.732 – 28.58

If HWR <40.75 but >38.25, then

Ectomorphy = HWR x 0.463- 17.63

If HWR <38.25, a rating of 0.1 is to be assigned.

Ex. 6.6 Calculate the ectomorphy rating if height and weight are 40 kg and 142 cm, respectively

HWR = 41.52

Ectomorphy = 41.52 x 0.732 – 28.58

= 1.81

One rating form is required to obtain somatotype on one subject; however, if the forms are in

short supply then all the subjects in a sample can also be somatotyped using a single rating form,

simply by nothing down the steps on a plain paper without marking anything on the rating form.

Table 6.3 provides information about the possible somatotypes available at a given ratio of
height/weight1/3

Insert table 6.3 somewhere here

6.3.4 Somatochart and Somatoplot

Sheldon used a somatotype triangle to represent individual somatotypes in it. The

somatotype triangle has all the three sides of equal length and is arc-shaped. The corners of the

triangle represent the extremes in each component. The left corner at the base of the triangle

represents extreme in endomorphy, the right corner at the base represents extreme in ectomorphy

and the top corner represents extreme in mesomorphy. The somatotypes can be plotted on the

somatotype triangle as dots whose visual inspection can be very useful in interpreting the

somatotypes.

Heath & Carter (1967) and Carter (1975) utilised the same concept and triangle to design the

somatochart (somatotype chart) - A typical somatochart has been displayed in Fig.6.1 where the

individual somatotypes can be plotted which are called somatoplots.

Insert Fig. 6.1 somewhere here

` The somatotypes can be divided into following categories depending upon the position of the

somatotypes on the somatochart (Fig. 6.2).

Insert Fig. 6.2 somewhere here

 Balanced endomorph- The first component dominates over second and third which are

either equal or differ by not more than 0.5 units (5-3-3, 5-3-2.5, 5-2.5-3).
 Balanced mesomorph- Second component dominates over the first and third components

which are either equal or differ by not more than 0.5 units (3-5-3, 2.5-5-3, and 3-5-2.5).

 Balanced ectomorph- Third component dominates, first and second are either equal or

differ by not more than 0.5 units (3-3-5, 3-2.5-5, and 2.5-3-5).

 Mesomorph- endomorph- First and second components either equal or differ no more

than 0.5 units and dominate over third component (5-5-3, 4.5-5-3,-4.5-3).

 Mesomorph- ectomorph- Second and third components either equal or differ no more

than 0.5 units and dominate over the first component (3-5-5, 3-5-4.5, 3-4.5-5).

 Endomorph –ectomorph- First and third components either equal or differ no more than

0.5 units and dominate over second component (5-3-5, 4.5-3-5, 5-3-4.5).

 Mesomorphic endomorph- First component greater than second and the third is the

smallest (5-3-2, 5-4-2).

 Ectomorphic endomorph-First component greater than the third and the second is the

smallest (5-2-3).

 Endomorphic mesomorph- Second component greater than first whereas the third is the

smallest (3-5-2).

 Ectomorphic mesomorph –Second component greater than third and the first is the

smallest (2-5-3).

 Endomorphic ectomorph- Third component dominates over first and the second is the

smallest (3-2-5).

 Mesomorphic ectomorph- Third component greater than second and the first is the

smallest (2-3-5).

 Central- All components are either equal or differ no more than one unit from the other

two, the ratings of all components should be within and consist of ratings of 2,3or 4 (3-3-

3,4-4-4,3.5-4-4,4-3.5-4,4-4-3.5,3.5-4-3.5).
 In the somatochart, distribution of possible somatotypes is displayed and is easy to locate.

Mostly when the somatotypes are in whole units, there is no problem in finding the suitable point

for plotting on the somatochart. Sometimes the difficulty arises when the values cannot be easily

located on the somatochart. This problem is solved by an availability of a superimposed grid on

the somatochart showing scales on X-axis and the Y-axis. A typical grid showing the scales on

both the axes can be seen in Fig. 6.3.

Insert Fig. 6.3 somewhere here

The ratings of the three components are first resolved into the values of X and Y in the following

manner:

X = Ectomorphy – Endomorphy

Y = 2 x Mesomorphy – (Endomorphy + Ectomorphy).

Ex. 6.7 To calculate the X and Y values of the somatotype 6–3.5–2

X = 2 – 6 = –4

Y = 2 x 3.5 – (6+2) = 7 – 8 = –1.

A point which corresponds to – 4 on the X axis and – 1 on the Y axis can very easily be

located and plotted.

6.3. 5 Somatotype Distributions

The somatoplots can be visually inspected in order to take stock of the type of distribution

they have on the somatochart. The three components of physique can be independently analysed

but it is not advisable because it isolates one component from the others. If seen in isolation the

dominance of one component on another cannot be taken care of which is very important in

understanding the somatotypes. The somatoplot is a good graphic representation because the

three components together determine the point so it is an integrated representation.

Rose and Wilson (1974) presented formulae to calculate the distance between any two
somatoplots and the dispersion around the mean somatoplot (or somatotype). The ‘somatotype

dispersion distance’ (SDD) is the distance between any two somatoplots having the scalar

coordinates X and Y as (X1, Y1) and (X2, Y2).

SDD = [3(X1 – X2)2 + (Y1 – (Y2)2]0.5

The SDD is represented in Y distance units.

The ‘somatotype dispersion mean’ (SDM) is the average of all the somatotype dispersion

distances. In the earlier studies it has been called the somatotype dispersion index (SDI). So, these

two expressions of SDI and SDM have been used synonymously, how-ever, it is better to use

SDM.

SDM = SDD/N

The SDD is ideal in comparing two mean somatotypes whereas SDM is useful in knowing

about the distributions of somatotypes in a group from its mean somatotype.

Ex. 6.8 Calculate the SDD between 6-3-2 and 2-5-4 somatoplots.

For somatoplot 6 –3 – 2 X1 = 2 – 6 = – 4

Y1 = 2 x 3 – (2+6) = – 2

For somatoplot 2 – 5 –4 X2 = 4 – 2 = 2

Y2 = 2 x 5 – (2+ 4) = 4

SDD = [3 (X1 – X2)2 + (Y1 – Y2)2] 0.5

= [3 (–6)2 + (–6) 2]0.5

= 12.0

Ex. 6.9 Calculate the mean somatotype of the following 5 somatotypes and then calculate the

SDD (Somatotype Dispersion Distance) of each somatotype from the mean somatotype and also

calculate the Somatotype Dispersion Mean (SDM).

Sr No. Somatotype (X, Y) SDD

 1. 2–4–4 (2, 2) 2.69

2. 3–2–5 (2, –4) 3.47

3. 5–5–3 (– 2, 2) 6.76

4. 2.5 – 3 – 5 (2.5, - 1.5) 1.80

5. 2 – 3 – 5.5 (3.5, - 1.5) 3.41

Mean 2.9 - 3.4 - 4.5 (1.6,-0.6)

SDM 3.63

It has been a practice to use two dimensional somatochart for plotting the somatotypes. But now-

a-days, assigning the position in a three-dimensional system has also been recommended by Ross

and Wilson (1973), Duquet and Hebbelinck (1977), Carter et al. (1983). The somatotype can be

represented conceptually in a three dimensional space called a somatopoint. The three axes x, y,

z, originate at a point with a theoretical somatotype of 0-0-0 ant these are at right angles to each

other. Fig. 6.4 shows a typical three dimensional graphic representation of somatotype.

Insert Fig. 6.4 somewhere here

The somatotype analyses in three dimensional representations are different. In three

dimensions, the distance between any two somatopoints is called ‘somatotype attitudinal

distance’ (SAD) and is calculated in the original units of the components and not in Y-units as

has been calculated for the somatotype dispersion distance in two dimensions.

SAD = (I A-IB)2 + (II A-IIB)2 +(III A-IIIB)2

where I is the first component

II is the second component

 III is the third component

A and B are two somatotypes

The ‘somatotype attitudinal mean’ (SAM) is the average of somatotype attitudinal distances

(SADs) of each somatopoint from the mean somatopoint and is represented as follows:

SAM = SAD/n

Ex. 6.10 Calculate the mean somatotype of the following 5 somatotypes and then calculate the

SAD (Somatotype Attitudinal Distance) of each somatotype from the mean somatotype and also

calculate the Somatotype Attitudinal Mean (SAM).

Sr No. Somatotype SAD

1. 2–4–4 1.19

2. 3–2–5 1.49

3. 5–5–3 3.04

4. 2.5 – 3 – 5 0.75

5. 2 – 3 – 5.5 1.40

Mean 2.9 - 3.4 - 4.5

SAM 1.58

Longitudinal follow up of the subjects for somatotypes provides information about the pattern of

change of somatotype or its stability. The stability9of a somatotype can be measured in terms of
the distance covered by the somatotype, direction of this change and reversals of the dominance

of components. According to Carter et al. (1983) the intensity (INT) of a somatotype is the

magnitude of the vector from the origin (hypothetical somatotype of 0-0-0 to the somatopoint in

three dimensions).

INTp = SADo,p

Where intensity of a somatotype p is equal to the magnitude of the SAD from the origin o to p.

Ex: Calculate the intensity of the somatotype 5-3-2.

INT5-3-2 = SAD 000, 532

INT 5-3-2 = [(5-0)2 + (3-0)2 + (2-0)2]0.5= 6.16

Intensity of a somatotype defines the distance of the somatotype from the origin of X, Y, Z

coordinates in three dimensions. It has a special application in children and in growth studies

where it can be made out in which direction the somatotypes are moving, i.e. towards or away

from the origin. There is no change in intensity if the values of components are similar but

interchanged, e.g. 5-3-2 or 3-5-2 will have the same intensity. The intensity is expressed in

component units.

The sum of various somatotype attitudinal distances (SADs) obtained at different times in

one's life is called the migratory distance (MD) (Carter et al. 1983) and can be expressed as

follows where there are four intervals when somatotypes were taken in an individual’s life :

MDP1P4 = SADP1P2 + SAD P2P3 + SAD P3P4

E. 6.11: Calculate the migratory distance (MD) between somatotypes taken at four

occasions in a person be as follows ;

P1 = 5-3-2

P2 = 3-5-2

P3= 4-3-2

P4 = 3-4-2
SADP1P2 = [(5–3)2 + (3–5)2 + (2–2)2]0.5= 2.83

SADP2P3 = [(4–3)2 + (5–3)2 + (2–2)2]0.5= 2.24

SADP3P4 = [(4–3)2 + (4–3)2 + (2–2)2]0.5= 1.41

MDP1P2P3P4 = 2.83 + 2.24 + 1.41 = 6.48

The migratory distance takes into account the whole of the pathway along which the subject's

somatotype has been developing, thus every change in somatotype at any given time in one's life

can be accounted.

Carter et al. (1983) gave formulae to compare the somatotype attitudinal distances or

somatotype attitudinal means between different groups or individuals. Cressie et al.(1986),

however, demonstrated that the recommended ANOVA test to find out statistical differenc3es

was not based on sound theoretical footing. The problem concerns the premature collapsing of the

three component somatotype vectors into a scalar SAD value along with the use of inappropriate

degrees of freedom for the F-Ratio. They recommended a one-way MANOVA, which according

to them is a powerful tool to explore statistical differences under the given situations.

6.3.6 Somatotyping Children

One of the major applications of somatotyping is to explore age changes in the individual

physiques. How the physique of an infant or child is transformed into that of an adult? Which

component registers major changes on the trajectory to adulthood and which component

dominates over others at what ages? The rating form earlier used can assess the endomorphy and

ectomorphy ratings in children; however, the mesomorphy cannot be assessed from that. It must

be noted that in children, the sum of the skinfolds must be corrected for height before assigning

the endomorphy ratings the reason is that the scale for endomorphy can be made to conform to a

universal mean height of 170.18 cm. In cases where the height of the subject is significantly

smaller as is the case in children, this correction would adjust the sum of skinfolds in such a way

so as the height of the subject would be projected to the universal average height (Corrected sum
of skinfolds=sum of 3 skinfolds x 170.18/height of subject).

An extended scale for assigning mesomorphy to children is available in Table 6.4. This scale

has been developed with the help of the computer by Carter (1975). The minimum values for

diameter, corrected biceps and calf muscle girths are 78.7 cm, 2.87 cm, 4.09cm, 13.1 cm and 15.3

cm, respectively and extend up to the maximum values of 280.7 cm, 10.59 cm, 15.10 cm, 48.3 cm

and 56.5 cm, respectively. So, the scale is so designed as to include almost everybody from the

small child to a huge Herculean man.

Since the scale is vertically designed, so while using this scale, the interpretation of rows

and columns be interchanged for assigning mesomorphy ratings.

According to Carter (1975) the somatotypes of children above 10 years of age can reasonably

be assessed whereas before 10 years, it may be questionable, and there is a need to combine the

photoscopic somatotypes with anthropometric somatotypes in order to obtain the real

somatotypes. The errors in assessing the somatotypes in small children may be because of a large

proportion of their bones being cartilaginous, varying degrees of compressibility of the

subcutaneous fatty tissue and the small size of the subjects. Table 6.4 represents extended Heath-

Carter scale for mesomorphy calculation.

Insert table 6.4 somewhere here

This scale can be linearly extended on either direction depending on the need. The extended

Heath-Carter scale for calculating second component or mesomorphy is constructed in the

following manner:

X = (Column height/ 177.8) Y

Where Y = 6.80 cm for humerus biepicondylar width

= 9.70 cm femur biepicondylar width

 = 31.0 cm for corrected biceps girth

= 36.3 cm fro corrected calf girth

Example: For the height column of 90.2 cm, various values would be as follows:

Humerus biepicondylar = (90.2/177.8) X 6.80= 3.45 cm

Femur biepicondylar = (90.2/177.8) X 9.70= 4.92 cm

Biceps = (90.2/177.8) X 31.0= 15.73 cm

Calf = (90.2/177.8) X 36.3 = 18.4 cm

These values of various measurements are approximated to height column which is one

column higher for constructing the scale for mesomorphy, i.e., these values should correspond to

a height value of 94.0 cm instead of 90.2 cm. Similarly other values can be generated for

completing the table.

6.3.7 Critical Evaluation of Heath-Carter Anthropometric Somatotype Method

 The most outstanding aspect of this method is its objectivity. However, the results

depend largely on how accurately the measurements are taken. Whatever is the

reason of inter and intra observer variations in taking measurements, the onus of

responsibility falls on the measurer rather than the method. Any two raters if

supplied with the same body measurements will calculate the same somatotype.

 It is an excellent tool to explore spatial-temporal variations in human body form, i.e.

age changes in body form of an individual as well as differences between individuals

ca be evaluated which can find its utility in various scientific disciplines.

 It is an easy, accurate and efficient method of somatotyping.

 Since there is no need to undress fully for taking the measurements, therefore more

hesitant groups can be accessible for somatotyping.

 It is suitable both in the field as well as in the laboratory whereas the somatotyping

with the Sheldon's method would have been almost impossible in most of the cases.
  The female groups can also be easily somatotyped whereas the somatotyping with

the Sheldon's method would have been almost impossible in most of the cases.

Since the Heath-Carter method provides a phenotypic expression of human physique at the

time of measurement and it may change with age and exercise, therefore it is useful in monitoring

the effects of physical exercise and nutritional regulations on somatotype. It is finding its

application in sport where the counselling to children can be provided to which sports they are

well suited by comparing their physiques with the most desirable ones at that age.

An easy step-by-step procedure to obtain somatotype with the help of somatotype rating form

has been given below for the help of readers.

Chapter 6 Exercises

Ex. 6.1. Calculate the corrected sum of skinfolds and endomorphy with height correction with
equations given by Carter with the help of equation in the following
a. sum of triceps, subscapular and supraspinale skinfolds, 67 mm, height 178 cm
b. sum of triceps, subscapular and supraspinale skinfolds, 5.2 cm, height 168 cm
c. sum of triceps, subscapular and supraspinale skinfolds, 55 mm, height 173 cm
d. sum of triceps, subscapular and supraspinale skinfolds, 7.8 cm, height 182 cm
e. sum of triceps, subscapular and supraspinale skinfolds, 77 mm, height 170 cm

Ex. 6.2 Calculate mesomorphy rating if values of

height, humerus biepicondylar, femur biepicondylar, corrected arm girth and calf respectively are as
follows:
a. 178 cm, 5.8 cm, 9.3 cm, 28.1 cm, 33.7 cm
b. 145 cm, 5.4 cm, 8.6 cm, 22 cm, 28 cm
c. 167 cm, 5.8 cm, 9.1 cm, 27.3 cm, 31.2 cm
d. 175 cm, 5.9 cm, 8.8 cm, 27.6 cm, 32.5 cm
e. 180 cm, 6.2 cm, 9.3 cm, 30.2 cm, 34.1 cm

Ex. 6.3 Calculate the HWR and ectomorphy rating in the following
a. Height 177 cm weight 75 kg
b. Height 181 cm weight 86 kg
c. Height 172 cm weight 73 kg
d. Height 174 cm weight 76 kg
e. Height 162 cm weight 66 kg

Ex. 6.4. If HWR is <38.25, what ectomorphy rating is assigned to the individual?

Ex. 6.5. Calculate the values of X and Y of the following somatotypes

a. 337
b. 463
c. 128
d. 732
e. 471
f. 444
g. 242
h. 633
i. 532
j. 145

Ex. 6.6 : Calculate the mean somatotype of the following 5 somatotypes and calculate the SDD
(Somatotype Dispersion Distance) of each somatotype from the mean somatotype and also calculate the
Somatotype Dispersion Mean (SDM).
a. 554
b. 362
c. 635
d. 351
e. 515

Ex. 6.7 Calculate the mean somatotype of the 5 somatotypes given in exercise no. 6 and calculate the
SAD (Somatotype Attitudinal Distance) of each somatotype from the mean somatotype and also calculate
the Somatotype Attitudinal Mean (SDM).

Ex. 6.8 : Calculate the somatotype attitudinal distances between the respective somatotypes and
calculate the migratory distance (MD) between the somatotypes taken at five occasions in a
person’s life as follows:
a. 345
b. 514
c. 445
d. 354
e. 554
Chapter 6 Answers

Ans. 6.1. Corrected sum of skinfolds and endomorphy ratings, respectively are:
a. 64.0 mm, 6.154
b. 52.67 mm, 5.242
c. 54.10 mm, 5.363
d. 72.93mm, 6.790
e. 77.08 mm, 7.067

Ans. 6.2.
a. 2.4562
b. 3.9508
c. 3.2241
d. 2.3473
e. 2.9966

Ans. 6.3.
a. 41.971 2.14
b. 41.005 1.44
c. 41.154 1.55
d. 41.078 1.49
e. 42.343 2.42

Ans. 6. 4. A rating of 0.1 is assigned.

Ans. 6.5.
a. X = 4 Y = -4
b. X = -1 Y= 5
c. X = 7 Y = -5
d. X = -5 Y = -3
e. X = -3 Y= 9
f. X = 0 Y= 0
g. X = 0 Y= 4
h. X = -3 Y = -3
i. X = -3 Y = -1
j. X = 4 Y= 2

Ans. 6.6
Mean somatotype = 4.4 – 4 – 3.4
SDD:
a. 0.8
b. 6.8
c. 5.2
d. 6.05
e. 8.38

SDM = 5.45

Ans. 6.7
Mean somatotype = 4.4 – 4 – 3.4
a. 1.31
b. 2.81
c. 2.47
d. 2.95
e. 3.45

Somatotype Attitudinal Mean (SDM) = 2.60

Ans. 6.8.
SADa,b 3.74
SADb,c 3.31
SADc,d 1.73
SADd,e 2.00

Migratory Distance (MD) = 10.78

Table 6.3 : Distribution of somatotypes according to HWR (height/ cube root of weight) for all
ages.
HWR
Somatotypes
Metric Imperial
Units Units
37.60 11.40 9-5-1
38.3 11.60 9-4-1 8-5-1
38.94 11.80 8-4-1 7-5-1
4-8-1
39.6 12.00 7-4-1 4-7-1
6-5-1 5-6-1
40.26 12.20 7-3-1 3-7-1
6-4-1 4-6-1 5-5-1
40.92 12.40 7-2-1 2-7-1 7-3-2 3-7-2
*3-6-1 6-3-1 6-4-2 4-6-2
5-4-1 4-5-1 5-5-2
7-1-1 1-7-1 *3-6-2 5-4-2
41.58 12.60 *2-6-1 6-2-1 4-5-2 7-2-2
2-7-2 6-3-2
7-1-2 1-7-2 6-3-3 3-6-3
42.24 12.80 6—2-2 5-3-2 5-4-3 4-5-3
*3-5-2 4-4-2
*2-6-2
42.90 13.00 6-1-2 1-6-2 *2-6-3 6-2-3
*2-5-2 5-2-2 *3-5-3 5-3-3
43.56 13.20 *2-5-3 5-2-3 *4-4-4
*4-3-3 6-1-3 5-3-4 3-5-4
 *3-4-3 1-6-3
44.22 13.40 *2-5-4 5-2-4
6-1-4 4-3-4
*3-4-4
44.88 13.60 4-2-4 3-3-4 *3-4-5
5-1-4 1-5-4 5-2-5 4-3-5
2-4-4
45.54 13.80 3-3-5 2-4-5
4-2-5 5-1-5
46.20 14.00 1-4-5 4-1-5 3-3-6 4-2-6
46.86 14.20 2-2-5 2-3-6 3-2-6
4-1-6
47.52 14.40 3-1-6 1-3-6
2-2-6 3-2-7
48.18 14.60 1-2-6 2-1-6 2-2-7 3-1-7
48.84 14.80 1-2-7 2-1-7
49.50 15.00 1-1-7
Adapted from Heath (1963)
* These somatotypes are in the same locations as in Sheldon’s (1940) table.

