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Body Composition

Malnutrition

Waterlow Criteria (wt/ht % std = degree of wasting)

80 % - 89 %

Mild

70 % - 79 %

Moderate

Severe

90 - 110

Normal Variation

110 - 120

Overweight

> 120

Obese

Malnutrition Symptoms:
  • Irritability
  • Apathy
  • Decreased social responsiveness
  • Anxiety
  • Attention deficits
Malnutrition physical signs:
  • Decreased subcutaneous tissue (legs, arms, buttocks, and bitemporal)
  • Edema
  • Oral changes (Cheilosis, angular stomatitis, papillar atrophy)
  • Abdominal distension
  • Hepatomegaly (fatty infiltration)
  • Nail changes (fissured or ridged)
  • Hair changes (thin, sparse, brittle, easily pulled out, color changes to dull brown or copper).
"Kids on HPN should develop & go through puberty as anticipated. In fact, proper balanced nutrition is important factor that keeps many on track. HPN team can help you identify issues that interfere w/ development, if possible -- as we're often your continuity nutrition providers."

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Chronic Malnutrition

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Body composition assessment 

  • Dual-energy X-ray absorptiometry (DXA)
  • Bioelectrical impedance
  • Anthropometrics
  • Bodpod (experimental)
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uncorrected arm muscle area in cm2
= ((((midarm circumference in cm) - (π(triceps skin fold thickness in cm)))2) / (4π))
 
Anthropometric Equations
Arm Muscle Area (AMA) = [(MAC in cm x 10) – (3.14 x tsf)]
12.56
Upper Arm Area = [(MAC in cm x 10)] x .785
[3.14]
 
Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981 Nov;34(11):2540-5. PubMed PMID: 6975564.
 
Frisancho AR. Triceps skin fold and upper arm muscle size norms for assessment of nutrition status. Am J Clin Nutr. 1974 Oct;27(10):1052-8. PubMed PMID:4419774.
 
Triceps skin Fold
 
ESPEN Guidelines for using BIA Part 1 Part 2
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