Use of mid-upper arm circumference for determining overweight and overfatness in children and adolescents

OBJECTIVE: To assess the use of mid-upper arm circumference (MUAC) for identification of overweight and overfatness in rural South African children and adolescents. METHODS: Anthropometric data (weight, height, MUAC and % body fat) from a cross-sectional sample of 978 black South African 5–14-year-olds were analysed. Receiver operating characteristic (ROC) curve analysis determined the validity of MUAC as a proxy for determining overweight and overfatness. FINDINGS: Area under the curve (AUC) results were generally high. Boys and girls aged 10–14 years had ROC-AUC for overfatness classed as ‘excellent’, 0.97 and 0.98 respectively. Cut-points in the MUAC distribution which optimised the ROC-AUC for identification of overfatness and obesity were determined for boys and girls aged 5–9 and 10–14 years, and had high sensitivity and specificity. CONCLUSIONS: MUAC may have potential for clinical and surveillance applications as an accurate yet simple and widely available indicator of overweight and overfatness in children and adolescents in resource-poor settings.