Table 6.4 An Extended Scale of the Second Components (Mesomorphy)

Corrected Corrected Calf
Height (in) Height (cm) Humerus(cm) Femur (cm)
Biceps(cm) (cm)
110.5 280.7 10.59 15.10 48.3 56.5
109.0 276.9 10.44 14.90 47.6 55.7
107.5 273.0 10.33 14.69 46.9 55.0
106.0 269.2 10.15 14.48 46.3 54.2
104.5 265.4 10.01 14.27 45.6 53.4
103.0 261.6 9.89 14.06 44.9 52.6
101.5 257.8 9.71 13.86 44.3 51.9
100.0 254.0 9.57 13.65 43.6 51.1
98.5 250.2 9.42 13.44 43.0 50.3
97.0 246.4 9.28 13.23 42.3 49.5
95.5 242.6 9.13 13.03 41.6 48.7
94.0 238.8 8.99 12.82 41.0 48.0
92.5 234.9 8.84 12.61 40.3 47.2
91.0 231.1 8.69 12.40 39.6 46.4
89.5 227.3 8.55 12.19 39.0 45.6
88.0 223.5 8.40 11.99 38.3 44.9
86.5 219.7 8.26 11.78 37.6 44.1
85.0 215.9 8.11 11.57 37.0 43.3
83.5 212.1 7.97 11.36 36.3 42.5
82.0 208.3 7.82 11.16 35.6 41.7
80.5 204.5 7.67 10.95 35.0 41.0
79.0 200.7 7.53 10.74 34.3 40.2
77.5 196.9 7.38 10.53 33.7 39.4
76.0 193.0 7.24 10.32 33.0 38.6
74.5 189.2 7.09 10.12 32.3 37.9
73.0 185.4 6.95 9.91 31.7 37.1
71.5 181.6 6.80 9.70 31.0 36.3
70.0 177.8 6.65 9.49 30.3 35.5
68.5 174.0 6.51 9.28 29.7 34.7
67.0 170.2 6.36 9.08 29.0 37.0
65.5 166.4 6.22 8.87 28.3 33.2
64.0 162.6 6.07 8.66 27.7 32.4
62.5 158.8 5.93 8.45 27.0 31.6
61.0 154.9 5.78 8.24 26.3 30.9
59.5 151.1 5.63 8.04 25.7 30.1
58.0 147.3 5.49 7.83 25.0 29.3
56.5 143.5 5.34 7.62 24.4 28.5
55.0 139.7 5.20 7.41 23.7 27.7
53.5 135.9 5.05 7.21 23.0 27.0
52.0 132.1 4.91 7.00 22.4 26.2
50.5 128.3 4.76 6.79 21.7 25.4
49.0 124.5 4.61 6.58 21.0 24.6
47.5 120.7 4.47 6.37 20.4 23.9
46.0 116.8 4.32 6.17 19.7 23.1
44.5 113.0 4.18 5.96 19.0 22.3
43.0 109.2 4.03 5.75 18.4 21.5
41.5 105.4 3.89 5.54 17.7 20.7
40.0 101.6 3.74 5.33 17.1 20.0
38.5 97.8 3.59 5.13 16.4 19.2
37.0 94.0 3.45 4.92 15.7 18.4
35.5 90.2 3.30 4.71 15.1 17.6
34.0 86.4 3.16 4.50 14.4 16.9
32.5 82.6 3.01 4.30 13.7 16.1
31.0 78.7 2.87 4.09 13.1 15.3
7. Anthropometry and Nutritional Status

Chapter details

The World Food Scenario

Anthropometry and Economic Development
Energy Homeostasis
Pregnant Mother and the Newborn
Anthropometric Indicators of Nutritional Status

The World Health Organization lays a lot of emphasis on anthropometry in finding out low birth

weight newborns and those children who are stunted, wasted and under weight. In its latest report

on low birth weight newborns it has claimed that out of the total newborns of the world during

2000-2002, as many as 16% are low birth weight babies (WHO 2008). In India, there are 30%

low birth weight newborns during the same period which is roughly double the global figures. In

this context, only two countries, namely Sudan and Yemen have reported higher figures of low

birth weight new born than those of India. The regional statistics on low birth weight new born

indicate that the south east Asia as the most vulnerable region of the world with a figure of 26%.

Even the African region with 14% of low birth weight newborns is left far behind the south east

Asian region. The low birth weight baby is defined as any child born with less than 2500 grams

of weight irrespective of the gestation period. Low birth weight mostly is a consequence of the

mother’s nutrition and her health. India has to do a lot of spadework in this respect. It has to

enlighten the prospective mothers to take good and nutritious food throughout the period of

pregnancy and also during lactation. As a long term approach, the girls must also be taken care of

their nutritional needs because they have to bear children when they become adults. The

proportion of stunted children below the age of 5 years in India during the decade of 1990-1999

was 51.0% which however reduced slightly to 47.9% during 2000-2002. On the other hand, the
proportion of underweight children during 1990-1999 and 2000-2002 was 44.4% and 43.5%,

respectively. These data indicate that though lot has been done to improve the situation of

newborn and young children yet it is far from satisfactory.

7.1 The World Food Scenario

There has been enough food available in whole of the world and if distributed evenly there can’t

be any malnutrition for want of food. According to the World Health Organization estimates, total

food availability for the world as a whole during 1961-63 was 2300 calories per person. This

increased to 2720 calories during 1990-92. Regional availability has also increased except for

sub-Saharan Africa. The projected estimates for 2010 even for developing countries stand at a

reasonably good estimates of 2730 calories per capita (WHO 1997). These average rosy figures

rather hide a dismal and gloomy global nutritional picture. The number of malnourished and

food-insecure individuals on the globe is alarming. Those who can not meet their daily needs of

calories and proteins figure beyond 800 million. Besides, more than 3 billion individuals are

deficient in micronutrients such as vitamin A, iron and iodine. Poverty and illiteracy have been

the major factors responsible for malnutrition. However, both of them can be handled with

appropriate social action and a strong will of the governments. The socialist countries have

demonstrated this by eradicating at least these two factors with grit and determination improving

the health and nutrition of its population.

Natural and man made calamities bring with them unforeseen aguish and misery. Food

scarcity and shortage usually occurs during these events. Acute malnutrition occurs in emergency

situations such as drought, warfare and mass migration of populations. The newspapers carry

unpleasant details of poverty, squalor and malnutrition in areas under drought, in countries

engaged in armed conflicts and situations of mass migration of populations as has happened

during 1947 when partition of India and Pakistan took place and millions of people lost their

homes and had to start afresh. Over-nutrition occurs in many situations of new found richness, in
fast growing economies, as a result of acculturation, green revolution, etc. Expanding technology

and modernization brings with it new values, new foods, new directions, social freedom and

thrilling ways of enjoying life, which naturally had to take its toll in the form of over-nutrition

and obesity in its initial phases. While acute under-nutrition brings with it lower levels of health

and susceptibility to infections the over-nutrition and obesity are generally inviting diseases like

non-insulin dependent diabetes mellitus, hypertension and cardiovascular disease.

Nutrition is the foremost need and is absolutely essential for a perfectly healthy child

whose growth and development is thus guaranteed. Inadequacies in diet in a child would result in

a sub-maximal level of work capacity and stunted growth, lowering of mental faculties and

increased risk of mortality and morbidity. This is of paramount importance for the development

of a healthy adult having optimal working capacity and normal reproductive performance. Such a

person can lead happy life as he is protected from the infections by virtue of his healthy immune

system. Insufficient diet results in two types of metabolic nutritional disorders: protein-energy

malnutrition (PEM) and micronutrient disorders (deficiencies). Long term inadequate food

consumption cannot meet the daily energy requirements and results in thinness in adults and

stunting in children. When there is a sudden and severe drop in food consumption, acute

malnutrition in the form of wasting occurs. These two forms of nutritional deficiencies are called

chronic under-nutrition. Its causes include recurrent infections and unavailability of sufficient

food or access to food, inadequate care of mothers and children.

Protein energy malnutrition is less severe than the prevalence of micronutrient

malnutrition. Iron deficiency is most prevalent in pregnant and lactating women and young

children under 5 years of age who are most vulnerable sections of society. This is assessed from

serum ferritin levels and is about twice as common as anemia which is a late sign. On a global

level, 3.6 billion people are iron-deficient and about 2 billion are anaemic and this is an alarming

situation keeping in mind the data on food which indicates reasonable sufficiecy (Table 7.1).
 Insert Table 7.1 somewhere here

Children can be affected even with mild form of anemia and their intellectual development takes

a big hit. Such children are hampered in their physical growth and in recreational and exploratory

activities. However, iron deficiency is easy to correct by a combination of iron supplementation,

iron fortification and dietary improvement. Iodine deficiency is an important situation to be

tackled. Constant iodine intakes less than 150 g per person per day over a long period produces

goiter and other metabolic disorders. Iodine deficiency causes the enlargement of thyroid and also

brain damage to the foetus and the infant. It results in cretinism in severe cases with mental

retardation. Cretin children are retarded in their growth and remain much shorter than their

normal peer. Iodine deficiency is spread in 118 countries affecting 760 million people. Iodine

fortification in common salt has worked as a panacea in case of goiter and the world scenario is

likely to present a happy situation in the near future. Imagine roughly 8 -10 % of the world

population suffers from iodine deficiency. The health authorities are eagerly awaiting the

amelioration of the iodine deficiency situation with widespread use of the iodized salt.

Breast fed children are generally protected from Vitamin A deficiency which occurs

when breast-feeding is reduced, or when food intake of dark green leafy vegetables, orange-

colored vegetables and fruits is low. Night blindness and eventual blinding conditions are caused

by the deficiency of Vitamin A. An alarming number of 258 million people are affected with

Vitamin A deficiency and the highest prevalence occurs in South-East Asia. Dietary

improvements and fortification of fats and sugars with Vitamin A and its supplementation are

required to eliminate this deficiency.

Other deficiencies prevalent around the world include rickets scurvy, beri beri and

pellagra. Rickets in young children and osteomalacia in adults results from the deficiency of

Vitamin D in diet and inadequate exposure to the sun rays. . Asia and Africa have a widespread
prevalence of this deficiency besides scurvy, beri beri and pellagra, which are due to the

deficiency of ascorbic acid, thiamine and niacin, respectively. But now the world health

organization implements special programmes where the proper nutritional education is provide to

the expectant mothers and along with suitable supplementation and fortification of the food.

A clean environment is absolutely necessary for a healthy living. Home and shelter

comes on the top of the list of basic necessities of human beings. The natural environment of the

world has undergone massive deterioration because of large scale pollution of soil, water and air.

The number of homeless individuals at present is roughly one billion which includes those living

in refugee camps, insecure and temporary accommodations. Another one billion of the global

population is devoid of any water supplies. In India, there are vast areas where even safe drinking

water is not available. About 600 million people worldwide live in shanty dwellings and life

threatening homes. The situation of air pollution has reached such a pass that about 3 million

deaths are accountable to it annually. Besides this, heart failure, asthma and other cardiovascular

diseases are also attributed to air pollution by carbon monoxide, sulfur dioxide, etc. The radiation

hazards of man-made nuclear reactors have been projected to be horrifying keeping in mind the

Hiroshima-Nagasaki episodes of World War II and the recent Chernobyl disaster. A large number

of children have suffered from thyroid cancer in Belarus and Ukraine after the Chernobyl

incident. About 500 million people are being exposed to pesticides directly or indirectly as a

result of agriculture spraying. The pollution of water and food with pesticides and chemicals is

increasing the risks of cancers, and ill health and also affecting the growth and development of

children. Food insecurity, homelessness, lack of safe drinking water and polluted air are

becoming the hallmarks of the environment of third world countries of Asia, Latin America and

Africa. There is widespread malnutrition, impairment of physical and intellectual development,

diminished working capacity and sub-optimal health of the residents of these continents. There

seems to be a clear relationship of the undesirable factors listed above with the lowered health

status of these populations. Anthropometry is emerging as an important indicator to evaluate the

physical status of individuals and populations which in turn highlights the nutritional status of the

populations and the history of their economic development.

7.2 Anthropometry and Economic Development

The mean heights of populations tell an interesting story about the history of their

economic development. These can be used as proxy measures for the living standards of the

people. Data on heights and weights has illuminated the relationship between industrialization

and demographic processes and the role played by food consumption in the industrial revolution

(Komlos 1994). The nutritional status of a population undoubtedly is influenced by the food

intake which consequently depends on the family income and the price of food. Some economists

including Steckel (1991) and Steckel and Haurin (1994) have found a positive correlation

between height and income in many populations. This indicates that the greater the income the

taller the heights of the populations. It seems imperative to quote Tanner (1994) who generalizes

that

“the variation between the heights of individuals within a subpopulation is indeed largely

dependent on differences in their genetic endowment; but the variation between the means of

groups of individuals (at least within an ethnically homogeneous population) reflects the

cumulative nutritional, hygienic, disease and stress experience of each of the groups”.

While addressing the question whether height be regarded as an index of well-being superior to

the other measures, Engerman (1994) opined, that modern living style is neither a pointer towards

maximizing life expectancy (prevalence of risk taking) nor increased per capita income leads to

increased nutrition (at least in rapidly changing societies) maximizing individual heights. Thus

the linkage between the income and the heights are not as simple as it seems to be. Numerous

other factors like the levels of modernization, urbanization and the indicators of the clean

environment also contribute a lot towards the dynamics of heights of the populations.
 The natives of Africa were brought to the United States of America for farm work. It is a

harsh reality that they were forced to work as slaves. Steckel (1979) and Eltis (1982) conducted

some studies and found that the nutritional status of adult American slaves was relatively high

than their compatriots left behind in Africa. The African Americans were also found to be taller

than the latter. It reflects that even the most disadvantaged members of American society

benefited to some extent from the resource abundance of the affluent America. The environment

of America has also been relatively favorable and disease free but may be a little less favorable

than their masters. Not only this fact of Africans being taller who migrated to America than their

native counterparts was true but was found similar in case of Europeans also. Sokoloff and

Villaflor (1982) found that the Americans of European descent were taller than their European

counterparts which is an example of American richness during the eighteenth century.

It was long after the period of industrialization that the urban environment became better

and hygienic and only then was the urbanite taller than its rural counterpart. Urban-rural

differentiation in height which is obtaining in the present day industrialized societies (Eveleth and

Tanner, 1990) has not been so during the pre-industrial societies. Actually in the pre-industrial

societies the self sufficient farmers were generally taller than their urban counterparts and were

much better than them nutritionally. A self sufficient farmer is likely to consume more quantity of

food and more varied in nature than an urbanite who is not only confronted with the issue of

rising prices of food but also a deteriorating overall urban environment of that period. But

generally children in most of the developed countries and in some of the developing world have

shown tendencies of getting bigger and maturing faster during the last one hundred and fifty years

(Eveleth and Tanner 1990). These tendencies are popularly known as secular trends and have

been well documented in different countries of Europe and America. These tendencies have

coincided with the improved standard of living including good and nutritious diet, decreasing of

the infectious load and the overall improvement in hygienic conditions. Almost universally it has

been noticed that the present day human race has been growing bigger, heavier and taller and also
maturing faster and earlier than its earlier generations. The credit for this goes to the overall

improvement of the environment which means better health, less rigorous work due to

mechanization and an improvement in nutrition. It was the second half of the eighteenth century

when rapid economic growth in Great Britain, East-Central Europe and Sweden took place

(Komlos, 1993). Similar type of situation emerged a little later in the nineteenth century in

Montreal and America (Ward, 1993, Ward and Ward, 1984). These were the great historic and

economic milestones in human history and it is during these episodes that the human height has

witnessed declines. It is here that the biological processes and the material standard of living has

gone haywire and in opposite directions, diverging from each other. Fogel (1986) discovered that

in the United States, the male birth Cohorts of 1830s as adults were more than two centimeters

shorter than their counterparts. The male cadets in their late teens were also quite underweight

during this period, when actually the economy was being refurbished and the net national product

increased by about 40% (Komlos 1987). In the second half of 18th century the birth weight was

also falling in Montreal (Ward and Ward 1984) and in Habsburg, height declined by three to five

centimeters during this period (Komlos 1985). Komlos (1990, 1994) observed in Europe a

widespread downturn in height in the second half of the eighteenth century and suggested it might

have occurred in the American slaves at the same time. Another decline in stature occurred in the

rather resource abundant America during 1830s. Both these downturns coincided with rapid

urbanization and industrialization.

Thus the heights of the populations were increasing and decreasing over a period of time

which was referred to as the height cycles. These discoveries of cycles in human height have

fascinated the biologists and economic historians equally. The economic historians got clues to

this downturn and were surprised to find that periods of rapid industrialization brought with it a

downturn in height cycles of the people. Thus a really functional indicator of such events in the

form of height was found. The reasons for this could be numerous and would vary from event to

event but would include highly strenuous work and a tiring work schedule along with shifting of
the economic priorities from food to other goods and infrastructural development especially

during the period of transition.

Whether the quantities of food consumed are real indicators of the intake of quality of

food or not is debatable. The consumption of goods is generally linked to the real wages of the

people. Sen (1981, 1987) emphasized that the standard of living be gauged in terms of functional

sense rather than the mere quantities of goods purchased or consumed. For instance, assessment

of some measure of net nourishment would be preferable to food intake which may be adequate

in quantity but lacking in quality by means of micronutrients. He was emphasizing on adequate

and balanced food rather than the simple quantity of food consumed. Indirectly, the other

indicators of nutritional status are thus equally important.

These findings need deep probing if the role of height as an indicator of economic

development is to be seriously considered. Most of the economic historians consider that these

periods of rapid industrialization were accompanied by a deteriorating overall epidemiological

environment and the per capita nutrient intake had also shown declines (Cuff 1992). So, the

expanding economic scenario is rather putting the human organism to a biological stress. It seems

paradoxical at first sight that the economy is growing but the heights of the people are

successively decreasing. But a deeper analysis by economic historians reveals that economic

development is taking place and at the same time there is lower food consumption associated

with deteriorating urban environment which is responsible for reduction in heights of the people.

7.3 Energy Homeostasis

Over nutrition and under nutrition are the two sides of a sword of health. Both take their toll in

morbidity and mortality. The present global situation of energy intake presents a picture where

the number of people suffering from hunger and undernourished is almost equal to the number of

obese and over-nourished. Thus the problem of nutrition has posed two-way consequences which

must be taken very seriously and combated with full efforts (Campbell 2000).
 In stable body weight situations, it is assumed that the intake of energy equals the output

of energy in the living organisms. However, the consumption of food varies greatly not only

from one meal to the next but also from one day to another. The factors involved in food intake

seem to be numerous from the emotional state of the individual to the availability of food and the

economic status. Apart from this the cultural milieu plays a crucial role in deciding what is to be

eaten. Edholm (1977) revealed that the daily energy intake among individuals is highly variable

and bears little, if any, correlation with daily energy expenditure. But if the energy balance in an

individual is judged over a considerable period of time then the energy intake matches nicely with

the energy expenditure. There seems to be an extremely efficient regulatory system which helps

maintaining the stability of the amount of fat in the body (stored energy) and is usually termed as

‘energy homeostasis’. How this system operates? It is a well known fact that a period of

starvation is usually followed by an increased food intake or hyperphagia. The reduced body

weight as also the normal levels of energy intake, are recovered within a short span of time.

Earlier it was postulated that the fat stores send inhibitory signals to the brain to limit food intake

(Kennedy 1953). But this hypothesis failed to account for the regulation of dietary intake between

the meals. Gibbs et al. (1973) proposed that the peptides secreted in the gastrointestinal tract

during meal supply necessary information to the brain when to stop eating.

Leptin is a hormone secreted by adipocytes which participates in regulating adiposity

among organisms. Insulin secreted by pancreas acts on brain to limit energy intake and

consequently the central nervous system controls the body weight (Woods et al., 1979). It is now

accepted that both these hormones, viz., insulin and leptin circulate in blood in levels proportional

to body fat content and subsequently percolate to the CNS in concentrations equal to those in

plasma (Bagdade et al., 1967, Baskin et al., 1999). Studies involving the direct administration of

these hormones to the brain inhibit food intake whereas their deficiency does the reverse (Porte et

al., 1998). If weight increases, insulin must also increase in order to maintain normal glucose

homeostasis which would put a check on further weight gain. But in case of failure of insulin
secretion, type 2 diabetes with obesity is the usual outcome. On the other hand, the relationship of

leptin secretion to body fat mass is governed by the glucose uptake and metabolism by the

adipocytes through insulin stimulation (Wang et al., 1998).

The working of the hormone leptin in the arcuate nucleus of the hypothalamus for its

expression on different neurons has presented in detail by Friedman (2000). Thus in the absence

of leptin, one group of neurons (neuropeptide Y - NPY and agouti-related protein - AGRP)

become maximally active and food intake increases whereas in the presence of leptin, another

group of neurons (pro-opiomelanocortin- POMC, cocaine-and amphetamine-regulated transcript

CART) become active and the food intake decreases. The cloning of the first obesity gene, ob can

be considered as a big breakthrough in obesity research. Several genes have now been identified

which are related to obesity and diabetes in the ob pathway related to energy expenditure and

satiety. The completion of the entire human genome and the functional genomics are likely to

open new vistas to the understanding and treatment of human disorders including obesity.

According to Barsh et al. (2000), “the role of genetics in obesity is two fold, studying rare

mutations in humans and model organisms provides fundamental insights into a complex

physiological process, and complements population-based studies that seek to reveal primary

causes. Approaches based on Mendelian and quantitative genetics may well converge, and lead

ultimately to more rational and selective therapies”.

Kopelman (2000) highlighted obesity as a major health problem in the new millennium

which is related to numerous diseases. It results from a combination of genetic susceptibility,

increased availability of high energy foods and decreased requirements for physical activity.

Studies have indicated that the signals for energy homeostasis regulate food intake by monitoring

the meal size which require modulation of the responses to satiety signals in the brain (Woods

and Strubbe 1994, Flynn et al., 1998, Schwartz et al., 2000). The above biological systems seem

to work under normal deviations in food intake. But if a person keeps on eating in spite of the

satiety signals, then this system becomes taxed and gives in. Our modernized settings of social
parties force the guests to consume extra quantities of eatables. On the other hand, the patients of

anorexia nervosa simply refuse to eat as they always feel panicky about becoming overweight

although they are not so and thus become thin, skinny and underweight. Therefore, not all

deviations are caused by the failure of the biological system of ‘energy homeostasis’, but it is

made to fail and the responsibility of this falls on the individuals themselves in many cases.

