Mid-upper arm circumference as a screening tool for identifying children with obesity: a 12-country study

Pediatr Obes. 2017 Dec;12(6):439-445. doi: 10.1111/ijpo.12162. Epub 2016 May 30.


Background: No studies have examined if mid-upper arm circumference (MUAC) can be an alternative screening tool for obesity in an international sample of children differing widely in levels of human development.

Objective: Our aim is to determine whether MUAC could be used to identify obesity in children from 12 countries in five major geographic regions of the world.

Methods: This observational, multinational cross-sectional study included 7337 children aged 9-11 years. Anthropometric measurements were objectively assessed, and obesity was defined according to the World Health Organization reference data.

Results: In the total sample, MUAC was strongly correlated with adiposity indicators in both boys and girls (r > 0.86, p < 0.001). The accuracy level of MUAC for identifying obesity was high in both sexes and across study sites (overall area under the curve of 0.97, sensitivity of 95% and specificity of 90%). The MUAC cut-off value to identify obesity was ~25 cm for both boys and girls. In country-specific analyses, the cut-off value to identify obesity ranged from 23.2 cm (boys in South Africa) to 26.2 cm (girls in the UK).

Conclusions: Results from this 12-country study suggest that MUAC is a simple and accurate measurement that may be used to identify obesity in children aged 9-11 years. MUAC may be a promising screening tool for obesity in resource-limited settings.

Keywords: Adiposity; arm circumference; body mass index; children.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adiposity*
  • Anthropometry / methods*
  • Arm
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Pediatric Obesity / diagnosis*
  • Sensitivity and Specificity