Mid-upper arm circumference for identifying adult overweight in large-scale population-based surveys: empirical evaluation using data of the EAT Addis study, Ethiopia

BMJ Open. 2021 Dec 2;11(12):e049602. doi: 10.1136/bmjopen-2021-049602.

Abstract

Objectives: The present study evaluates body circumferences as a nutrition screening tool for women of reproductive age with children less than 5 years of age to improve the detection of overweight and obesity in a community setting.

Design: This study draws data from a community-based cross-sectional study conducted between July-August 2017 and January-February 2018 to account for seasonality in Addis Ababa, Ethiopia.

Setting: One hundred and sixteen districts were included in Addis Ababa, Ethiopia.

Participants: A total of 4914 women of reproductive age with children less than 5 years of age were participated in this study.

Primary and secondary outcome measures: Primary outcome measures included anthropometric indices. There were no secondary outcomes.

Results: The optimal cut-off points to identify overweight women of reproductive age were >87.5 cm for waist circumference (WC), >31.7 cm for neck circumference (NC) and >28.0 cm for mid-upper arm circumference (MUAC) based on the highest corresponding Youden index. The area under the receiver operating characteristics curve was 0.92 (95% CI: 0.91 to 0.93) for WC, 0.83 (95% CI: 0.82 to 0.84) for NC and 0.91 (95% CI: 0.89 to 0.92) for MUAC.

Conclusions: Our result shows that WC and MUAC are alternative tools to body mass index. Both WC and MUAC are effective in identifying overweight women. We recommend using MUAC in large-scale population-based assessments to identify overweight and obesity in low-income settings as it is logistically simpler and operationally feasible.

Keywords: nutrition; nutrition & dietetics; public health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anthropometry
  • Arm* / anatomy & histology
  • Body Mass Index
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Ethiopia / epidemiology
  • Female
  • Humans
  • Overweight* / diagnosis
  • Overweight* / epidemiology
  • Waist Circumference