7.4 Pregnant Mother and the Newborn

Healthy mothers are likely to produce healthy children. Mother’s health is the all important

determinant of the health and well being of the newborn. Maternal anthropometric status has

emerged as a good indicator of the health of the mother and also of the birth outcome of the

baby. It is a generally accepted fact that overweight women with excessive weight gain during

pregnancy give birth to large-for-dates babies. Among the various parameters of the pregnant

mothers influencing birth outcome include the pre-pregnancy weight, weight gain during

pregnancy, pregnancy weight gain at each trimester, skinfold thicknesses and limb

circumferences (Alberman 1984, Kramer 1987, 1988, Defe and Partin 1993, Vega et al., 1993,

WHO 1995a,1995b, Backstrand 1995). A pre-pregnancy weight of 40 kg is usually taken as a cut-

off value in developing countries where the women carry a large risk of delivering low birth

weight babies (Karim 1998). In his meta-analysis, Kramer (1987) predicted an effect on birth

weight of 20.3 grams per kilogram of pregnancy weight gain, in an average woman. Low

pregnancy weight gain is also linked to fetal and neonatal mortality. WHO has given a standard

of 2500 gm as the birth weight below which the baby is termed as low birth weight (LBM)

irrespective of gestational age? But if gestational age is taken into consideration, then the cases of

pre-maturity can be distinguished from intra-uterine growth retardation. The studies indicate that

women with less than 40 kg of body weight at the end of 2nd trimester (6 months) had 2.1 times

the risk of delivering severely low birth weight infants and 3.5 times the risk of severe stunting in

their infants. It has also been shown that women with a pre-pregnancy weight of 38 kg or less

delivered infants with an average birth weight of 2467 grams as compared to 2595 grams for
women with a pre-pregnancy weight of 41 kg and more. The prevalence of low birth weight

(LBW) babies as a percentage of all live births is not only interesting but an eye opener to us.

China has only 6% of LBW babies of all live births compared 30% in India.

Body Mass Index (BMI) has been found to be really important in pregnant mothers in

order to find out the pregnancy outcome. BMI of mothers has shown a linear relationship with

birth weight of the newborn. In other words, it can be stated that the lower BMI of mothers is

associated with lower birth weight of babies and a higher BMI with higher birth weight. Perhaps,

BMI of mothers is a pointer towards identifying small for date, average-for-date or large-for-date

babies.

The arm circumference and skinfold thicknesses are generally regarded as good

indicators of nutritional status in pregnant mothers. These often find their usage in pregnant

women while predicting birth outcome. Some studies have provided a cut-off of 23.5 cm of arm

circumference below which the risk of low birth weight baby is considerable. Studies from

Bangladesh indicate that arm circumference is slightly better than height, weight and pregnancy

weight-gain in predicting the infant and fetal mortality. But some sort of standardization with

respect to the height of the pregnant mother must also be taken into consideration. Because it is

expected that mothers with equal nutritional status but different in height would also be different

in upper arm circumference. The weight gain during pregnancy may not be considered as a

one-way preposition. It rather requires a healthy and normal range; while a lower weight gain

during pregnancy is invariably linked to low birth weight baby, the higher weight gain, on the

other hand, is linked to unfavorable birth outcomes including labor abnormalities, caesarian

section, macrosomia, etc.

7.5 Anthropometric Indicators of Nutritional Status

Body measurements provide useful Information about the nutritional status of an

individual. Table 7.2 provides the minimum list of recommended measurements as given by

Chumlea and Roche (1988) for judging nutritional status of an individual.

 Insert table 7.2 somewhere here

The growing children are required to be judged from the standards relevant for their ages.

Weight for age, height for age and weight-height standards are available on numerous world

populations through which the children can be screened for malnutrition. Children with deficit in

height and weight carry health risks and it is now well understood that they have a greater chance

of morbidity and mortality (Jelliffe 1966, Vella et al., 1992; Schroeder & Brown, 1994). Cut-off

values have also given standardized for height-age and weight-age of children not only to

distinguish between normal and undernourished ones but also to discriminate between acute and

chronic under-nourished children (Waterlow et al., 1977; WHO 1995a, 1995b). It is important to

note that the age of the child should be precisely known for using the height-age and weight-age

standards. But weight-height standards can be used even if the accurate age of the child is not

known. The weight-height standards can be used in identifying wasted children as well as acutely

undernourished ones. Height-age standards are suitable in identifying stunted children but are not

helpful in categorizing wasted children. Detailed surveys of nutrient intakes in Himalayan regions

have indicated nutritional inadequacies resulting in stunted growth of children (Singh & Sidhu,

1980; Singh, 1999). Weight-age standards fall in between height-age and weight-height standards

in judging stunting, wasting and acute undernutrition.

It is valuable to provide reference values of weight for height and length of children (the

sexes combined) recommended by Centers for Disease Control (CDC) Atlanta and WHO for the

purpose of screening children between the lengths/height from 58 cm to 110 cm. These standards

dispense with the age of the child and hence in the case of questionable ages of the children these

are the best for the assessment of malnutrition. It must be noted that children below 2 years of age

are generally measured for length (while lying down) whereas those above 2 years are measured

for height (while standing):

  Length: up to 2 years or when a child measures up to 85.0 cm

 Height: more than 2 years or when child measures above 85.0 cm

Table 7.3 provides reference values of weight for length for designating children who are

malnourished and who are between 58.0 cm to 84.5 cm in length.

Insert table 7.3 somewhere here

Information about the reference values for judging malnutrition among children who

measure in height beyond 85.0 cm is provided in Table 7.4

Insert table 7.4 somewhere here

On the basis of weight for height or length standards the children can be designated as severely

malnourished or seriously malnourished as follows:

 Seriously or acutely malnourished: if the child’s weight for height/length values

are below 2 Z - values

 Critically or severely malnourished: if the child’s weight for height/length values

are below 3 Z – values

The z-scores referred to above are the differences between the child’s measurements and that of

the reference values which are expressed in terms of the standard deviation of the reference group

for that measurement. It means if the difference is equal to the value of the standard deviation, the

z-score would be equal to 1 and so on.

Ex. 7.1 Describe the malnutrition of following children in terms of z-scores (use tables 7.3, 7.4).
a. Length 63 cm weight 5.0 kg

b. Length 68 cm weight 5.5 kg

c. Length 73 cm weight 7.0 kg

d. Length 81 cm weight 9.0 kg

e. Length 75 cm weight 7.0 kg

Ans.

a. Below 2 z-score (Seriously or acutely malnourished)

b. Below 3 z-score (Critically or severely malnourished)

c. Below 2 z-score (Seriously or acutely malnourished)

d. Below 2 z-score (Seriously or acutely malnourished)

e. Below 3 z-score (Critically or severely malnourished)

The children below 2 Z-scores are in serious acute condition and those below 3Z-scores in the

real life threatening situations (WHO 1995b). Generally the percentage of all children below 2Z-

scores must be considered in order to describe the nutritional situation of a group or a community.

The interpretation about the nutritional situation of a child population can be made on the basis of

the frequencies of children below 2Z-score as given in the table 7.5

Insert table 7.5 somewhere here

A combination of weight and height, which is very popular in public health screening, is

the Body Mass Index (BMI), and can be expressed as follows:

BMI = Weight (kg) / Height (m)2

Reference standards of BMI on some populations are available for monitoring growth and

development and also for judging normal, thin and obese adults (Cronk et al., 1982, Rolland-

Cachera et al., 1982, 1991; Frisancho, 1990). There is a good likelihood that low values of BMI

indicate undernutrition and higher the overnutrition. WHO (1995a) has provided standards of
BMI with cut-offs for designating underweight, normal and overweight adults which are

presented in Table 7.6.

Insert table 7.6 somewhere here

Underweight category with BMI less than 18.5 has been further split up into three categories of

chronic energy deficiency (CED) as mild, moderate and severe with cut-offs of BMI at 18.5, 17.0

and 16.0, respectively (James et al., 1988; Ferro-Luzzi et al., 1992). It must be made very clear

that the above BMI values for designating overweight and underweight are only meant fo the

adult individuals and should not be applied to children. There are standards of BM<I in case of

growing children which vary with age and sex. Interestingly, the BMI values on the lower side in

case of anorexia nervosa patients who are mortally afraid of eating touch 15 or below. The

heaviest reported men on earth have values of BMI around an unbelievable figure of 150.

Generally speaking, very low values of BMI and very high values of BMI carry an increased

mortality risk almost in all cultures (Waaler 1984, Bray 1987). It seems as if nature is pruning the

undesirable body weights which carry functional handicaps. While the role of BMI in diagnosing

both undernutrition and overnutrition is indisputable, nevertheless, the cut-offs would vary from

culture to culture (Campbell and Ulijaszek 1994, Kennedy and Garcia 1994). With advancing

age, the BMI even among the normal population shows an uptrend and opinion is building to

have age-based BMI statistics from adulthood to old age (James and Francois 1994).

Gorstein et al. (1994) commented on the usefulness of these standards and graded the

weight-age, height-age and weight-height indicators from 1 to 4 indicating the best (1) and the

least (4) usefulness of these standards (Table 7.7).

Insert table 7.7 somewhere here

 Most of the body fat is stored under the skin and therefore skin and subcutaneous tissue

fold thicknesses reflect the amount of stored fat and energy reserves. The usefulness of skinfolds

as indicators of malnutrition is based on the fact that the adipose fat storage is a function of

positive energy balance. If the energy balance is negative then this storage depletes which is

reflected in smaller thicknesses of the fat folds. The subcutaneous tissue is compressible and a

universal protocol of taking the skinfolds at a pressure of 10g/mm2 is being followed. The intra

and inter-observer measurement errors are generally considerable in taking skinfolds in

comparisons to those of other body measurements. Insight into the actual amounts of body fat in

babies and in adults has been provided by 42 cadaver dissections conducted during 19th and 20th

century (Cameron 1998). The information available from this direct assessment of body fat is

presented in table 7.8 below. It highlights that the adult fat deposition is proportionally enormous

as compared to that of the babies in both the sexes. It also highlights the sexual differentiation in

the amount of fat where females have more than double the amount of fat possessed by men. The

male baby has 5% of body fat as compared to 19.2% of an adult male. The female baby ion the

other hand has 15.0% fat as compared to 38.2% found in the adult females.

Insert table 7.8 somewhere here

Body fat distribution reflects the sites on which the body has more amounts of adipose

tissue. This is very different in the two sexes. Not only does it reflect the grey and bad areas of

the body’s fat deposition but it also carries an association with cardiovascular diseases,

hypertension and NIDDM. The role of ‘centripetal fat patterning’ is generally highlighted in the

above mentioned diseases. Waist circumference and its ratio with hip circumference are good

indicators of centripetal fat.

One of the body parts easily accessible for measurements and also a good indicator of the

nutritional status is the upper arm circumference incorporates muscles, fat and bone. The
thickness of the shaft of bone remains almost similar from 1 to 5 years of age. There is some

decrease in the thickness of fat ring in the mid upper-arm whereas there is some increase in the

muscle size. The effects of these two components seem to annual each other. It is fairly

reasonable therefore to generalize that the mid upper arm circumference more or less remains

similar during 1 to 5 years of age and hence can be used as an indicator for under-nutrition during

this age. This age-independence of arm circumference is useful in situation where ages are not

known and also under emergency situations. Children aged 12 to 59 months who were admitted

to a hospital in Kenya with severe malnutrition and kwashiorkor were studied by Berkley et al.

(2005) for mid upper arm circumference (MUAC). Clinical symptoms of malnutrition were

prominently displayed among children with MUAC less than or equal to 11.5 cm as compared to

among who had Weight for height less than 3 z-scores. MUAC is thus a useful screening tool for

diagnosing severe malnutrition. Moreover the area of the arm is a visible sign and most often

comes under public gaze for making a judgment. Frisancho (1990) and Strickland (1990) have

given this rationale along with the standards to use mid arm circumference for the purpose of

identifying children who are undernourished. Mid upper arm circumference and skinfolds at

biceps and triceps find their usage in calculating the arm muscle area and arm fat area (Ulijaszek

1997).

Total Arm Area (TMA cm2) = (Arm circ.) 2 /(4 x (22/7))

Arm muscle Area (AMA cm2) = [(Arm circ.-  (Biceps + Triceps)/2]2/ 4 

Arm Fat Area (AFA cm2) = Total Arm Area (TMA cm2) - Arm muscle Area (AMAcm2)

Ex. 7.2 Calculate the arm muscle area and arm fat area with the above equation of Ulijaszek

(1997) when arm circumference is 25 cm and biceps and triceps skinfolds are 8 mm and 18 mm,

respectively.

Total Arm Area (TMA cm2) = (Arm circ.) 2 /(4 x (22/7))

= (25.0) 2 / (4 x (22/7))
2
=49.71591 cm
 Arm muscle Area (AMA cm2) = [(25.0-  (0.8 + 1.8)/2]2/ 4 
2
= 34.79377 cm
Arm Fat Area (AFA cm ) = Total Arm Area (TMA cm2) - Arm muscle Area (AMAcm2)
2

2 2 2
=49.71591 cm - 34.79377 cm = 14.92214 cm

Frisancho (1990) and Norgan and Jones (1990) have recommended the use of only triceps

skinfold in calculating the arm muscle area and Arm Fat Area :

Arm Muscle Area (AMA cm2) = Arm circ.- ( x Triceps skinfold)2/ 4 

Arm Fat Area (AFA cm2) = (Arm circ.2/ 4 ) - AMA

The arm and thigh circumferences were assumed to be circular for the purposes of calculations by

Vague et al. (1971) who devised formulae to estimate adipose mass and muscle mass in arm and

thigh and consequently adipo-muscular ratios in these regions of the body from body

measurements. The procedure for calculating the fat area and muscle area is similar to that used

by Frisancho (1990). The only difference is that instead of using only the triceps skinfold, Vague

et al. (1971) have used four skinfolds, viz., anterior, posterior, lateral and medial for the arm as

also for the thigh. Thereafter, a ratio of adipo-muscular areas is calculated for arm (brachial) and

thigh (femoral) and is called brachial adipo-muscular and femoral adipo-muscular ratios. These

two are used to obtain a mean adipo-muscular ratio. A detailed account of these calculations are

given in Chapter 4. The percentage of adipose mass can be calculated as follows (Vague et al.,

1971) :

Per cent of Adipose Mass = Mean Adipo-Muscular Ratio x Mean % age of fat in adipose tissue

(0.80) x Density of adipose mass (0.92) x 100

Ex. Calculate the % of adipose mass if the mean adipo-muscular ratio of a person is 0.32

% Adipose Mass = Mean Adipo-Muscular Ratio x Mean % age of fat in adipose tissue

(0.80) x Density of adipose mass (0.92) x 100

= 0.32 x 0.80 x 0.92 x 100

= 23.55 %

In the case of Calcutta residents, Arm Fat Area (AFA), Arm Muscle Area (AMA) or percent of

body fat were not as good in relation to BMI when morbidity risks were evaluated (Campbell and

Ulijaszek, 1994). Strickland and Ulijaszek (1994) found Arm Muscle Area as a very sensitive

index of health in Sarawak, Malaysian adults and it emerged as a stronger index than Body Mass

Index (BMI).

There are numerous studies which recommend the use of calf circumference and medial

calf skinfold in order to judge the effect of under-nutrition. The utility of calf circumference is

also emphasized in older children engaged in physical and productive work where measurements

on the upper part of the body alone may not be representative (Strickland 1990). This has a

greater significance in the developing world because even the young children take part in

productive work and activities. A study by Visweswara et al. (1978) on Indian children has

demonstrated that calf circumference in association with calf skinfold really emerge as good

indicators of protein-energy malnutrition especially when clinical signs of it are apparent and

score better than arm circumference. The waist-hip circumference ratios apart from height,

weight, skinfolds and BMI are being pressed into service to diagnose obesity and overnutrition.

This is also being associated with higher risks of non-insulin dependent diabetes mellitus

(NIDDM), cardiovascular diseases like coronary heart disease and hypertension (Lev-Ran and

Hill 1987, Gerber et al., 1990, 1995, Yao et al., 1991, Freedman et al., 1995, Colman et al.,

1995). Grading of waist circumference in men and women for increased risk and substantially

increased risk of NIDDM, hypertension and cardiovascular disease have been provided by

Kopelman (2000) and is given in Table 7.9.

Ex. 7.3 Find out which of the following waist circumferences have the increased risk or

substantially increased risk of NIDDM, hypertension and cardiovascular disease (use table 7.9 of

Kopelman 2000).

a. male 98 cm b. female 78 cm c. male 85 cm

d. female 95 cm e. male 105 cm f. female 82 cm

Ans:

a. increased risk b. no risk c. no risk

d. substantially increased risk e. substantially increased risk f. increased risk

Insert table 7.9 somewhere here

Waist circumference along with the hip circumference seems to be a better indicator of the

abdominal adiposity. Now-a-days waist hip ratio is used to identify disease risks in adults and is

popularly known as WHR. It is calculated as follows,

WHR = Waist circumference/Hip circumference

Pinchon et al. (2008) conducted studies on a large series of patients covering almost a decade and

found that waist circumference and waist-to-hip ratios were strongly associated with the risk of

death. The male patients with values of more than 102.6 cm of waist circumference which is

above 95th percentile, the risk of death was 2.1 times more. In case of women the risk increased to

1.8 times in those cases where the waist circumference was more than 88.9 cm (95th percentile).

The WHR above 95th percentile was more than 0.98 in case of males who had carried the risk of

death by 1.8 times. In females, the similar value was more than 0.84 and the relative risk was 1.5

times.

Ex. Calculate the WHR in the following:

Male: Waist circumference = 98 cm, Hip circumference =92 cm

WHR = Waist circumference/Hip circumference

= 98/92 = 1.065, show an increased risk

Female: Waist circumference = 70 cm, Hip circumference =88 cm

WHR = Waist circumference/Hip circumference

= 70/88 = 0.795 Low risk

A relatively large head circumference as compared to length or arm circumference at

birth is indicative of intra-uterine growth retardation especially in case of full-term babies. Head

circumference is generally larger than chest circumference at birth. Since the growth of head

circumference is slow as compared to that of chest circumference, therefore the latter overtakes

the former in absolute terms sometime after birth. A ratio of head-chest circumferences is of great

significance in detecting PEM. The Indian children (ICMR, 1972) on an average reach an

equality between these two parameters at the age of about two years whereas the American

children achieve this equality around 3 to 9 months (Sharma 1992). This shows a very slow and

stunted growth of Indian children where malnutrition is highly prevalent. Pediatricians use head

circumference to detect pathological situations such as hydrocephalus, microcephaly or

macrocephaly (Sullivan et al., 1991). Judged in the context of reference standards, it is important

in diagnosing chronic undernutrition especially during the first two years of life.
Chapter 7 Exercises

Ex. 7.1. Calculate the body mass index (BMI)of he following and designate them according to
WHO classification:
a. Height 177 cm weight 75 kg
b. Height 1.81 m weight 86 kg
c. Height 172 cm weight 73 kg
d. Height 174 cm weight 76 kg
e. Height 162 cm weight 66 kg
f. Height 1.66 m weight 88 kg
g. Height 180 cm weight 86 kg
h. Height 179 m weight 73 kg
i. Height 174 cm weight 76 kg
j. Height 160 cm weight 66 kg

Ex. 7.2. Give the ratings on the basis of usefulness of the following types of standards, in a
population where age is unknown, as given by Gorstein et al. 1994 (Consult table 7.7)
a. Weight- -for age,
b. Height –for- age
c. Weight –for- height

Ex. 7.3. Describe the malnutrition status of following children in terms of z-scores (use tables
7.3, 7.4).
a. Length 60 cm weight 4.0 kg
b. Length 63 cm weight 5.0 kg
c. Length 75 cm weight 10 kg
d. Length 59 cm weight 3.4 kg
e. Length 65 cm weight 7.0 kg
f. Length 61 cm weight 5.0 kg
g. Length 64 cm weight 6.5 kg
h. Length 76 cm weight 10.2 kg
i. Length 6 7 cm weight 7 kg
j. Length 74 cm weight 9 kg

Ex. 7.4. Take into consideration the sample/population of 10 children given in ex. 3. Calculate
the percentage of children below 2 Z-scores and designate this child population with the help of
table 7.5.

Ex. 7.5. Calculate the arm muscle area and arm fat area with the equation of Ulijaszek (1997)
in the following:
a. arm circumference 34 cm biceps skinfold 12 mm triceps skinfold. 22 mm
b. arm circumference 32 cm biceps skinfold 10 mm triceps skinfold. 20 mm
c. arm circumference 30 cm biceps skinfold 8 mm triceps skinfold. 16 mm
d. arm circumference 28 cm biceps skinfold 9 mm triceps skinfold. 18 mm
e. arm circumference 29 cm biceps skinfold 13 mm triceps skinfold. 17 mm

Ex. 7.6 Find out which of the following waist circumferences have the increased risk or
substantially increased risk of NIDDM, hypertension and cardiovascular disease (use table 7.9 of
Kopelman 2000).
a. male = 86 cm b. female = 86 cm c. male = 99 cm d. female = 81 cm
e. male = 105 cm f. female = 79 cm g. male = 95 cm h. female = 89 cm
i. male = 90 cm j. female = 82 cm

Ex. 7.7 Calculate the % of adipose mass of the following mean adipo-muscular ratios
(Use the equation of Vague et al. 1971)
a. 0.19
b. 0.25
c. 0.21
d. 0.31
e. 0.42
Chapter 7 Answers

Ans. 7.1.The values of BMI and their designation respectively are as follows:
a. 23.94, normal
b. 26.25, grade 1 overweight
c. 24.68, normal
d. 25.10, grade 1 overweight
e. 25.15, grade 1 overweight
f. 31.93, grade 2 overweight
g. 26.54, grade 1 overweight
h. 22.78, normal
i. 25.10, grade 1 overweight
j. 25.78, grade 1 overweight

Ans. 7.2.
a. 4, very poor
b. 4, very poor
c. 1, very good

Ans. 7.3.
a. – 2 Z-score (Seriously or acutely malnourished)
b. – 2 Z-score (Seriously or acutely malnourished)
c. normal
d. – 3 Z-score score (Critically or severely malnourished)
e. normal
f. normal
g. normal
h. normal
i. normal
j. normal

Ans. 7.4. There are 30% children below 2 z-scores.

This child population can be designated as critical.

Ans. 7.5. The arm muscle area and the arm fat area, respectively are:
a. 65.33 cm2 26.63 cm2
2
b. 59.22 cm 22.23 cm2
2
c. 54.72 cm 16.87 cm2
2
d. 44.90 cm 17.47 cm2
2
e. 46.92 cm 19.98 cm2

Ans. 7.6
a. no risk b. increased risk c. increased risk d. increased risk
e. substantially increased risk f. no risk g. increased risk
h. substantially increased risk i. no risk j. increased risk

Ans. 7.7 The % of adipose mass

a. 13.984
b. 18.4
c. 15.456
d. 22.816
e. 30.912
Table 7.1 Frequency of world population affected by nutritional deficiencies (WHO 1997)

Sr. No. Condition People affected

1. PEM 800 million

2. Iron deficiency 3600 million

3. Micronutrients’ deficiency 3000 million

4. Vitamin A deficiency 258 million

5. Anaemia 2000 million

6. Iodine deficiency 760 million

Table 7.2 Indicators for nutritional assessment in healthy children, normal adults and handicapped

adults

Healthy children and adults Handicapped Adults

Stature Knee height

Weight Weight

Arm circumference Subscapular skinfold

Calf circumference Triceps skinfold

Triceps Arm circumference

Sub scapular Calf circumference

Table 7.3 Reference values for designating malnourished children on the basis of weight for

length who are between 58.0 cm to 84.5 cm in length (CDC/WHO 1995b)

Length Weight (kg) Length Weight (kg)

(cm) – 2 Z-score – 3 Z –score (cm) – 2 Z-score – 3 Z -score

58.0 3.9 3.3 71.5 7.3 6.5

58.5 4.0 3.4 72.0 7.4 6.6
59.0 4.1 3.5 72.5 7.6 6.7

59.5 4.2 3.6 73.0 7.7 6.8

60.0 4.4 3.7 73.5 7.8 6.9
60.5 4.5 3.8 74.0 7.9 7.0

61.0 4.6 4.0 74.5 8.0 7.1

62.5 4.8 4.1 75.0 8.1 7.2
62.0 4.9 4.2 75.5 8.2 7.3

62.5 5.0 4.3 76.0 8.3 7.4

63.0 5.1 4.4 76.5 8.4 7.5
63.5 5.3 4.6 77.0 8.5 7.6

64.0 5.4 4.7 77.5 8.6 7.7

64.5 5.5 4.8 78.0 8.7 7.8
65.0 5.6 4.9 78.5 8.8 7.9

65.5 5.8 5.0 79.0 8.9 8.0

66.0 5.9 5.2 79.5 8.9 8.1
66.5 6.0 5.3 80.0 9.0 8.2

67.0 6.1 5.4 80.5 9.1 8.2

67.5 6.3 5.6 81.0 9.2 8.3
68.0 6.4 5.7 81.5 9.3 8.4

68.5 6.5 5.8 82.0 9.4 8.5

69.0 6.7 5.9 82.5 9.5 8.6
69.5 6.8 6.1 83.0 9.6 8.7

70.0 6.9 6.2 83.5 9.7 8.8

70.5 7.0 6.3 84.0 9.8 8.9
71.0 7.2 6.4 84.5 9.8 8.9
Table 7.4 Reference values for designating malnourished children on the basis of weight for

height who are beyond 85.0 cm (CDC/WHO 1995b)

Length Weight (kg) Length Weight (kg)

(cm) – 2 Z-score – 3 Z –score (cm) – 2 Z-score – 3 Z –score

85.0 9.8 8.8 98.5 12.5 11.2

85.5 9.9 8.8 99.0 12.6 11.3
86.0 10.0 8.9 99.5 12.7 11.4

86.5 10.1 9.0 100.0 12.9 11.5

87.0 10.2 9.1 100.5 13.0 11.6
87.5 10.3 9.2 101.0 13.1 11.7

88.0 10.4 9.3 101.5 13.2 11.8

88.5 10.5 9.4 102.0 13.3 11.9
89.0 10.6 9.5 102.5 13.4 12.0

89.5 10.7 9.6 103.0 13.5 12.1

90.0 10.8 9.7 103.5 13.6 12.2
90.5 10.9 9.8 104.0 13.7 12.3

91.0 11.0 9.8 104.5 13.0 12.4

91.5 11.1 9.9 105.0 14.0 12.5
92.0 11.2 10.0 105.5 14.1 12.6

92.5 11.3 10.1 106.0 14.2 12.7

93.0 11.4 10.2 106.5 14.3 12.8
93.5 11.5 10.3 107.0 14.5 12.9

94.0 11.6 10.4 107.5 14.6 13.0

94.5 11.7 10.5 108.0 14.7 13.2
95.0 11.8 10.6 108.5 14.8 13.2

95.5 11.0 10.7 109.0 15.1 13.4

96.0 12.0 10.8 109.5 15.2 13.5
96.5 12.1 10.9 110.0 15.3 13.6

97.0 12.2 10.9

97.5 12.3 11.0
98.0 12.4 11.1
Table 7.5 Designation of a child population on the basis of frequencies of children below 2 z-

scores for Weight for Height values

Percentage of Wt/Ht below 2 Z-scores Interpretation

<5 Acceptable

5 - 9.9 Poor

10 - 14.9 Serious

15 or >15 Critical
Table 7.6 Cut-off points of BMI values as proposed by WHO (1995a) for the classification of

underweight, normal and overweight among adults.

BMI (kg/m2) WHO classification Popular Description

< 18.5 Underweight Thin

18.5 – 24.9 Normal Healthy, acceptable

25.0 – 29.9 Grade 1 overweight Overweight

30.0 – 39.9 Grade 2 overweight Obesity

> 40.0 Grade 3 overweight Morbid Obesity

Table 7.7. The grading of weight and height measures according to their utility in different

situations.

Situations Weight for age Height for age Weight for height

Usefulness in population 4 4 1

where age is unknown

Usefulness is identifying 3 4 1

wasted children

Usefulness is identifying 2 1 4

stunted children

Sensitivity to weight 2 4 1

change over a short time

Table 7.8 Percentage and actual amounts of body fat in infant male (3.5 kg) , infant female (3.0

kg), adult male (70 kg) and adult female (60 kg) as obtained from cadavers

Life cycle stage % of body fat Actual fat (kg)

Adult : Male 19.2 13.44

Adult : Female 38.2 22.92

Baby : Male 5.0 0.175

Baby : Female 15.0 0.45

Table 7.9 Grading of waist circumference for risk assessment of NIDDM, hypertension and

cardiovascular disease.

Sex Increased risk Substantially Increased risk

Male > 94 cm > 102 cm

Female > 80 cm > 88 cm

 Anthropometric Indicators of Health

Promila Mehta

Human Biology Dept, Punjabi Unievsrity Patiala

Body measurements provide useful Information about the health status of an individual.
But weight-height standards can be used even if the accurate age of the child is not known. The
weight-height standards can be used in identifying wasted children as well as acutely
undernourished ones. Height-age standards are suitable in identifying stunted children but are not
helpful in categorizing wasted children. Detailed surveys of nutrient intakes in Himalayan regions
have indicated nutritional inadequacies resulting in stunted growth of children (Singh & Sidhu,
1980; Singh, 1999). Weight-age standards fall in between height-age and weight-height standards
in judging stunting, wasting and acute undernutrition.A combination of weight and height, which
is very popular in public health screening, is the Body Mass Index (BMI), and can be expressed
as follows:
BMI = Weight (kg) / Height (m)2
Reference standards of BMI on some populations are available for monitoring growth and
development and also for judging normal, thin and obese adults (Cronk et al., 1982, Rolland-
Cachera et al., 1982, 1991; Frisancho, 1990). There is a good likelihood that low values of BMI
indicate undernutrition and higher the overnutrition. Underweight category with BMI less than
18.5 has been further split up into three categories of chronic energy deficiency (CED) as mild,
moderate and severe with cut-offs of BMI at 18.5, 17.0 and 16.0, respectively (James et al., 1988;
Ferro-Luzzi et al., 1992). It must be made very clear that the above BMI values for designating
overweight and underweight are only meant fo the adult individuals and should not be applied to
children. There are standards of BMI in case of growing children which vary with age and sex.
Interestingly, the BMI values on the lower side in case of anorexia nervosa patients who are
mortally afraid of eating touch 15 or below. The heaviest reported men on earth have values of
BMI around an unbelievable figure of 150. Generally speaking, very low values of BMI and very
high values of BMI carry an increased mortality risk almost in all cultures (Waaler 1984, Bray
1987). It seems as if nature is pruning the undesirable body weights which carry functional
handicaps. While the role of BMI in diagnosing both undernutrition and overnutrition is
indisputable, nevertheless, the cut-offs would vary from culture to culture (Campbell and
Ulijaszek 1994, Kennedy and Garcia 1994). With advancing age, the BMI even among the
normal population shows an uptrend and opinion is building to have age-based BMI statistics
from adulthood to old age (James and Francois 1994).

Most of the body fat is stored under the skin and therefore skin and subcutaneous tissue
fold thicknesses reflect the amount of stored fat and energy reserves. The usefulness of skinfolds
as indicators of malnutrition is based on the fact that the adipose fat storage is a function of
positive energy balance. If the energy balance is negative then this storage depletes which is
reflected in smaller thicknesses of the fat folds.
Body fat distribution reflects the sites on which the body has more amounts of adipose
tissue. This is very different in the two sexes. Not only does it reflect the grey and bad areas of
the body’s fat deposition but it also carries an association with cardiovascular diseases,
hypertension and NIDDM. The role of ‘centripetal fat patterning’ is generally highlighted in the
above mentioned diseases. Waist circumference and its ratio with hip circumference are good
indicators of centripetal fat.
 The waist-hip circumference ratios apart from height, weight, skinfolds and BMI are
being pressed into service to diagnose obesity and overnutrition. This is also being associated
with higher risks of non-insulin dependent diabetes mellitus (NIDDM), cardiovascular diseases
like coronary heart disease and hypertension (Lev-Ran and Hill 1987, Gerber et al., 1990, 1995,
Yao et al., 1991, Freedman et al., 1995, Colman et al., 1995). Grading of waist circumference in
men and women for increased risk and substantially increased risk of NIDDM, hypertension and
cardiovascular disease have been provided by Kopelman (2000) .
Waist circumference along with the hip circumference seems to be a better indicator of the
abdominal adiposity. Now-a-days waist hip ratio is used to identify disease risks in adults and is
popularly known as WHR. It is calculated as follows,
WHR = Waist circumference/Hip circumference
8. GROWTH, MATURATION AND PHYSICAL PERFORMANCE

Chapter details

Physical growth
Physical fitness
AAHPERD Youth Fitness Test (1976)
The Presidential Youth Physical Fitness Award Program
Bodily Maturity, strength and physical fitness

Physical activity and play is one of the most cherished and important activities of a child.

Children are capable of innovating unlimited playful activities and they learn by involving

themselves into these activities. Very young children while playing often find their leaders. They

start obeying their commands and do all jobs dictated by them. It is a sheer chance that while

playing, the child most often successful becomes a natural leader. At the time birth there are

differences in children in their weight and length. These differences originate because of the

genetic factors. Some part of these differences might be attributed to the fact that there are some

children who are early maturers and others he late maturers. The differences between early and

late maturing children becomes very prominent during adolescence. Early maturity of a child is

also responsible for their better physical performance. Bodily strength has relationship with the

maturity status of a child and that's why the early maturing children excel in age based sports

competitions. There is an intricate relationship with the physical growth of children, their

maturity status and physical performance.

8.1 Physical growth

All living organisms grow with distinctive patterns which are peculiar to themselves. During

the growth period from birth to maturity, many developmental stages are covered by a human

child during whom the rate of growth does not remain constant. It is sometimes fast but slow at
other times. The rate of growth of height shows a sharp decline during the first few years of life

decreases slightly or remains almost constant till before adolescence. Then follow the

revolutionary period of increased velocities and sexual maturation when a boy and a girl suddenly

develop into a mature man and a woman, respectively. The changes are very quick and proceed at

an astonishing rate.

The physical and maturational changes in a boy include the growth of genitalia, hair on the

pubes, in the axilla and all over the body, and the change of voice to a coarse and a husky one. In

girls, there is a development of the breast, growth of hair on the pubes and in the axilla and the

onset of menstruation. These pubertal changes place through the hypothalamus-pituitary-gonadal

axis and follow the increased secretions of the sex hormones.

Human growth can be evaluated from longitudinal and cross-sectional studies. In

longitudinal studies, the same child is repeatedly measured over a given time span, sometimes

covering the whole growth period. The total growth period in humans is very long. say around 18

to 20 years, therefore a purely longitudinal study must extend over this time span. The limitation

of time and energy are major handicaps in the execution of longitudinal type of studies is in the

type of studies. The merit of longitudinal studies is in the construction of velocity standards

where the peak height velocity of very subject can be studies and used in the construction of the

velocity standards, by taking into account the peak height velocities.

In cross sectional studies every child is measured only once in a study. For studying various

problems, children in various ages are simultaneously measured and the complete growth period

can be covered within a very short time. Such Studies are useful in constructing distance

standards and in evaluating the effect of various factors affecting the growth and maturity

phenomena of children.

When it is difficult to complete the longitudinal study then the growth period can be divided

into small parts and children at various ages can be followed for some years. The study which

includes some subject’s studies for a long time, others followed for short periods and still others
only once, is called a mixed longitudinal study.

Human race has been growing taller in height, bigger in various body dimensions and

heavier in body weight and maturing faster over the last 150 years or so. The menarche is

occurring in the girls at earlier ages almost in all cultures over their successive generations. These

are called secular trends or secular growth shifts. There are some indications that the human race

is becoming slightly thinner over this period. The findings on secular trends have been reported

from various factors responsible fro it may include better quality of life, greater medical and

health care, lower risks of disease and infections, heterosis due to the changing values due to

modernisation and greater mobility, etc. The rate of the secular shifts has been fast in the

beginning but slow thereafter. There may be a possibility of these trends coming to a gradual halt

in the near future.

The growth is organised in such a way that a child grows along a pre-destined curve under

the optimal environmental conditions. This process of the children's growth to adhere to their

genetic curves is called canalization. There is a complex interaction between the genetic make-

up sets the upper limits of growth, the favourable and optimal environmental factors help to

accomplish that target. Thus this nature-nurture interaction is complimentary to each other during

growth.

That the growth process it is highly organised, has led to the construction of norms or

standards for judging the growth of children. The children usually follow any line in these

standards which are population, age and sex specific. Only during adolescence do the children

sometimes wander across the lines of growth norms whereas at all other ages they generally

follow a given centile line. This deviation during adolescence happens because there are some

children who enter their adolescent spurts earlier or later than the others of their age.

It is quite interesting to note that during adolescent period the boys and girls can be seen in al

stages of their development. For example, at 14 years, in any population there will be certain

number of boys who are still to enter their adolescent or pubertal periods. They will look like
preadolescent children, having no growth of sexual hair, and no abrupt increase in height. There

can be another group of children midway through their adolescent cycles. They may show certain

level of development of sexual maturation characteristics and may exhibit increased velocities.

Still some others may have completed their full sexual growth. The growth of genitalia and pubic

hair may be complete in them and physically they may look like full grown men. This is all part

of the normal pubertal variations in human which are so dramatic. The children who enter

adolescence later are called late maturers and those entering early are referred to as early

maturers. There is no indication that the late maturers will end up smaller than their early

maturing counterparts. Rather they will get more years to grow and have tendencies of linearity.

Not only do the variations in ages at entry of various pubertal characteristics exist but the duration

of various developmental stages and complete maturation processes also vary greatly. It is largely

their genetic make-up which sets up the tempo of growth and development.

The subcutaneous fat generally increases in thickness from birth to about 9 months and then

reduces in thickness up to around 5-6 years. There may be some increase in thickness afterwards.

Towards the end of the adolescent period, fat again starts accumulating.

There exist large variations in the ages of adolescence in boys and girls in different

populations. Generally the populations of the west and those more affluent are advanced in

reaching adolescent periods. The maximum increment in height during the adolescent spurt is

called peak height velocity (PHV). The ages at PHV are informative and refer to an important

developmental milestone. The girls are generally advanced by about two years than the boys in

adolescent height spurt and in maturing sexually.

The period of adolescence is responsible in magnifying sexual differences in physique. The

girls, in the average, are ahead of the boys in reaching adolescence by about two years. Because

of the fact that the girls are advances than the boys in their adolescent period, they suddenly

become taller and may temporarily outgrow their male counterparts. The growth of hip width is

relatively greater in the girls whereas the boys become broad shouldered and heavily muscled.
These bodily changes are sex specific and may have had some role to play in attracting the

attention of the opposite sex for mating purposes during the evolutionary history. Not all sex

differences originate at adolescence; there are some measurements which show sex differences

even at birth. For example, a female baby would have a relatively larger pelvic outlet than a male

baby. This seems to be associated with the sexual roles of a female in child bearing process

because the child has to pass through this opening during birth. Thus a wider pelvic outlet is an

adaptation in the female to bear children in later years to life.

8.2 Physical fitness

The muscular strength as judged with the help of dynamometers and tensiometers, generally

increase with age during childhood. In males, the gain in muscular strength during adolescence is

very much prominent when the spurt in muscular strength takes, place. Girls on the other hand,

do register increase in muscular strength but generally an appreciable spurt takes place during

adolescence. Sex differences in muscular strength place during adolescence. Sex differences in

muscular strength exist even in childhood but during adolescence, those get magnified.

The active life style requires sufficient levels of flexibility of the body especially that of

the trunk and extremities and a reasonably good level of cardio respiratory function of the body.

Maintaining an active life style is a key to physical fitness which leads to better quality of life.

Physical fitness and motor fitness are often used synonymously. But actually motor fitness is a

broader term and includes physical fitness. According to Clarke (1971) the motor fitness can be

evaluated on the basis of seven components.

The seven component of motor fitness

Muscular Strength
Muscular strength relates to the amount of force which muscles can generate and exert in doing

various jobs. Tests for judging it include pull-ups, flexed arm hang, push –ups.

Muscular endurance

Endurance means the ability to perform work till one is exhausted. Tests included for the

assessment of muscular endurance includes bent knee sit –up.

Muscular power

Muscular power is described as the ability to release the maximum force in the shortest time. For

example the standing broad jump is a test to judging the muscular power.

Cardio-respiratory fitness

Cardio-pulmonary fitness relates to the moderate contractions of large muscles of the body over a

very long period of time. The criteria include long distance running.

Agility

It is the ability of how fast and how often the body can change its position. The shuttle-run is the

usual test done to test agility.

Flexibility

The range of movements executed at various joints of the body reflects its flexibility.

Speed

It reflects the fastness of human movement. Generally 50-yard run is the test designed for testing.

The American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD)

has recommended many tests out of which Youth Fitness Test (YFT) (1976), Presidential Youth

Physical Fitness Award Program and AAHPERD Health Related Fitness Test (HRFT) are the

most prominent and internationally recognized fitness tests.

8.2.1 AAHPERD Youth Fitness Test (1976)

The following is the list of items included in this test battery

Pull-up for boys; flexed arm hang for girls

Sit-up (flexed leg; one minute)

Shuttle run

Standing long jump

50-yard sprint

600-yard run

Pull–Up Test

Equipment: A horizontal bar is required for this test which should be at such a height so that the

subject while hanging to it is above the ground and does not touch it.

Technique: The subject should hang free from the ground and the hanging position is such that in

the overhand grip the palms face forward. With the force of the muscles the body is pulled

upwards till the chin rests above the horizontal bar. The body is lowered until the arms become

straight. This process is repeated till the subject is unable to perform any more pull ups. Care

should be taken that the subject does not attempt kicking or jerking movements while pulling up,

it should be a smooth movement.

Scoring: Scoring is done by counting the number of correctly executed pull-ups.

Flexed arm hang

Equipment: A horizontal bar is required for this test which should be at such a height so that the

subject while hanging to it freely above the ground and does not touch it.

Technique: The subject is lifted off the ground with the help of two supporters one in front and

the other at the back so that he is made to grasp the horizontal bar with the palms facing forward

and his chin above the bar with elbows flexed. After that the support is withdrawn. Now the

subject must maintain this position as long as one can. The time is taken with a stopwatch. The

stopwatch is started when the subject attains the hanging position. The watch is stopped when

 the subject’s chin touches the bar,

 the subject tilts the head backwards to keep the chin above the bar,
  the chin of the subject falls below the bar.

Scoring: Scoring is done by counting the number of seconds the subject has been able to hold on

the correct position.

Sit-up (flexed leg; one minute)

Equipment: A smooth and clean surface and a stopwatch.

Procedure: The subject lies on his back. The knees are bent at right angle; the feet should be on

the ground, the heels and the buttock’s distance being kept at about 12 inches. The subject should

place his hands behind his neck with fingers clasped and the elbows touching the ground. The

subject bends forward by contracting the muscles of the abdomen till his elbows touch his knees.

This is considered one sit-up. The subject has to return to the starting position to execute another

sit-up. The subject begins the process with a command of “Go” and stops with the command of

“Stop”.

Scoring: The scoring is done by counting the number of correctly executed sit-ups in 60 seconds.

Shuttle run

Equipment: Ground, stop watches and two wooden blocks of 2” X 2” X 4” size.

Technique: Two parallel lines are laid on the ground 30 feet apart. The subject stands behind the

first line. Two wooden blocks of above sizes are placed behind the second line. In this test, the

subject runs towards the second line picks up one block, returns back and places the block behind

the first line. The subject again runs to the second line, picks up the second block and place

behind the first line. The subject would start the run with the command Go. The investigator

would start the watch with the command Go and would stop it when the subject has placed the

second wooden block behind the line.

Scoring: The score is the running time from the command Go to the time when the subject has

placed the second wooden block behind the line in seconds up to the nearest one-tenth. Each

subject is allowed two trials and the better of the two is to be taken. In case, the subject falls or

slips, he should be given another trial.

Additional requirements: For efficiently administering the test and inculcating competition spirit

amongst the runners, it is advised to administer this test at least to two subjects. Two stop watches

are required.

Standing Long Jump

Equipment: A measuring tape and another tape for straddling the feet. A suitable floor surface is

required for jump.

Technique: Mark a starting line and the subject should stand behind this line. The two feet should

be apart by a width equal to that of the shoulders. The two feet of the subject are straddled with a

tape. The subject should first squat and then jump horizontally to cover the maximum distance.

While performing this test the subject’s feet should keep straddling the tape.

Scoring: The subject is allowed three trials and the best of the three distances jumped is taken in

to consideration. The scoring is done in feet and inches.

Additional requirements: Since learning this test improves the distance, therefore enough

practice is allowed to be done by the subjects.

50-Yard Sprint

Equipment: The test track of suitable length and a stopwatch.

Technique: The test is performed by asking two subjects to take part in the sprint in order to

build competition among them. The subjects stand on the starting line and the starter gives the

command of “Ready” and then “Go” and also gives a visual signal to the time keeper who stands

at the finish line. The time keeper starts the watch when he sees the signal and stops it when the

participants reach the finish line.

Scoring: The time taken by the subject to complete the 50-yard distance is to be noted (up to the

nearest one-tenth of a second).

Additional requirements: The students must warm-up properly and should also be allowed one or

two practice trials.

600-Yard Run
Equipment: A stopwatch and a running track or any running course of a rectangular shape of 30

feet by 120 feet or a square having each side of 50 feet.

Technique: The subject is instructed to start running at the command “Go” and has to run as fast

as one can to finish the required distance. In case a subject finds it difficult to run, he is allowed

fast walking as well but the distance has to be covered.

Scoring: The time of completing the distance of 600 feet is taken in minutes and seconds.

8.2.2 The Presidential Youth Physical Fitness Award Program

The American President’s Council on Physical Fitness and Sports in 1987 recommended the

following test battery for physical fitness which is a slight modification of the AAHPERD YFT

battery:

 Curl-up. This is the Flexed leg Sit-up for 60 seconds of the YFT.

 Pull-up. This is the Pull-up test of YFT.

 V-Sit Reach or Sit and Reach. This is the new test described below.

 One –mile Run/Walk. This is the time taken to complete one mile distance either running

or walking fast.

 Shuttle Run. This is same as the shuttle run in YFT.

V-Sit Reach or Sit-and -Reach.

The test measures the flexibility of the lower back and posterior thighs.

Equipment: A specially designed box of 12” X 12” X 21” dimensions is required. The top plane

of the box is 21” in length that means it extends over the box by 9” or 23 cm. A measuring scale

is provided on this top plane so that the scale reads 23 cm at the level of the feet.

Technique: The subject sits down without shoes, knee fully extended and the feet a little apart.

The feet should touch the vertical surface of the box. The subject places both his hands on the top

plane of the box. The subject is asked to reach maximally forward with his hands along the
measuring tape four times. He is asked to give the maximum output on the fourth trial and is

asked to hold on to the position at least for one second.

Scoring: It is the maximum distance covered by the subject with both hands.

AAHPERD Health Related Physical Fitness (HRFT)

AAHPERD (1980) recommended another test battery known as the AAHPERD Health-Related

Physical Fitness Test. The following is the list of the tests included in this battery:

 Cardio respiratory function: one-mile run or other variations in distance recommended by

different protocols.

 Body Composition: skinfolds at triceps and subscapular sites.

 Abdominal and low back musculo-skeletal function: sit and reach test, bent-knee sit up.

8.3 Bodily Maturity, strength and physical fitness

There exists some relationship between muscular strength and body mass and lean body mass

during growing years. The greater the body mass and LBM the greater would be the muscular

strength. During adolescence, the average yearly increase in muscular strength in body may reach

up to 23%. This astonishing gain in muscular strength is more prominent in trunk and upper

extremity regions of the body. Generally, increase in strength continues even up to the thirties

especially in males.

Physique as assessed with the help of Heath-Carter Anthropometric Somatotype method

show age changes in both the boys and the girls as opposed to the original concept of

immutability of somatotype proposed by Sheldon and his associates. Endomorphy ratings

decrease with age from childhood to adolescence. During adolescent and post adolescent periods,

the somatotype component ratings show changes. Ectomorphy increases from childhood to

adolescence. Sex difference in somatotype during growth is quite apparent. The girls generally

have greater endomorphy whereas the boys have greater mesomorphy ratings.
 The distribution of somatotypes during adolescence is generally towards endo-mesomorphic

and ecto-mesomorphic sectors in boys and towards the meso-endomorphic and ecto-endomorphic

sectors in girls. The girls are more conservative in somatotype distributions than the boys who are

widely scattered in the triangle.

The sexual dimorphism in lean body mass is such that the girls during post-adolescent years

possess absolute lean body mass values only around two-thirds of their male counterparts. In

fatness, the adult females excel the males by double the amount. As described in chapter4, some

part of fatness in females is the sex specific fat situated over the breasts and the hips and which

cannot be reduced, beyond a minimum level.

The boys and the girls do not differ much during childhood in the muscle mass, however, in

bone width the sex differences exist. A typical boy possesses wider bones. The increase in muscle

and bone is appreciable during adolescence. The boys gain considerable amounts of muscle mass

than the girls.

General tests for evaluating motor abilities are the running, jumping and throwing

performances of the subjects. These abilities improve with age and a small sexual difference

exists during childhood. During adolescence the boys perform much better than the girls. While

the improvement in performance continues in boys during and after adolescence, a maximum

limit is reached at by the girls around 13-14 years. After which, the girls generally do not improve

much in their physical performances.

The peak growth velocity of muscles as judged from the arm and calf radiographs occurs

later than the PHV. Again there is asexual difference in the growth of the muscles. The peak

years earlier to that of the boys. The girls thus temporarily look more muscular than the boys of

their age. The cross-sectional area of muscles is directly proportional to the strength. As the

muscle bulk increases, there is a corresponding increase in the strength also. The large difference

in physical strength between the two sexes is more obvious during and after the adolescent

period.
 Chronological ages tell very little about the growth status of children especially during

adolescence because of their differential maturity status. Various development or maturational

milestones represent growth or maturity status more accurately. There are many maturity

characteristics but the skeletal maturity is unique in the sense that it can be used to assess

maturity generally throughout the growth period. Skeletal maturity can be judged from the

radiograms of various bones by inspecting the ossification centres, the ossified areas and the

epiphysis. Radius, ulna and short bones (RUS) of the hand and wrist are being widely used as

skeletal maturity indicators.

Greulich and Pyle published an atlas of radiograms. This atlas is a standard work on the basis

of which the children can be assessed for their skeletal maturity. Tanner and white house (TW2)

method is one of the most popular methods these days which utilises RUS bones for judging

skeletal maturity and is based on the longitudinal data.

Milk teeth appear between 6 months and 2 years. The permanent teeth erupt around 6 years

to 12 years. So the period between 6 months to 2 years and from 6 years to 12 years is useful in

assessing the dental maturity. The best dental maturity assessments can be made from the

standards which refer to the number of teeth present in the oral cavity and the maturational status.

Other measures of maturity, e.g. the genitalia maturity, the growth the public hair, axillary

hair and the facial hair in males and the development of breast, the growth of public hair, axillary

hair and the onset of menstruation in females are useful in maturity assessment but only at certain

ages.

The sequence of events or developmental stages generally does not change in a given child.

What may change is the age at which various developmental stages are reached.

There is a considerable association between different measures of maturity especially the

dental and the skeletal. For example, if a child is early maturer in skeletal maturity then he is most

likely to be advanced to some extent in dental maturity as well. Pubertal characteristics generally

do not provide and correlation's with skeletal maturity.

 It is advised that different measures of maturity should independently be assessed for

understanding the complete maturational process.

The adolescent behaviour is influenced by the maturity status of children. For example, an

early maturer is likely to become taller and stronger, may be for a short period, than the peers of

his age. He will be getting more attention, will be respected by others and may emerge as the

leader of his group. A later maturer, on the other hand, is mot likely to remain short and weak for

sometime compared to his normally growing peers, therefore he may face physical and emotional

humiliation and handicaps, during this period. The ultimate physical status of an early and a later

maturer may be the same but the course along which they have been maturing has been different.

Similar type of problems may be encountered by the adolescents who want to take part in certain

sports where the physical structure has a major role to play.

Body size is an important feature which moulds the psyche of the subject drastically. Type of

work, life style and the social status sometimes depend on the stature or size of the person. There

are certain professions and certain sporting activities where some minimum limit of height is

required. For example, the volleyball and basketball players ought to be taller in order to be more

successful. On the other hand, a horse race course jockey should be small with a light body

weight. What can be the adult size? This is a question which probably crops up in every child’s

mind. The importance of this question increases manifold if a child is plans a career in sports

where the physique and body size play an important role. Is it possible to assess the adult body

size of a child? What would be the accuracy of such predictions? The height of the parents, the

bone age of the child and the child's height at a given age are important determinants in good

predictions of adult height.

The adult stature can be predicted from the height measurements of children after the age of

3 years. Before 3 years, the correlation coefficient between the adult height and the height/ length

attained at that age is very low. The reasons for low correlations around and a little after birth are

that the birth length is mainly influenced by the intrauterine factors and the actual genotype
determining height of the child may start expressing around 3 years. The correlations increase

with age and thus improve the accuracy of such predictions.

Still better predictions can be made using bone age of the child. The known height of the

child and his maturity status or bone age in combination with each other are used in adult height

predictions. It is also sometimes recommended to apply parental height correction before

predicting the adult height. The predictions based on certain formulae which are definitely

population specific show predictions of height within+- 7 cm of the actual height. At higher bone

age of subjects, the predictions based on them become more accurate and within narrow limits.

During preadolescent years, the endomorphic and mesomorphic boys tend to be stronger. In

the adolescent years, as the muscularity increases, the muscular strength also increases. However,

strength has a negative correlation with ectomorphy before and after adolescence.

As regards the performance and body build, the fatty children tend to perform lower in the

abilities requiring agility. The muscular children and adolescents perform much better in various

physical activities. Generally, thin and lean persons who lack muscles and the conspicuously fatty

individuals, have lower physical performances. So, excessive fat and lack of muscles are the

factors limiting performance.

The higher the lean body mass the greater the muscular strength in children and adolescents.

The absolute value of lean body mass is important in certain physical activities where the object

is projected and the movement of human body is restricted. On the other hand, the relative

amount of lean body mass and its distribution per unit height is of a greater significance where

body is projected, e.g. in the running and swimming activities.

The boys who are advanced in skeletal maturity tend to be stronger. But generally these early

maturers have grater body mass as well. If body mass and height are made comparable then

perhaps the role of skeletal maturity is very much limited. In that case, even the early maturer

may not find himself stronger than a late maturer.

The motor performance of adolescent boys depends on the skeletal maturity. An early
maturer is better in physical performance than his late maturing counterpart. There do not seem to

be much influence of maturity status on the performance of adolescent girls. Generally, late

maturing girls outpoint the others in the physical performance tests.

There are certain findings which indicate that effective participation in physical activity

during 9 to 15 years largely depend upon the physical maturity of the boys. After 15 years of age,

the maturity status is of a minor significance in determining the physical activities. Those boys

who are late maturers generally feel shy of taking part in various physical activities.

Body size and muscular strength are also related during adolescence. The body mass shows

qualitative change in boys indulging in vigorous physical activity. The adipose tissue is mobilised

and gets used up to a major extent and the net result is a lower amount of fatty tissue. On the

other hand, there is an increase in the lean body mass. It has also been found that the fatty tissue

interferes in the motor activities of a person. The mechanical efficiency of a subject is likely to

increase after a reduction of his fatty tissue.

The physical activity is important in maintaining good physique and a healthy body. In the

present day highly mechanised environment most of the activities are done by the machines and

there are checks on the habitual physical activity. So, there is an urgent need to develop a

physical culture by arousing awareness and inculcating interest towards physical exercise and

activity. The physical activity during infancy or first year of life depends upon the amount of

fatness of the child. A fatty child is likely to indulge less in physical activity than his normal

counterparts. This tendency becomes a habit in the following years. So, to a major extent the

drive towards physical activity during infancy or first year o life depends upon the amount of

fatness of the child. A fatty child is likely to indulge less in physical activity than his normal

counterparts. This tendency becomes a habit in the following years. So, to a major extent the

drive towards physical activity in early life depends on the food habits of the baby and his body

composition which is inherited to some extent and is modified by environmental factors through a

complex interaction. Regular physical exercise is important in developing healthy individuals on

whom the health of the nation depends. The healthy citizens require lower expenditure on their

medical and health bills and are capable of contributing greater number of man hours to the

national development.

Chapter 8 Exercises

Ex. 8.1 Name the test(s) used for judging the muscular strength in AAHPERD Youth Fitness Test (1976)
battery.

Ex. 8.2 The test used to judge agility in AAHPERD Youth Fitness Test (1976) battery is called the_____.
Ex. 8.3 Which sex is advanced to the other in achieving sexual maturity and by how many years?
Chapter 8 Answers

Ans. 8.1 Pull-up for boys; flexed arm hang for girls
Ans. 8.2 Shuttle run

Ans. 8.3 Girls, by about two years

9. APPLICATIONS OF ANTHRTOPOMETRY

Chapter details

Growth and development

Prediction of adult height
Physique and disease
Nutritional Status
Estimating skeletal frame size
Obesity
Chronic illness and health
Sports
Human dimensions for design solutions
Appliances for left hander

It is a well known fact tat the human beings evolved through the course of evolution. One

of the unique quality they developed was to use their forelimbs. This quality developed

further and became highly specialized. Now they could use the forelimbs for doing many

tasks. This made it possible to use the hind limbs for walking and running. They left the

other animals far behind them in the race of evolution and became their masters. The

result has been a very rapid technological development in which unlimited number of

instruments and devices were invented. The interest in measuring the body is of ancient

origin. But with the modernization sophisticated instruments for the measurement of

human body came into existence. The body measurements are useful in studying different

groups. The absolute and proportional differences between groups can reveal a lot of

information and throw light on the factors responsible for effecting such a change. Any

group migrated to an affluent setting can be compared to the native group in order to

gauge the effect of migration which might be responsible for a drastic change in the life

style as a result of acculturation. A comparison of the body measurements between

normal and abnormal groups can reveal the differences and the effect of such abnormality

on human body. Everything which has been designed for the use of man involves

anthropometry directly or indirectly and hence the use of anthropometry is vast. In the

following section, different applications of anthropometry have been described.

9.1 Growth and development

Children grow from birth to maturity and keep on increasing with age in their height and weight. By

measuring height, weight and other dimensions we can get an idea about the child’s growth. It is every

parent’s ideal to know whether their child is growing normally or not. The pediatrician or a doctor can

judge the situation of the child’s growth. Let us first examine the normal growth pattern of the child. There

is a classic example of the height of the child measured at every birthday studied by Tanner (1962) which is

given in Fig. 9.1. This chart is popularly known as the ‘Distance Curve’.

Insert Fig 9.1 somewhere here

If the height of child is subtracted from that of the previous year we get a value which means the child has

added or increased that amount in one particular year. If this process is repeated for all the years, we will

get values of all the annual increments in height of the child. The increments in height of children with age

are shown in Fig. 9.2. This type of chart is known as the ‘Velocity Curve’.

Insert Fig 9.2 somewhere here

Some special mention should be made between the growth of boys and the girls. Before adolescence, there

is not much difference in the size and weight of the boys and the girls. But the girls enter adolescence about

2 years earlier than the boys and complete their entire growth in height also 2 years earlier to that of the

boys. The maximum yearly increase in height which is known as the Peak Height Velocity (PHV) also

occurs about years earlier in the girls. It can be said that the girls mature earlier than the boys.
By conducting large scale surveys on normal children of different ages and taking their heights and

weights, the experts make growth standards or charts. These charts have to be made for boys and girls

separately. Since there are big differences across different populations, therefore it has been advised to

make these growth standards separately for different populations. The standards also represent different

ages during the whole growth period which extends roughly up to 20 years. World Health Organization

(WHO) and National Center for Health Statistics (NCHS) of the United States have made standards for

judging the growth of children. Fig.9.3 shows typical weight standards.

The child whose growth is to be judged is first measured for his height and weight and his age is also noted.

Thereafter, the height/weight is plotted against his age on the standards which are applicable to him which

means the boys should be plotted in the boy’s chart and a girl in the girl’s chart.

Insert Fig 9.3 somewhere here

These standards start from the bottom line which is designated as 5 and then go to 10, 25, 50, 75, 90 and

95. Let us give meaning to these lines by considering this chart for the height of the boys. The line which is

written as 5 on the standards represents the bottom 5% children in the population, 10 means bottom 10% of

children and so on. The top most line is designated as 95 which mean that 95% of the children fall below

this line. In other words, any child who is plotted on 95 th line for his age has 95 % of children shorter than

him. On the other hand, the line representing 5 means that below this line there are only 5% of the children

in height in the population. That means there are 5% of the children who would be shorter in height than

this value. Any child whose growth is to be judged, if plotted way below the bottom line (5th percentile) of

these standards seems to be failing in his growth.

9.2 Prediction of adult height

The children usually follow a pre-destined growth curve and would try to follow them

religiously. Only during the period of adolescence can they wander slightly from these

curves. This highly organized characteristic of children’s growth opens new vistas in the

field of prediction of adult height. Usually the height achieved at any age is a good

indicator of how tall a child would be as an adult. Height of the child at any given age

clubbed with a few more indicators as the skeletal age, parental height and growth
velocity during the preceding few years, can be a wonderful combination in the

prediction of adult height. The accuracy of such predictions is very high. The bone age in

the tables of prediction of adult height given here uses the Tanner Whitehouse (TW2)

radius, ulna and short bones (RUS) skeletal ages (Tanner et al. 1983). The equations for

the prediction of adult height of boys have been given in table 9.1 and those for girls

appear in table 9.2. These equations use the height of the child at the given age, the

skeletal age and the growth increment during the preceding few year.

Ex.9.1 Predict the adult height of the11 year old boy with following characteristics (Use

table 9.1 and choose the coefficients for height, chronological age, bone age and height

increment as well as the constant for age 11.0 years .)

Age 11.0 years

Height 140.0 cm

Bone age (TW2 RUS age) 10.0 years

Increment of height in the previous year 5 cm

The following is the appropriate equation for the this boy for predicting his adult height

(Tanner et al 1983):

Adult height = 1.19 (height in cm) – 3.1 (chronological age in years)

-1.5 (bone age in years ) -0.3 (increment in height in previous year in cm) + 59

= (1.19 X 140.0) – (3.1 X 11.0) – (1.5 X 10.0) – (0.3 X 5.0) + 59 cm

= 175 cm

Ex. 9.2 Predict the adult height of the 9 year old girl with following characteristics

(Use table 9.2 and choose the coefficients for height, chronological age and bone age as

well as the constant for age 9.0 years .)

Height = 138 cm
Age = 9.0 years

RUS bone age = 8.1 year

The following equation suits this girl:

Adult height = (0.92 x height) – (1.7 x chronological age) – (2.4 x RUS bone age) + 81

= (0.92 x 138) – (1.7 x 9.0) – (2.4 x 8.1) + 81

= 173.22 cm

Bone age in conjunction with the chronological age can predict the age at menarche reasonably well.

Marshall and Limongi (1976) have give the following equation to predict the age at menarche from bone

age and actual age as follows:

Age at menarche = 13.3 – (RUS bone age – chronological age)

Ex. 9.3 Predict the menarcheal age of a girl with RUS bone age as 8.1 year and chronological age as 9.0

years from the equation of Marshall and Limongi (1976).

Age at menarche = 13.3 – (RUS bone age – chronological age)

= 13.3 - (8.1 – 9.0) = 13.3 + 0.9 years

= 14.2 years.

9.3 Physique and disease

It seems to be a common observation that there are specific diseases which afflict specific types

of physiques. It may be assumed that the particular type of physique provides a fertile ground for

a disease to thrive on. Outlook of the body reflecting shape, size and body proportion varies from

individual to individual. Attempts at linking physique to disease are age old. An Italian physician

Viola (1921) devised a method of human physique analysis by utilizing body measurements. He

grouped physique into four categories as longitype, brachitype, normotype and the mixed type.

Extending the concept further, Italian scientist Pende (1949) categorized human physique as

longilinear and brevilinear. Each category was further divided into sthenic and asthenic on the

development of the muscularity. The middle category of normolinear was also included later on.

The body proportions of brachilinear were like a child. They were less mature biochemically,

physiologically and psychologically. This category has vociferous eating habits. They show
allergic hyper reactions. A greater activity of adrenal, pancreas and sex glands is explicit in them.

Temperamentally they show extraversion of personality. The longilinear have a dominant role of

thyroid and hypophysis glands. They show lower activities of sex glands and are prone to

schizophrenia and also show introversion of personality.

The major shortcoming in earlier methods of analysis of human physique of a three or four

discrete types was removed by Sheldon et al. (1940). They devised a method to classify human

physique on the basis of nude photographs and termed his method as somatotyping. The help of

body measurements was taken so as to make it simpler, easily executable and more objective by

Bullen and Hardy 1946, Cureton 1947, Hooton 1951, Damon et al. 1962, Petersen 1967,. But

most of these methods remained relatively unused because of certain discrepancies. The Heath-

Carter method of somatotyping is one such attempt which fulfils to a major extent these

requirements and is widely in use throughout the world during the last two decades. Its

application is immense in the fields of sports sciences, anthropology, human biology, child

growth, etc. It is based on anthropometric measurements which are easy to take on the subjects.

Heath (1963) critically examined the shortcomings in Sheldon's method and suggested alterations

and modifications in it. Later on, Heath and Carter in 1967 gave their own method of

somatotyping. Though this method differs from that of Sheldon's in the sense that it evaluates the

body form or physique at the given time compared to the unchanging somatotype of Sheldon. The

ratings of three primary components of physique are assigned from the tables or can be calculated

directly using equations given by Carter (1980), Heath and Carter (1990) on the basis of the

anthropometric measurements. Heath and Carter (1967) have defined these concepts as follows:

"A Somatotype is a description of the present morphological conformation. It is expressed in a

three numeral rating, consisting of three sequential numbers, always recorded in the same

manner. Each numeral represents the evaluation of three primary components of physique which

describe individual variations in human morphology and composition."

Studies have tried to investigate the association of specific type of somatotype with disease. It has been

shown that in case of patients of coronary artery disease (CAD), endomorphy was significantly correlated

with abdominal circumference, the abdomen-to-hip ratio and the abdominal sagittal diameter whereas

mesomorphy was not related to these indicators of android or abdominal adiposity with the help of partial

regression analysis (Williams et al. 2000). It has also been observed that ectomorphy or leanness of the

body was inversely related to the indices of general and regional adiposity. In other words, the greater is the

linearity the lesser is the general fatness over the body and also the regional fatness. It suggests that

adiposity or fatness and muscularity are important determinants in terms of increased CAD risk, whereas

linearity seems to be beneficial. Study by Herrera et al. (2004) found an association between ectomorphy

and both systolic blood pressure (SBP) and diastolic blood pressure (DBP). The sample showed that as

ectomorphy increased the blood pressure decreased during adulthood, except for the oldest age group.

Endomorphy and mesomorphy didn’t show any correlation with blood pressure in males indicating that

endomorphy and mesomorphy exhibit a neutral stance in determining the blood pressure. In females this

pattern has been inconsistent and thus no conclusion of body type with blood pressure could be elicited.

The somatotype distribution of persons with high levels of SBP and DBP had shown an overlap to the

somatotypes of those of other male groups characterized by myocardial infarction, coronary heart disease

and the risk of hypertension, indicating that these somatotypes may be associated with cardiovascular risk

factors. It may be generalized that the individuals who had a cardiovascular risk profile are more

endomorphic and mesomorphic and less ectomorphic than those with a lower cardiovascular risk profile.

The individuals of robust physique (with high endomorphy and mesomorphy) or the Viola’s brachitype

physique showed high mean values of systolic and diastolic BP, whereas the smallest persons had the

lowest BP values (Kalichman et al. 2004). They also suggested the possibility of the involvement of

pleiotropic genes and/or epigenetic mechanisms in the regulation of the development of body physique and

blood pressure. A group of young men were followed for 18-years to monitor their blood pressure (Harlan

et al 1962). Seven hundred and eighty-five (96 per cent) survived during this period and were re-evaluated

who had the mean age as 42 years. Significant correlations were observed between the indicators of

weight and somatotype. A significantly greater increase in blood pressure with increasing weight was
noticed indicating the role of higher body weight in increasing the blood pressure. Subjects with a

predominance of ectomorphic characteristics had shown a smaller increment of blood pressure over the

period of study. It means that the lean persons had shown almost stable blood pressures over the period of

study. Endomorphic subjects had a greater increment of blood pressure. Patients showing a significantly

greater increase in blood pressure had a predisposition because of the family history in these subjects. The

greater increment in blood pressure associated with a positive family history was independent of weight

gain that means if there is a family history the chances of hypertension increase. ut

Not only does the sedentary endomorphic persons show raised blood pressure values but those who

indulged in physical activity also show increased blood pressure (Badenhorst et al. 2003). The somatotype

and elevated blood pressure showed associations and an increase in physical activity did not lower the

resting blood pressure values of endomorphic boys. Relationships between Heath-Carter anthropometric

somatotype components and cardiovascular risk factors were also investigated by Malina et al. (1997) in

642 healthy adults. Risk factors included systolic and diastolic blood pressures (SBP, DBP), fasting

glycaemia , and blood lipids. Correlations between risk factors and each somatotype component were

calculated after controlling for the effects of the other two somatotype components. Endomorphy or relative

fatness tended to be positively related to risk factors like blood pressure, fasting glycaemia and blood

lipids in older females. In case of older males ectomorphy or relative linearity tended was negatively

related to risk factors. It means that the more an ectomorphic a person is the lesser would be the values of

his blood pressure, blood sugar and blood lipids. The individuals who represented the extremes of the

somatotype distributions had by and large more values of each risk factor. Persons with higher risk profile

tended to be more endomorphic and mesomorphic and less ectomorphic than those with a lower risk

profile.

Katzmarzyk et al. (1998) explored the relationship between physique and metabolic fitness of 413 boys

and 343 girls in the age ranger of 9-18 years from Québec. Physique was assessed using the Heath-Carter

anthropometric somatotype. The metabolic fitness was assessed from plasma triglyceride levels (TG), high

density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and blood glucose

levels (GLY). In both boys and girls there is a significant correlation between the physique and metabolic

fitness variables. The Heath-Carter anthropometric somatotype explains 8% to 19% of the variance in
metabolic fitness variables. The results of this study indicate that a physique characterized by high

endomorphy and mesomorphy has a propensity to have higher blood lipids even during very young ages

of 9-18 years.

The somatotypes of female patients has been investigated for different categories of genital tract cancer by

Eiben et al. (2004). The patients suffering from ovarian cancer had a somatotype as 6.8-5.3-1.0. This is an

extremely fatty physique associated with a strong muscularity. The endometrial cancer patients had a

somatotype as 7.9-5.8-0.9 which is even more fatty than that of the ovarian cancer patients. The variance

analysis showed that there was no significant difference among majority of the patients who had

mesomorphic-endomorph. It means most of the patients had very similar somatotypes. The endomorphic

elements dominated in their physique and mesomorphy (robusticity) was greater than ectomorphy

(linearity).

Butova et al (2005) tried to distinguish the somatotypic characteristics of healthy women and patients with

mammary gland cancer. There was a dominance of athletic type in patients of mammary gland cancer

which means a high development of mesomorphy especially during mature age. The oncological pathology

in the studied periods of ontogenesis has demonstrated a predominance of a mesomorphic vector in

shaping their somatotype. Caldin et al. (1959) investigated 400 patients admitted consecutively to a

Veterans Hospital for pulmonary tuberculosis with the help of photographs for obtaining somatotype

evaluation according to Sheldon's method. Analysis of the data revealed that almost all of the patients had

mesomorphy and endomorphic-mesomorphy predominant in their body characteristics. Only 14 per cent of

the subjects of the study showed the thin, narrow ectomorphic physique which traditionally has been

associated with tuberculosis. Clinical impression of the patients , however, suggests that tuberculosis

patients may be having weak-looking body physiques. The folk wisdom which seems to relate thin body

build and tuberculosis in the past has been attributed by the present authors to confusion between weight

loss or emaciation which may be a consequence of the disease and the fundamental physique which

existed prior to the onset of the illness. Patients with Down’s syndrome seem to have a somatotype which

goes much beyond the boundary of the endo-mesomorphic sector and meso-endomorphic sector of the

soamtochart. Most of these patients possess endomorphy and mesomorphy ratings above 6 each (Buday

and Eiben 1982, Buday 1990). It means endomorphy ratings are usually very high and their muscularity
also matches to a major extent with that of their fatness. A study on thallasemia child patients has been

conducted by Gaur and Sarkar (1998) which reflect a different set of somatotypes of the patients from those

of the control children.

A review of the epidemiological studies on somatotype/physique and disease indicate strong relations in

many cases. There are numerous organic diseases which indicate that there is a clustering of the risks in

the families. There seems to be some common link between somatotype and disease. The physiological

path indicating the clear cut relationship between the two remains obscure. The interaction between

heredity and environment in the origin of the disease is almost undeniable. Sing et al. (2003) are of the

opinion that the distribution of disease among individuals, families, and populations result from interactions

between the effects of many susceptibility genes and many environmental exposures. All regulatory

mechanisms ultimately become integrated to produce not the normal phenotype but the disease phenotype

(Sing et al. 1992, Strohman 2002, Dennis 2003). The organic diseases generally seem to have a complex

multifactorial etiology where neither the genetic nor environmental inputs of an organism act

independently to cause disease. The numerous genes through different routes of metabolic pathways would

be responsible for the disease condition. Even complete information about an individual’s hereditary

constitution or exposures to adverse environments cannot predict with certainty the onset, progression, or

severity of disease. Zerba et al. (2000) are of the opinion that disease develops as a consequence of

interactions between the "initial" conditions, which the genes exhibit along with exposures to

environmental agents and which develops through special temporal plane. The views on the causation of

the disease are very diverse. One of the beliefs is that each case of a disease is caused by a variation in a

single agent while the other viewpoint is that disease is a consequence of the ‘Complex’ organization of

interacting agents. In order to understand the complexity of the etiologies of disease there is a need to

conduct extensive studies which include variations in gender, age, and other measures of environmental

effects. So the researchers must look into the vast laboratory the mother nature provides to find out about

the types of experiment and the model that should be used to describe the nature of disease (Anderson

1972, Kardia et al. 1999, Stengård et al. 1999).

9.4 Nutritional status

The body measurements of the child serve as a very good proxy measure of his

nutritional status. The child spends energy on growth, maintenance and play. If his

energy intake is more than these needs combined together he is stated to be in a positive

energy balance and would grow favorably and may also run the risk of becoming fat. If

on the other hand, he maintains an equilibrium between the energy intake and the energy

expenditure including all his needs of growth as well, he is healthy and grows normally.

But a situation where the energy balance is negative which means the energy intake is

lower than the energy expenditure, the child would be undernourished. In this case, the

growth of the child runs the risk of being affected. Nutritional anthropometry which is

based on various measurements like height, weight, fatfolds and upper arm circumference

is considered to be a safe, easy and quite effective way of screening the children whether

they grow normally or not with a comment on their nutritional status. A detailed

discussion on anthropometric indicators has already been provided in Chapter 7.

9.5 Estimating Skeletal Frame size

The skeletal frame of the human body is a wonderful anchor which has a tremendous

capability of carrying not only the load of the human body but also that of many articles

of daily use. Imagine the weight of the heaviest man on earth who is more than 400 kg in

the context of another man with a matching height but with a body weight as low as only

60 kg. The soft tissues can rearrange themselves in many different ways and in different

proportions in the human body. The sturdy bones and joints have the capacity to support

huge amounts of soft tissues whereas a frail skeletal frame has a lot of limitations in

putting on soft tissues. There are various measures of the estimation of skeletal frame
size. Generally the widths of the joints are considered to be the best indicators of the

skeletal frame size of the body. Humerus bicondylar, femur bicondylar, shoulder and hip

widths, chest breadth and chest depth, wrist and ankle breadths are some of the important

measures of skeletal frame of an individual. Western Insurance Corporations judge the

skeletal frame as small, medium and large on the basis of elbow breadth. The skeletal

frame size is an indicator of the lean tissues of the body and seems to correlate highly

with this compartment of the body (Himes and Frisancho 1988). The elbow width and

stature are used to estimate the skeletal frame size as small, medium and large.

9.6 Obesity

Obesity is emerging as a global epidemic as a result of the general affluence,

modernization, pleasure seeking habits and lesser hours of work by the people. It is

because of the excessive storage of fat in the body as a result of the positive energy

balance. An excessive fatty tissue results in cardiovascular complications leading to

morbidity and mortality. Among the anthropometric measurements, the most logical ones

seem to be the skin and subcutaneous tissue fold thicknesses. The adipose tissue has a

good correlation to the overall amount of body fat and hence skinfolds are considered to

be the best. There are lots of sites on the body as well as on the limbs which are not only

convenient but are representative measures also. The ones on the trunk include thoracic,

abdominal, suprailiac and subscapular whereas those over the extremities include triceps

and biceps, thigh and calf. As the person becomes more and more obese, it becomes

increasingly difficult to take the measurements of skinfolds. The underlying thick layers

of fatty tissues pose problems in picking up the required fold of the adipose tissue and

hence the measurements taken on them would include lot of errors and cannot be
considered as accurate. However, the circumferences of mid arm, thigh, chest, waist and

hips are very good in assessing obesity. The circumferences are generally preferred over

skinfolds in the case of obese individuals because the inter- and intra- observer

measurement errors are small and also because all the circumferential measurements can

be taken on the obese whereas some skinfolds might be possible to measure. The

distribution of aft over the body is considered to be linked to the disease risk. It is the fat

over the abdomen and inside the body cavities that is specially linked to disease. Two

types of fat distributions are proposed such as android or apple type and gynoid pear type

(Fig 9.4).

Insert Fig.9.4 somewhere here

• Android fat is on the trunk, abdomen, chest, shoulders, but less on lower portions

of the body like hips and thighs and is typical of males.

• Gynoid fat is prominent on the lower portions of the body including hips and

thighs but less over the abdomen and is typical of females.

• Inter-changes of these patterns can be found in both the sexes.

Fat which is located deep within the abdomen is called intra-abdominal fat. Fat being

sticky wraps itself around various vital organs of the body. It is a well known fact that

fat people would be having lots of intra abdominal fat. Even thin people may have this

fat. Women who are generally protected before menopause have a strong tendency to

develop intra abdominal fat after menopause. Intra abdominal fat increases the risk of

cardiovascular disease, high blood pressure, high cholesterol, diabetes and many other

systemic diseases.
9.7 Chronic Illness and disease

In the healthy individuals, the energy intake and energy expenditure equals each other

and the body weight remains constant over a very long period of time although the

subject do not seem to make any conscious efforts in maintaining it. On the other hand, a

positive energy balance means that the triglycerides are stored as energy reserve in

adipose tissue increasing the fat mass whereas the synthesis of proteins increases the lean

tissue amounts. The net result is weight gain, may be due to increase in lean tissue or fat

tissue or both of these. In case of negative energy balance, the soft tissues serve the

purpose of body fuels. Depletion of protein and mobilization of adipose tissue would take

place resulting in the wasting of muscles, adipose tissue and other soft tissues of the

body. Heymsfield (1988) represented the above events diagrammatically which are given

in Fig 9.5.

Insert Fig. 9.5 somewhere here

The square X represents the hypothetical situation of a healthy individual in whom the

energy input and output equal each other. In other words, in this person:

 Energy balance is zero

 Protein (Nitrogen) balance is zero

 Water balance is zero.

The largest square Ya represents the hypothetical situation of a person in whom energy

input outweighs energy output. Therefore in him:

 Energy balance is positive

  Protein (Nitrogen) balance is positive

 Water balance is positive.

The weight gain in this person would be very high and at the upper extreme of positive

energy balance, there would be one of the most obese person possible .

The smallest square Yb represents a hypothetical individual in whom the energy intake is

very small compared to the energy output and the gap is very big. His position would

represent:

 Energy balance is negative

 Protein (Nitrogen) balance is negative

 Water balance is negative.

It may be mentioned here that the situations of Ya and Yb represent the limits of survival

based on the maximum and minimum amounts of soft tissues. As the person moves

either way from the situation of X towards Ya or Yb, the chances of a morbid event

taking place increase and near the limits, the chances of mortality increase drastically.

The anthropometry can be of use in the following ways:

 In establishing the protein – energy content of the patient with respect to his

normal range

 To monitor the changes in protein - energy balance over a given period of time

and to take into account the rate at which these occur

 To project potential complications arising out of obesity or undernutrition

resulting in the occurrence of some morbid event.

Cancer is a dreaded and almost incurable disease in its terminal stage which is taking a big toll of human

lives. Diet is considered to be one of the important risks for cancer. The role of anthropometry in cancer
can be evaluated indirectly where it can help in assessing the nutrition of the individuals. Since the nutrition

affects the growth and development of children therefore indirectly the body measurements can be of help

in cancer research. Micozzi (1988) has found significant associations between cancer mortality rates and

body weight, shoulder width and stature.

The adult body ratios and those of the children bear a lot of resemblance and hence can provide vital clues

about the possible associations between the chances of cancers and body measurements. The overall frame

size of the body also holds a lot of potential in this respect. However, no single measurement can be of

much use in finding susceptibility of individuals to cancer. It is desirable to think of multiple combinations

of measurements and their relationships which might prove useful in individuals suffering from different

types of cancers and also in finding the susceptibility of the subjects.

 Cardiovascular risk

Presently the propensity to various metabolic diseases and illnesses is being judged with

the help of anthropometric measurements. Epidemiological studies related to

cardiovascular risk assessment rely a lot on these measurements. Studies on blood

pressure vs skinfolds over the triceps and subscapular has revealed that the risk of

higher blood pressure is better determined with the help of central fat rather than the

peripheral fat.

 The subscapular skinfold provides a better assessment of risk of hypertension as

compared to the triceps skinfold.

 There is evidence that increased muscularity as judged with the help of

somatotype has a greater susceptibility to premature coronary heart disease.

 Body build is more related to hypertension as compared to the general fatness.

  Persons with greater values of the ratio between abdominal circumference to chest

circumference (expanded) have a greater chance of mortality in the older age

groups.

 Waist circumference to hip circumference ratio is a good indicator of stroke and

ischemic heart disease.

 Andriod type of obesity is related to non-insulin dependent diabetes mellitus

(NIDDM) irrespective of the sex of the person whereas gynoid type of obesity

seems to correlate with psychological problems

9.8 Sports

There are many sports events where the persons with similar body physiques excel. When

such groups are analyzed for somatotype distributions on the somatocharts, they tend to

cluster narrowly in a particular area on the soamtochart. This also highlights the fact that

certain physiques have definite advantage in certain sports. Having conformed the role of

physical structure the next step is to quantify the physical structure most suited for the

given sport. Since the top performers in any sports are generally found in the Olympics or

World games, so these are the most important places to hunt for the suitable physiques.

Indeed there are many studies on athletes of different Olympics which are available. Thus

the clues about the most suitable type of physique in any given sport are available. The

subjects with the most wanted type of physique can be identified and encouraged to take

part in those events or sports to which their physiques would get an advantage. They can

have a definite edge over others simply by way of their desired physiques and if they are

equal on stamina, endurance, technique and all other qualities then they would be natural
winners. Physique would best be studied with the help of anthropometric measurements

and thus identification of suitable physiques can easily be made.

With the help of anthropometric techniques the age changes in physical structure sand its

association with the functional characteristics and motor abilities can be made. The

longitudinal follow up can unravel the individual variations in these characteristics.

Such studies can answer the vital question of the individual trends in development of

physique over the years. The prediction of various parameters like height at adulthood

can be made with accuracy from those at younger ages. If such predictions tell us about

the adult physique of persons then a comparison of his physique with that of the most

desirable physique of the Olympic athlete of different sports can be made. If there is

matching of the physique of the two then it would a potent case of surpassing in the game

and the child can be groomed at younger ages to become a champion later on. This opens

the way for talent hunt in sports.

9.9 Human dimensions for design solutions

Anthropometry is useful in the automobile industry in designing luxury seating

arrangements for the passengers and good driving seats for the drivers. The panel of

controls are also designed keeping the human dimensions of arm and leg in mind. The

space shuttles, the aero planes and fighter jets all have to depend to the size of the

prospective drivers and crew. The size of the head and face provide important clues for

the designing of the respirators, oxygen masks, protective clothing, helmets and gloves

for firefighters, military personnel, and industrial workers, prosthetic limbs, eye wear,

medical and surgical devices, scuba diving gear, bicycle helmets and more. The garment

and shoe is a very big industry which cannot make compromises on the sizes of the
products made by them. The clothes have to fit properly and the shoes must not pinch

the wearer. All such efforts are based on the collection of vast data base on the foot

dimensions and other body measurements for right sizing the population’s needs for such

utilities.

Anthrotech is a multinational company which provides design solutions with the help of

human body measurements (http://www.anthrotech.net/home.html). Its job is to

provide the body size data which can help in:

 Developing accurate sizing systems

 Improving garment fit using 3-D scanning

 Diversifying the market for products

 Avoiding costly post-production re-design

 Improving consumer comfort and work safety

 Reducing inventory costs

9.10 Appliances for left hander

Gone are the days when the children were reprimanded or punished for doing work with left hands. Now-a-

days the teachers, parents and society encourage the left-handed children to use their left hands for writing

and also for other types of work. But there are specific tasks which cannot be performed by left-handers

with the ordinary machinery and tools available in the market. Scissors is one such example and which is

used in routine work by a majority of people. Ask a left-hander to use the scissors and he would explain

how painful and inefficient it is to work with the scissors available because these are made for the right-

handed ones. But now the manufacturers produce numerous articles for left-handed persons. These include

scissors, pens, peelers, musical instruments and guitars, golf sticks, playing cards, watches, etc. Famous

Indian actors Amitabh Bachhan and Abhishek Bachhan are left handed persons.
Chapter 9 Exercises

Ex. 9.1. Predict the adult height of the following boys:

a. height 145 cm, age 11.0 year, bone age 10 years, increment during the previous year 10 cm
b. height 151 cm, age 12.0 year, bone age 13 years, increment during the previous year 8 cm
c. height 138 cm, age 11.0 year, bone age 9 years, increment during the previous year 7 cm
d. height 149 cm, age 11.0 year, bone age 10 years, increment during the previous year 9 cm
e. height 155 cm, age 12.0 year, bone age 11.3 years, increment during the previous year 11 cm

Ex. 9.2. Predict the adult height of the following girls:

a. height 125 cm, age 7.0 year, bone age 8.2 years
b. height 131 cm, age 9.0 year, bone age 7.6 years
c. height 118 cm, age 7.0 year, bone age 7.5 years
d. height 139 cm, age 9.0 year, bone age 10.8 years
e. height 115 cm, age 7.0 year, bone age 5.9 years
Ex. 9.3. Predict the age at menarche in the following girls:
a. chronological age 10 yr RUS bone age 12 yr
b. chronological age 9 yr RUS bone age 10.8 yr
c. chronological age 7 yr RUS bone age 5.9 yr
d. chronological age 8.5 yr RUS bone age 9 yr
e. chronological age 7.5 yr RUS bone age 8.2 yr

Chapter 9 Answers

Ans. 9.1. The predicted adult heights of the boys are as follows:
a. 179.45 cm
b. 171.56 cm
c. 173.52 cm
d. 184.51 cm
e. 176.301 cm

Ans. 9.2. The predicted adult heights of the girls are as follows:
a. 167.044 cm
b. 167.98 cm
c. 161.745 cm
d. 167.66 cm
e. 161.203 cm

Ans.9.3. Predicted age at menarche

a. 11.3 yr
b. 11.5 yr
c. 14.4 yr
d. 12.8 yr
e. 12.6 yr

Table 9.1. Coefficients and constants of adult height prediction in boys (adapted from

Tanner et al. 1983)

Age (yr) Constant Height Actual age Bone age Increment

(cm) of height
(yr) (RUS yr) (cm)
11.0 59 +1.19 - 3.1 -1.50 0.3

12.0 73 +1.15 -2.3 -2.73 -1.5

13.0 91 +1.03 -1.6 -3.57 -1.0

14.0 109 +0.95 -1.1 -4.73 -0.5

15.0 95 +0.89 -0.7 -3.68 -0.2

Table 9.2. Coefficients and constants of adult height prediction in girls (adapted from

Tanner et al. 1983)

Age (yr) Constant Height (cm) Actual age Bone age

(yr) (RUS yr)
6.0 89 +0.89 -3.3 -1.15

7.0 87 +0.89 -2.9 -1.33

8.0 84 +0.89 -2.2 -1.73

9.0 81 +0.92 -1.7 -2.40

10.0 86 +0.91 -1.6 -3.03

Ya
+

Yb

- ___
Fig. 9.5 Diagrammatic representation of Deviations in energy balance and weight gain
resulting in morbid events. Square X shows hypothetical situation of a healthy individual
where energy balance is zero and no weight gain. The largest square Ya represents the
situation of positive energy balance and hence more weight whereas the smallest square
Yb represents a situation of negative energy balance and hence less weight. The upward
arrow from square X indicates the possibility of morbid events of +ve energy balance
whereas downward arrow from X indicates the morbid events of –ve energy balance.
 REFERENCES

AAHPERD. 1976. Youth Fitness Test Manual. Washington, DC.

AAHPERD.1980. Health Related Physical Fitness Manual. Washington, DC.
Alberman, E. 1984. Low Birth Weight. In : Perinatal Epidemiology. Bracken, M. (Ed.). Oxford University
Press, New York.

Anderson, P.W. 1972. More is different: broken symmetry and the nature of the hierarchical structure of
science. Science. 177: 393–396.

Backstrand, R. 1995. Maternal Anthropometry as a risk predictor of pregnancy outcome: The Nutrition
CSRP in Mexico. Bulletin of the WHO, 73 (Suppl.), 96-97.
Badenhorst, L., de Ridder, J.H. and Underhay, C. 2003. Somatotype, blood pressure and physical activity
among 10- to 15- year old South African boys: the THUSA BANA study. Afr. J. Physical Hlth. Edu.
Recreation and Dance, 9: 184-195.
Bagdade, J.D., Bierman, E.L. and Porte, D. Jr. 1967. The significance of basal insulin levels in the
evaluation of the insulin response to glucose in diabetic and non diabetic subjects. J. Clin. Invest.,
46, 1549-1557.
Barsh, G.S., Farooqi, I.S. and O’Rahilly, S. 2000. Genetics of body weight regulation. Nature, 404, 644-
651.
Baskin, D. Breininger, J. and Schwartz, M. 1999. Leptin receptor mRNA identifies a sub-population of
neuropeptide Y neurons activated by fasting in rat hypothalamus. Diabetes 48, 828-833.
Baumrind, S. 1986. Integrated surface and deep structure mapping of the human anatomy. In Perspectives
in Kinanthropometry, (ed.) Day J.A.P., Human Kinetics, Champaign. 269-284.
Becque, M.D., Katch, V.L., and Moffatt, R.J. 1986. Time course of skin plus fat compression in males and
females. Hum. Biol., 58, 33-42.
Beddoe, A.H., Streat, S.J. and Hill, G.L. 1984. Evaluation an in vivo prompt gamma neutron activation
facility for body composition studies in critically ill intensive care patients: results in 41 normals.
Metabolism, 33, 270-280.
Behnke, A.R. and Wilmore, J. 1974. Evaluation and regulation of body build and composition. Englewood
Cliffs, N.J.
Behnke, A.R. 1942. Physiologic studies pertaining to deep sea diving and aviation, especially in relation to
fat content and composition of the body. Harvey Lecture Series, 37, 198-226.
Best, W.R., Kuhl, W.J. and Consolazio, L.F. 1953. Relation of creatinine co-efficients to leanness-fatness
in man. J. Lab. Clin. Med., 42, 784.
Bray, G.A. 1987. Overweight is risking fate. Definition, classification, prevalence and risks. Ann. NY Acad.
Sc. 499, 14-28.
Brozek, J., Grande, F., Anderson, T. and Keys, A. 1963. Densitometric analysis of body composition:
revisions of some quantitative assumptions. Ann. N .Y. Acad. Sc., 110, 113-140.
Buday, J. 1990. Growth and Physique in Down Syndrome Children and Adults.: Humanbiologia
Budapenstinesis, Budapest.
Buday, J. and Eiben, O.G. 1982. Somatotype of adult Down’s patients. Anthropologiai Kozlemenyek, 26:
71-77.
Bugyi, B. 1972. Lean body weight estimation in 6-16 year old children based on wrist breadth and body
height. J. Sports Med. Phys. Fitness, 12, 171-173.
Bullen A.K. and Hardy, H.L. 1946. Analysis of body build photographs of 175 college women. Am. J.
Phys. Anthrop., 4, 37-65.

Butova, O.A., Ereminm V,A. and Seifulina, G.V. 2005. Somatotype of women of the Stavropoulos region
with mammary gland pathology. Morfologiia, 127:46-48.

Caldin, G., Dupertuis, C.W. and Lewis, W.C.: Body Types and Tuberculosis. Psychosomatic Medicine
21:460-472 (1959).
Cameron, N. 1998. Fat and Fat Patterning, In : Human Growth and Development. S.J. Ulijaszek, F.E.
Johnston and M.A. Preece (Eds.) Cambridge University Press, Cambridge, 230-232.
Campbell, P. 2000. Obesity. Nature, 404, 631-631.
Campbell, P. and Ulijaszek, S.J. 1994. Relationships between anthropometry and retrospective morbidity in
poor men in Calcutta, India. Eur. J. Clin. Nutr., 48 , 507-512.
Carter, J.E.L. 1975. The Heath-Carter somatotype method. SDSU Syllabus Service, San Diego.
Carter, J.E.L., 1980. The Heath-Carter somatotype method. SDSU Syllabus Service, San Diego. 2nd
Edition.
Carter, J.E.L. and Heath, B.H. 1990. Somatotyping - Development and Applications. Cambridge:
Cambridge University Press.
Carter, J.E.L., Ross, W.D., Duquet, W. and Aubry, S.P. 1983. Advances in somatotype methodology and
analysis. Yearbook of Physical Anthropology, 26, 193-213.
Chumlea, W.C. and Roche, A.F. 1988: Assessment of the Nutritional Status of Healthy and Handicapped
Adults. In : Anthropometric Standardization Reference Manual. T.G. Lohman, A.F. Roche and R.
Martorell (Eds.). Human Kinetics, Champaign, 115-119.
Clarke, H.H. 1971. Physical and Motor Tests in the Medford Boys Growth Study. Englewood-Cliff, New
Jersey.
Clarys, J.P., Drinkwater, D.T., Martin, A.D. and Marfell-Jones, M.J. 1987. The skinfold: myth or reality? J.
Sport Sc., 5, 3-33.
Cohen, J. 1977. Statistical power analysis for the behavioural analysis. Academic Press, New York.
Cohn, S.H., Vartsky, D., Yasumura, S., Sawitsky, A., Zanzi, I., Vaswani, A.N. and Ellis, K.J. 1980.
Compartmental body composition based on total body nitrogen, potassium and calcium. Am. J.
Physiol., 239, 524-530.
Colman, E., Toth, M.J., Katzel, L.I., Fonong, T., Gardener, A.W. and Poehlman, E.T. 1995. Body fatness
and weight circumference are independent predictors of the age-associated increase in fasting
insulin levels in healthy men and women. Int. J. Obes. 19, 798-803.
Crenier, E.J. 1966. La prediction du poids corporel ‘normal’. Biometr. Hum., 1, 10-24.
Cressie, N.A.C., Withers, R.T. and Craig, N.P. 1986. The statistical analysis of somatotype data. Yearbook
of Physical Anthropology, 29, 197-208.
Cronk, C.E., Roche, A.F., Kent, R., Berkey, C., Reed, R.B., Valadian, I., Eichorn, D., and McCammon, R.
1982. Longitudinal trends and continuity in weight/ stature from 3 months to 18 years. Hum. Biol.
54, 729-750.
Cuff, T. 1992. A Weighty Issue Revisited: New Evidence on Commercial Swine Weights and Pork
Reduction in Mid-Nineteenth Century America. Agricultural History, 66, 55-74.
Cureton, T.K. 1947. Physical Fitness, Appraisal and Guidance. Kimpton, London.
Cureton., T.K. 1951 Physical fitness of champion athletes. University of Illinois Press, Urbana, Illinois.
Damon, A., Bleibteaue, H.K., Elliot, O. and Giles, E. 1962. Predicting somatotype from body
measurements. American Journal of Physical Anthropology, 20, 461-474.
Defe, B.K. and Partin, M. 1993. Determinants of low birth weight - a comparative study. J. Biosoc. Sc., 25,
87-100.
Drinkwater, D.T. and Ross, W.D. 1980. Anthropometric fractionation of body mass. In Kinanthropometry
II. ed. M. Ostyn, G. Beunen and J. Simons. University Park Press, Baltimore, 178-189.
Drinkwater, D.T., Martin, A.D., Ross, W.D. and Clarys, J.P. 1986. Validation by cadaver dissection of
Matiegka’s equations for the anthropometric estimation of anatomical body composition in adult
humans. In Perspectives in Kinanthropometry, ed. J.A.P. Day, Human Kinetics, Champaign, 221-
227.
Duquet, W. and Hebbelinck, M. 1977. Application of the somatotype attitudinal distance to the study of
group and individual somatotype status and relations. In: O. Eiben (ed.) Growth and development:
Physique. Akademiai Kiado, Budapest, 377-384
Durnin, J.V.G.A. and Rahaman, M.M. 1967. The assessment of the amount of fat in the human body from
measurements of skinfold thickness. British Journal of Nutrition, 21, 681-689.
Durnin, J.V.G.A. and Womersley, J. 1974. Body fat assessed from total body density and its estimation
from skinfolds thickness: measurements on 481 men and women aged from 16 to 72 years. British
Journal of Nutrition, 32, 77-97.
Edholm, O. G., Adam, J. M. and Best, T. W. 1974. Day-to-day weight changes in young men. Ann. Hum.
Biol., 3, 3-12.
Edholm, O.G. 1977. Energy balance in man. J. Human Nutr. 31, 413-431.
Edwards, D.A.W., Hammond, W.H., Healy, M.J.R., Tanner, J.M. and Whitehouse, R.H. 1955. Design and
accuracy of callipers for measuring skinfold tissue thickness. Br. J. Nutr., 2, 133-143.
Eiben O.G., Buday, J. and Bosze, P. 2004. Physique of patients with carcinoma of the female genital tract.
Eur. J. Gynaecol. Oncol., 25:683-688.

Eltis, D. 1982. Nutritional Trends in Africa and the Americas : Heights of Africans, 1819-1839. Journal of
Interdisciplinary History, 12 : 453-475.
Engerman, S. 1994. Comments. In : Stature, Living Standards and Economic Development. J. Komlos
(Ed.). pp. 205-209. The University of Chicago Press, Chicago.
Eveleth, P.B. and Tanner, J.M. 1990. Worldwide Variation in Human Growth. Cambridge University Press,
Cambridge.
Ferro-Luzzi, A., Sette, S., Franklin, M.F. and James, W.P.T. 1992. A simplified approach to assessing adult
chronic energy deficiency. Eur. J. Clin. Nutr., 46, 173-86.
Fidanza, F., Keys, A. and Anderson, J.T. 1953. The density of body fat in man and other mammals. J. App.
Physiol., 6, 252-256.
Flynn, M., Scott, T., Pritchard, T. and Plata-Salaman, C. 1998. Mode of action of OB protein (leptin) on
feeding. Am. J. Physiol., 275, 174-179.
Fogel, R. W. 1986. Nutrition and the Decline in Mortality since 1700. Some Preliminary Findings. In :
Long-Term Factors in American Economic Growth. Stanley L. Engerman and Robert E. Gallman
(Eds). NBER Studies in Income and Wealth, Vol. 51. Univ. of Chicago Press, Chicago, 439-555.
Forbes, G.B. 1962. Methods for determining composition of the human body. Paediatrics, 29, 477-494.
Forbes, G.B. 1987. Human Body Composition. Springer-Verlag, New York.
Forsyth, R., Plyley, M. and Shephard, R.J. 1988. Residual volume as a tool in body fat prediction. Ann.
Nutr. Metab., 32, 62-67.
Freedman, D.S., Williamson, D.F., Croft, J.B., Ballew, C. and Byers, T. 1995. Relation of body fat
distribution to ischemic heart disease. Am. J. Epid. 142, 53-63.
Friedman, J.M. 2000. Obesity in the new millennium. Nature 404, 632-634
Frisancho, A.R. 1990. Anthropometric standards for the assessment of growth and nutritional status.
University of Michigan Press, Ann Arbour.
Fuchs, R.J., Theis, C.F. and Lancaster, M.C. 1978. A nomogram to predict lean body mass in men. Am. J.
Clin. Nutr., 31, 673-678.
Garn, S.M. and Shamir, Z. 1958. Methods for research in human growth. Thomas, Springfield.]
Gaur, R., and Sarkar, P. 1998. Somatotypes of North Indian children with thalassemia major. Acta Medica
Auxologica, 30 : 89-95.
Gerber, L.M., Schnall, P.L. and Pickering, T.G. 1990. Body fat and its distribution in relation to casual and
ambulatory blood pressure. Hypertension 15 : 508-513.
Gerber, L.M., Schwartz, J.E., Schnall, P.L. andPickering, T.G. 1995. Body fat distribution in relation to sex
differences in blood pressure. Am. J. Hum. Biol. 7, 173-182.
Gibbs, J., Young, R.C. and Smith, G.P. 1973. Cholecystokinin decreases food intake in rats. J. Camp.
Physiol. Psycho., 84, 488-495
Gorstein, J., Sullivan, K., Yip, R., de Onis, M., Trowbridge, F., Fajans, P. and et al. 1994. Issues in the
assessment of nutritional status using anthropometry. Bull. WHO, 72, 273-283.
Graystone, J.E. 1968. Estimation of total body water and extra cellular volume. In : Human Growth, ed
D.B. Cheek, Lea and Febiger, Philadelphia, 668-673.
Habicht, J.P., Yarbrough, C. and Martorell, R. 1979. Anthropometric field methods: Criteria for selection.
In: Nutrition and Growth, Jelliffe, D.B. and Jelliffe, E.E.P. (Eds.), Plenum Press, New York, 365-
387.
Harlan, W.R., Osborne, R. K. and Graybiel, A. 1962. A longitudinal study of blood pressure. Circulation,
26: 530.
Harrison, G. G. 1987. The measurement of total body electrical conductivity. Hum. Biol., 59, 311-317.
Harrison, G.G. 1988. Skinfold thickness and measurement technique. In : Anthropometric Standardization
Reference Manual. T.G. Lohman, A.F. Roche and R. Martorell (Eds.). Human Kinetics,
Champaign, 55-70.
Heath, B.H. and Carter, J.E.L. 1967. A modified somatotype method. American Journal of Physical
Anthropology, 27, 57-74.
Heath, B.H. 1963. A need for modification of somatotype methodology. American Journal of Physical
Anthropology, 21, 227-233.
Heaton, J.M. 1972. The distribution of brown adipose tissue in the human. Journal of Anatomy, 112, 35-39.

Herrera, H., Rebato, E., Hernández, R., Hernández-Valera, Y. and Alfonso-Sánchez, M.A. 2004.
Relationship between Somatotype and Blood Pressure in a Group of Institutionalized Venezuelan Elders.
Gerontology, 50:223-229.

Heymsfield, S.B. and Wang, Z.M. 1995. The future of body composition research. In: Body Composition
Techniques in Health and Disease. Davies. P.S.W. and Cole, T.J. (eds.).Cambridge University
Press, Cambridge, 255-270.
Heymsfield, S.B. 1988. Anthropometric measurements in acute and chronic illness. In : Anthropometric
Standardization Reference Manual. T.G. Lohman, A.F. Roche and R. Martorell (Eds.). Human
Kinetics, Champaign, 137-142.
Himes, J.H. and Frisancho, R.A. 1988. Estimating frame size. In : Anthropometric Standardization
Reference Manual. T.G. Lohman, A.F. Roche and R. Martorell (Eds.). Human Kinetics,
Champaign, 121-124.
Hodgdon, J.A. and Fitzgerald, P.I. 1987. Validity of impedance prediction at various levels of fatness.
Hum. Biol., 59, 281-298.
Hooton, E.A. 1951. Handbook of Body Types in the United States Army. Harvard University, Cambridge.
ICMR 1972. Growth and physical development of Indian infants and children. Tech. Rep. Ser. No. 18.
ICMR, New Delhi.
International Commission on Radiological Protection. 1975. Report of the task Group on Reference Man.
No.23. Pergamon Press, Oxford.
Jackson, A.S., Pollock, M.L. and Gettman, L.R. 1978. Intertestrer reliability of selected skinfold and
circumference and per cent fat estimates. Res. Quart., 49, 546-551.
Jackson, A.S. and Pollock, ML. 1978. Generalised equations for predicting body density in men. Journal of
Nutrition. 40, 497-504.
James, W.P.T. and Francois, P. 1994. The choice of cut-off point for distinguishing normal body weights
from underweight or ‘chronic energy deficiency’ in adults. Eur. J. Clin. Nutr., 48 (Suppl. 3), 179-
184.
James, W.P.T., Ferro-Luzzi, A. and Waterlow, J.C. 1988. Definition of chronic energy deficiency in adults.
Am. J. Clin. Nutr. 42, 969-981.
Jebb, S.A. and Elia, M. 1995.Multi-compartment models for the assessment of body composition in health
and disease. In: Body Composition Techniques in Health and Disease. Davies. P.S.W. and Cole,
T.J. (eds.).Cambridge University Press, Cambridge, 240-254.
Jelliffe, D.B. 1966. The assessment of nutritional status of the community. World Health Organization
Monograph Series No. 53 WHO, Geneva.
Kalichman, L,, Livshits, G.and Kobyliansky, E. 2004. Association between somatotypes and blood
pressure in an adult Chuvasha population. Ann. Hum. Biol., 31: 466-476.

Kardia, S.L.R., Haviland, M.B., Ferrell, R.E. and Sing, C,F. 1999. The relationship between risk factor
levels and presence of coronary artery calcification is dependent on Apolipoprotein E genotype.
Arterioscler. Thromb. Vasc. Biol., 19: 427–435.

Karim, E. 1998. Maternal anthropometry and birth outcome, pp. 297-299. In : Human Growth and
Development. S.J. Ulijaszek, F.E. Johnston and M.A. Preece (Eds.) Cambridge University Press,
Cambridge.
Katch, F.I. and McAradle, W.D. 1983. Nutrition, weight control and exercise. Lea and Febiger,
Philadelphia.
Katch, F.I., Behnke, A.R. and Katch, V.L. 1979. Estimation of body fat from skinfolds and surface area.
Hum. Biol., 51, 411-424.
Katzmarzyk, P.T., Malina, R.M., Song, T.M.K. and Bouchard, C. 1998. Somatotype and indicators of
metabolic fitness in youth. Am. J. Hum. Biol., 10: 341-350.

Kennedy, E. and Garcia, M. 1994. BMI and economic productivity. Eur. J. Clin. Nutr., 48 (Suppl. 3), 45-53
Kennedy, G.C. 1953. The role of depot fat in the hypothalamic control of food intake in the rat. Proc. R.
Soc. Lond. B., 140, 579-592
Keys, A. and Brozek, J. 1953. Body fat in adult men. Physiol. Rev., 33, 245-345.
Komlos J. 1994. On the significance of Anthropometric History. In : Stature, Living Standards and
Economic Development. J. Komlos (Ed.). The University of Chicago Press, Chicago, 210-220.
Komlos, J. 1985. Stature and Nutrition in the Habsburg Monarchy : The Standard of Living and Economic
Development in the Eighteenth Century. American Historical Review, 90 (5), 1149-1161.
Komlos, J. 1987. The Height and Weight of West Point Cadets : Dietary Change in Antebellum America.
Journal of Economic History, 47, 897-927.
Komlos, J. 1990. Height and Social Status in Eighteenth-Century Germany. Journal of Interdisciplinary
History, 20, 607-621.
Komlos, J. 1993. The Secular Trend in the Nutritional Status of the Population of the United Kingdom,
1730-1860. Economic History Review, 46 , 115-144.
Kopelman, P.G. 2000. Obesity as a medical problem. Nature, 404, 435-443.
Kramar, M.S. 1987. Determinants of intra uterine growth and gestational duration: A critical assessment
and meta-analysis. Bulletin of the World Health Organization, 65 (5), 663-737.
Kramer, M.S. 1988. Determinants of Intrauterine Growth and Gestational Duration : A Methodological
Assessment and Synthesis. WHO, Geneva.
Kretschmer, E. 1925. Korperban und Charakter (26th ed.), Springer Verlag, Berlin.
Laubach, L.L. and McConville, J.T. 1967. Notes on anthropometric technique: Anthropometric
measurements – right and left sides. Am. J. Phys. Anthrop., 26, 367-370.
Leger, L.A., Lambert, J. and Martin, P. 1982. Validity of plastic skinfold calliper measurements. Hum.
Biol., 54, 667-675.
Leonard, J.I., Leach, C.S. and Rambaut, P.C. 1983. Quantitation of tissue losses during prolonged space
flight. Am. J. Clin. Nutr., 38, 667-679.
Lev-Ran, A. and Hill, L.R. 1987. Different body-fat distributions in IDDM and NIDDM. Diabetes Care,
10, 491-494.
Lohman, T. 1986. Applicability of body composition techniques in children and youths. Adv. Pediat. Sport
Sc., 2, 29-57.
Lohman, T.G. 1981. Skinfolds and body density and their relation to body fatness: a review. Hum. Biol.,
53, 181-225.
Lohman, T.G., Roche, A.F. and Martorell, R. 1988. Anthropometric Standardization Reference Manual.
Human Kinetics, Champaign.
Malina, R.M., Katzmarzyk, P.T., Song, T.M.K., Theriault, G. and Bouchard, C. 1997. Somatotype
and cardiovascular risk factors in healthy adults. Am. J. Hum. Biol., 9:11-19.

Martin, A.D. 1984. An anatomical basis for assessing human body composition: Evidence from 25
dissections. Burnaby, BC: Simon Frazer University, Ph.D. Thesis.
Martin, A.D., Ross, W.D., Drinkwater, D.T. and Clarys, J.P. 1985. Prediction of body fat by skinfold
calliper: assumptions and cadaver evidence. Int. J. Obesity, 9, Suppl., 1, 31-39.
Martin, R. and Saller, K. 1959. Lehrbuch deer Anthropologie. Fischer, Sttutgart.
Marshall, W.A. and Limongi, Y. 1976. Skeletal maturity and the prediction of age at menarche. Ann. Hum.
Biol., 3, 235-243.
Martorell, R., Mendoza, F., Mueller, W.H. and Pawson, I.G. 1988. Which side to measure: Right or left? In
: Anthropometric Standardization Reference Manual. T.G. Lohman, A.F. Roche and R. Martorell
(Eds.). Human Kinetics, Champaign , 87-91.
Matiegka, J. 1921. The testing of physical efficiency. Am. J. Phys. Anthrop., 4, 223-230.
Mazess, R.B., Peppler, W.W. and Gibbons, M. 1984. Total body composition by dual photon ( 153Gd)
absorptiometry. Am. J. Clin. Nutr., 40, 834-839.
McArdale, W.D., Katch, F.I. and Katch, V.L. 1989. Exercise Physiology. Lea and Febiger, Philadelphia.
Mendez, J., Keys, A., Anderson, T. and Grande, F. 1960. Density of fat and bone mineral of mammalian
body. Metabolism, 9, 472-477.
Merklin, R.J. 1974. Growth and distribution of human foetal brown fat. Anatomical Record, 178, 637-646.
Mettau, J.W., Degenhart, N.J., Visser, H.K.A. and Holland, W.P.S. 1977. Measurement of total body fat in
new borns and infants by absorption of non-radioactive xenon. Paediatr. Res., 11, 1097- 1101.
Micozzi, M.S. 1988. In : Anthropometric Standardization Reference Manual. T.G. Lohman, A.F. Roche
and R. Martorell (Eds.). Human Kinetics, Champaign, 151-154.
Murray, S. and Shephard, R.J. 1988. Possible anthropometric alternatives to skinfold measurements. Hum.
Biol., 60, 273-282.
Noppa, H., Andersson, M., Bengtsson, C., Bruce, A. and Isaksson, B. 1979. Body composition in middle
aged women with special reference to the correlation between body fat mass and anthropometric
data. Am. J. Clin. Nutr., 32, 1388-1395.
Norgan, N.G. 1995. The assessment of the body composition of populations. In Body Composition
Techniques in Health and Disease. P.S.W. Davies and T.J. Cole (Eds.). pp195-221. Cambridge
University Press, Cambridge.
Norgan, N.G. and Ferro-Luzzi, A. 1985. The estimation of body density in man. Are equations general?
Ann. Hum. Biol., 12, 1-15,
Norgan, N.G. and Jones, P.R.M. 1990. Anthropometry and body composition. In : Handbook of methods
for the measurement of work performance, physical fitness and energy expenditure in tropical
populations. Collins, K.J. (ed.), International Union of Biological Sciences, Paris 95-115.
Parizkova, J. and Goldstein, H. 1970. A comparison of skinfold thickness using the Best and Harpenden
calipers. Hum. Biol., 42, 436-441.
Parnell, R.W. 1954. Somatotyping by physical anthropometry. American Journal of Physical
Anthropology, 12, 209- 239.
Pende, N. 1947. Modern Science of the Human Person. Aldo Garazanti, Milan. Pp 432.
Pinchon, T. et al. (47 of his associates) 2008. General and abdominal adiposity and risk of death in Europe.
N. Eng. J. Med., 359, 2105-2120.
Pollock, M. and Jackson, A.S. 1984. Research progress in validation of clinical methods of assessing body
composition. Med. Sc. Sports Exerc.,16, 606-613.
Porte, D.J., Woods, S., Baski, D., Seeley, R. and Schwartz, M. 1998. Obesity, diabetes and the central
nervous system. Diabetologia, 41, 863-881.
Rolland- Cachera, M.F., Sempe, M., M, Guilloud – Bataille, M., Patois, E., Pequignot-Guggenbuhl, F. and
Fautrad, V. 1982. Adiposity indices in children. Am. J. Clin. Nutr., 36, 178-184.
Rolland-Cachera, M.F., Cole, T.J., Sempe, M., Tiochet, J., Rossignol, C. and Charraud, A. 1991. Body
mass index variations : centiles from birth to 87 years. Eur. J. Clin. Nutr., 45, 13-21.
Ross, W.D. and Wilson N.C. 1974. A stratagem for proportional growth assessment. In: J. Borms and M.
Hebbelinck (eds): Acta Paediatr. Belg. Suppl., 28, 169-182.
Ross, W.D., Karr, R.V. and Carter, J.E.L. 2000. Anthropometry Illustarted. Turnpike Electronic
Publications, Inc., Canada.
Ross, W.D. and Wilson, B.D. 1973. A Somatotype dispersion index. Research Quarterly for exercise and
Sport, 44, 372-376.
Ross, W.D. and Ward, R. 1982. Human proportionality and sexual dimorphism. In: R. Hall (ed.) Sexual
dimorphism in Homo sapiens.. Praeger, New York, 317-361.
Ross, W.D. Brown, S.R. Hebbelinck, M. and Faulkner, R.A. 1978. Kinanthropometry terminology and
landmarks. In: J. Shephard and H. La. Vallee (eds.) Physical Fitness assessment principles,
Practices and applications. Charles C. Thomas, Springfield, Illinois, 44-50.
Ross, W.D., Eiben, O.G., Ward, R., Martin, A.D., Drinkwater, D.T. and Clarys, J.P. 1986. Alternatives for
the conventional methods of human body composition and physique assessment. In Perspectives
in Kinanthropometry , ed. J.A.P. Day. Human Kinetics, Champaign, Ill, 203-220.
Ross, W.D., Martin, A.D. and Ward, R. 1987. Body composition and aging: theoretical and methodological
implications. Coll. Antropol., 11, 15-44.
Ross, W.D. and Ward, R. 1984a. Proportionality of Olympic athletes, In : Physical structure in Olympic
athletes. Part- II Kinanthropometry of Olympic athletes. Ed. Carter, J.E.C. Karger, Basel pp. 110-
145.
Ross, W.D. and Ward, R. 1984b. The O-Scale System. Surrey: Rosscraft.
Ross, W.R., Drinkwater, D.T., Bvailey, D.A., Marshall G.R. and Leahy. R.M. 1980. Kinanthropometry:
Traditions and new perspectives. In: M. Ostyn, G. Beunen and J. Simmons (eds.)
Kinanthropometry II.. University Park Press, Baltimore, 3-27.
Ross,W.D. and Wilson, N.C.1974. A stratagem for proportional growth assessment. In: J. Borms
and M. Hebbelinck (eds) Children in exercise. Acta Paediat. Belg. 28, 169-182
Ross. W.D. 1978. Kinanthropometry: An emerging scientific technology. In: F. Landry and W.A.R.Orban
(eds.) Biomechanics of Sports and Kinanthropometry, 6, 269-282. Symposia Specialists, Miami.
Satwanti, Bhardwaj, H .and Singh, I.P. 1978. Estimation of body fat and lean body mass from
anthropometric measurements in young Indian Women. Human Biology, 50, 515- 527.
Schroeder, D.G. andBrown, K.H. 1994. Nutritional status as a predictor of child survival : Summarizing the
association and quantifying its global impact. Bull. WHO, 72, 569-579.
Schwartz, M.W., Woods, S.C., Porte (Jr.), D., Seeley, R.J. and Baskin, D.G. 2000. Central Nervous System
Control of Food Intake. Nature, 404, 661-671.
Sen, Amartya , 1981. Poverty and Famines : An Essay on Entitlement and Deprivation. : Clarendon Press,
Oxford.
Sen, Amartya 1987. The Standard of Living : The Tanner Lectures, Clare Hall, 1985 : Cambridge Univ.
Press, Cambridge.
Sharma, J.C. 1992. Human Growth and assessment of nutritional status. In : Application Areas of
Anthropology, Anil Mahajan and Surinder Nath (Eds.) Reliance Publishing House, New Delhi,
129-152.
Sheldon, W. H.. Stevens, S.S. and Tucker, W.B. 1940. The varieties of human physique. Harper and
Brothers, New York.
Sheldon, W.H. Dupertuis, C.M. and Mc Dermott, E. 1954. Atlas of Men. Harper and Brothers, New York.
Sheldon, W.H. Lewis, N.D.C. and Tenney, A.M. 1969. Psychotic patterns and physical constitution. In
Schizophrenia, Current Concepts and Research., D.V. Siva Sanker (ed.) pp 839-911. PJD
Publications, New York.

Shephard, R.J. 1991. Body Composition in Biological Anthropology. Cambridge University Press,
Cambridge.
Simons, L.A. and Gibson, J.C. 1980. Lipids: A Clinicians’ Guide. MTP Press, Lancaster, UK.
Sing, C. F., Stengård, J.H. and Kardia, S.L. R. : Genes, environment and cardiovascular disease.
Arteriosclerosis, Thrombosis, and Vascular Biology, 23:1190 (2003).

Sing, C.F., Haviland, M.B., Templeton, A.R., Zerba, K.E. and Reilly, S.L.: Biological complexity and
strategies for finding DNA variations responsible for inter-individual variation in risk of a common chronic
disease. Ann Med., 24: 539–547 (1992).

Singh, A.P. and Singh, S.P. 2007. Bilateral Variations in Adipose Tissue Distribution, Segmental lengths
and Body Breadths in Relation to Physical Activity Status. The Anthropologist, 9, 251-254.

Singh, P.P. 1999. Physical growth of Spitian males with special reference to altitudinal and nutritional
stress. Ph.D. thesis submitted to Punjabi University, Patiala (unpublished).
Singh, S.P. and Sidhu, L.S. 1980. Nutrient intakes in Gaddi Rajput boys in the Himalayas. Ind. J. Paediat.,
47, 207-212.
Siri, W.E. 1961. Body composition from fluid spaces and density. In Techniques for Measuring Body
Composition, ed. J. Brozek and A. Henschel, pp. 108-117. Washington, DC: National Academy of
Sciences.
Slaughter, M.H., Lohman, T.G., Boilean, R.A. Horswill. C.A., Stillman. R J., Van Loan, M.D. and
Bemben, D.A. 1988. Skinfold equations for estimation of body fatness in children and Youth.
Human Biology, 60,709-723.
Sloan, A.W. 1967. Estimation of Body fat in Young men. Journal of Applied Physiology, 23,311-315.
Sokoloff, K. and Villaflor, G. 1982. The Early Achievement of Modern stature in America. Social Science
History, 6, 453-481.
Steckel, R. H. 1979. Slave Height Profiles from Coastwise Manifests. Explorations in Economic History,
16, 363-380.
Steckel, R. H. 1991. Heights, Living Standards and History : A Review Essay. Historical Methods, 24,
183-187.
Steckel, R.H. and Haurin, D.R. 1994.Health and Nutrition in the American Midwest : Evidence from the
Height of Ohio National Guardsmen, pp. 117-128. In : Stature, Living Standards and Economic
Development. J. Komlos (Ed.). The University of Chicago Press, Chicago.
Steinkamp, R., Cohen, N. L., Gaffey, W. R., McKay, T., Bron, G., and Siri, W.E., Sargeant, T. W. and
Isaacs, E. 1965. Measures of body fat and related factors in normal adults – I. Introduction and
methodology. II. A simple clinical method to estimate body fat and lean body mass. J. Chron.
Dis., 18, 1279-1290, 1291-1307.

Stengård, J.H., Kardia, S.L., Tervahauta, M., Ehnholm, C., Nissinen. A. and Sing, C.F. : Utility of the
predictors of coronary heart disease mortality in a longitudinal study of elderly Finnish men aged 65 to 84
years is dependent on context defined by Apo E genotype and area of residence. Clin Genet., 56: 367–377
(1999)

Strickland, S.S. and Ulijaszek, S.J. 1994. Body mass index and illness in Sarawak. Eur. J. Clin. Nutr., 48
(Suppl.), 98-109.
Strickland, S.S. 1990. Traditional economies and patterns of nutritional disease. In : Diet and Disease in
traditional and developing societies. Harrison, G.A. and Waterlow, J.C. (ed.), Cambridge
University Press, Cambridge, 209-239.

Strohman, R.C. : Manoeuvring in the complex path from genotype to phenotype. Science, 296: 701–703
(2002).

Sullivan, K., Trowbridge, F., Gorstein, J. and Pradilla, A. 1991. Growth References. Lancet, 337, 1420-
1421.
Tanner, J.M. 1962. Growth at Adolescence. Blackwell Publishers, London.
Tanner, J.M. 1964. The physique of the Olympic athlete. George Allen and Unwin, London.
Tanner, J.M. 1994. Growth in Height as a Mirror of the standard of living, pp 1-6. In : Stature, Living
Standards and Economic Development. J. Komlos (Ed.). The University of Chicago Press,
Chicago.
Tanner, J.M., Jarman, and Hiernaux, 1969. Anthropometry. In Practical Human Biology. (Eds.) Weiner,
J.S. and Lourie, J.A. Academic Press, New York.
Tanner, J.M., Jarman, and Hiernaux, 1981. Anthropometry. In Practical Human Biology. (Eds.) Weiner,
J.S. and Lourie, J.A. Academic Press, New York.
Tanner, J.M., Whitehouse, R.H., Cameron, N., Marshall, W.A., Healy, M.J.R. and Goldstein, H. 1983.
Assessment of skeletal maturity and prediction of adult height (TW2 Method). 2nd ed. Academic
Press, London.
Tanner, J.M., Whitehouse, R.G., Marshall, W.A., Healy, M.J.R. and Goldstein, H. 1975. Assessment of
skeletal maturity and prediction of adult height: TW2 method. Academic Press, New York.
Tanner, J.M., Whitehouse, R.H. and Powell, J.H. 1958. Armadillo: a protective clothing as a shield from X-
radiation. Lancet 2, 279-280.
Tucker, W.B. and Lessa, W.A. 1940. Man: A Constitutional Investigation. The Quarterly Review of
Biology, 15, 411-455.
Ulijaszek, S.J. and Lourie, J.A. 1994. Intra- and inter-observer error in anthropometric measurement. In :
Anthropometry : the individual and the population. Ulijaszek, S.J. and Mascie-Taylor, C.G.N.
(eds.), Cambridge University Press, Cambridge, 30-55.
Ulijaszek, S.J. 1997. Anthropometric Measures. In : Design Concepts in Nutritional Epidemiology. B.M.
Margetts and M. Nelson (Eds.). Oxford University Press, Oxford, 289-311.
Vague, J., Vague, P., Boyer, J. and Cloix, M.C. 1971. Anthropometry of obesity, diabetes, adrenal and
beta-cell function, pp 517. In Diabetes. Rodriguez (Ed.). Excerpta Medica, Amsterdam.
Valdez, R., Seidell, J.C., Young, I.A. and Weiss, K.M. 1993. A new index of abdominal adiposity as an
indicator of risk for cardiovascular disease. A cross population study. Int. J of Obes., 17, 77-82.
Vega, S.G., Smith, M., Agurto, M. and Morris, N.M. 1993. Risk factors for low birth weight and
intrauterine growth retardation in Chile. Revista Medica De Chile, 121, 1210-1219.
Vella, V., Tomkins, A., Borghesi, A., Migliori, G.B., Adriko, B.,C. and Crevatin, E. 1992. Determinants of
child nutrition and mortality in north west Uganda. Bull. WHO, 637-643.

Vickery, S.R., Cureton, K. J. and Collins, M. A. 1988. Prediction of body density from skinfolds in black
and white young men. Hum. Biol., 60, 135-149.
Viola, J. 1921. La Costituzione Individuale. Bologna: L. Cappelli.
Visweswara Rao, K., Reddy, P.J. and Narayan, T.P. 1978. A comparison of arm and calf circumferences as
indicators of proteins-calorie malnutrition in early childhood. Ind. J. Nutr. Diet., 17, 25.
Waaler, H.T. 1984. Height, weight and mortality. The Norwegian experience. Acta Med. Scand, 215
(Suppl. 679), 1-56.
Wang, J., Lieu, R., Hawkins, M., Barzilai, N. and Rossetti, L. 1998. A nutrient-sensing pathway regulates
leptin gene expression in muscle and fat. Nature, 343, 684-688.
Wang, Z.M., Heshka, S., Peirson, R.N. Jr. and Heymsfield, S.B. 1995. Systematic organization of body
composition methodology: overview with emphasis on component based methods. Am. J. Clin.
Nutr., 61, 457 – 465.
Wang, Z.M., Pierson, R.N. Jr. and Heymsfield, S.B. 1992. A five level model: a new approach to
organizing body composition research. Am. J. Clin. Res., 56, 19-28.
Ward, P. W. and Ward. P. C. 1984. Infant Birth Weight and Nutrition in Industrializing Montreal.
American Historical Review, 89, 324-345.
Ward, P. W. 1993.Birth Weight and Economic Growth : Women’s Living Standards in the Industrializing
West. Univ. of Chicago Press, Chicago.
Waterlow, J.C., Buzina, A., Keller, W., Lane, J.M., Nichaman, M.Z. and Tanner, J.M. 1977. The
presentation and use of height and weight data for comparing the nutritional status of groups of
children under the age of 10 years. Bull. WHO, 55, 489-498.
Weiner, J.S. and Lourie, J.A. 1969. Human Biology: A Guide to Field Methods. IBP no.9, Blackwell,
Oxford.
Weiner, J.S. and Lourie, J.A. 1981. Practical Human Biology. Academic Press, New York.
Weltman, A. and Katch, V.L. 1978. A non Population specific method for predicting total body
volume and percent fat. Human Biology, 50, 151-158.
Weltman, A. and Katch, V.L. 1978. A non-population specific method for predicting total body volume and
per cent fat. Hum. Biol., 50, 151-158.
WHO. 1986. Use and interpretation of anthropometric indicators of nutritional status. Bull. WHO, 64, 929-
941.
WHO 1995a. Physical Status : The Use and Interpretation of Anthropometry. WHO Tech. Rep. Ser. No.
854. WHO, Geneva.
WHO. 1995b. Field Guide on Rapid Nutritional Assessment in Emergencies. World Health Organization,
Geneva.
WHO 1997. The World Health Report 1997. WHO, Geneva.
WHO 2008. The World Health Statistics 2008. WHO, Geneva.
Widdowson, E.M. and Dickerson, J.W.T. 1964. Chemical composition of the body. In Mineral Metabolism,
Vol. 2, Part A, ed. C.L. Comar and F. Bronner, Academic Press, New York, 111-247.
Williams, S.R., Goodfellow, J., Davies, B., Bell, W., McDowell, I. and Jones, E. 2000. Somatotype and
angiographically determined atherosclerotic coronary artery disease in men. Am. J. Hum. Biol.,
12:128-138.
Wolanski, N. 1972. Functions of the Extremities and their influence of the asymmetric structure of the body
in children and young persons from different environmental conditions. Acta.Med.Auxol., 4: 1-10.
Woods, S., Lotter, E., McKay, L. and Porte, E.J. 1979. Chronic intra-cerebro-ventricular infusion of insulin
reduces food intake and body weight of baboons. Nature, 282, 503-505.
Woods, S.C. and Strubbe, J.H. 1994. The psychobiology of meals. Psychonomic Bull. Rev., 1, 141-155.
Yao, C-H., Slattery, M.L., Jacobs, D.R., Folsom, A.R. and Nelson, E.T. 1991. Anthropometric predictors of
coronary heart disease and total mortality : findings from the US Railroad Study. Am. J. Epid.,
134, 1278-1289.
 Zerba, K.E., Ferrell, R.E. and Sing, C.F.: Complex adaptive systems and human health: the influence of
common genotypes of the apolipoprotein E (ApoE) gene polymorphism and age on the relational order
within a field of lipid metabolism traits. Hum Genet., 107: 466–475 (2000).

Zerfas, A. 1985. Checking continuous measures. Manual for Anthropometry. UCLA, Los Angeles.

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