Stanley J. Ulijaszek

Anthropometric measurement error and the assessment of nutritional status.

Anthropometry involves the external measurement of morphological traits of human beings. It has a widespread and important place in nutritional assessment, and while the literature on anthropometric measurement and its interpretation is enormous, the extent to which measurement error can influence both measurement and interpretation of nutritional status is little considered. In this article, different types of anthropometric measurement error are reviewed, ways of estimating measurement error are critically evaluated, guidelines for acceptable error presented, and ways in which measures of error can be used to improve the interpretation of anthropometric nutritional status discussed. Possible errors are of two sorts; those that are associated with: (1) repeated measures giving the same value (unreliability, imprecision, undependability); and (2) measurements departing from true values (inaccuracy, bias). Imprecision is due largely to observer error, and is the most commonly used measure of anthropometric measurement error. This can be estimated by carrying out repeated anthropometric measures on the same subjects and calculating one or more of the following: technical error of measurement (TEM); percentage TEM, coefficient of reliability (R), and intraclass correlation coefficient. The first three of these measures are mathematically interrelated. Targets for training in anthropometry are at present far from perfect, and further work is needed in developing appropriate protocols for nutritional anthropometry training. Acceptable levels of measurement error are difficult to ascertain because TEM is age dependent, and the value is also related to the anthropometric characteristics of the group of population under investigation. R > 0.95 should be sought where possible, and reference values of maximum acceptable TEM at set levels of R using published data from the combined National Health and Nutrition Examination Surveys I and II (Frisancho, 1990) are given. There is a clear hierarchy in the precision of different nutritional anthropometric measures, with weight and height being most precise. Waist and hip circumference show strong between-observer differences, and should, where possible, be carried out by one observer. Skinfolds can be associated with such large measurement error that interpretation is problematic. Ways are described in which measurement error can be used to assess the probability that differences in anthropometric measures across time within individuals are due to factors other than imprecision. Anthropometry is an important tool for nutritional assessment, and the techniques reported here should allow increased precision of measurement, and improved interpretation of anthropometric data.

High fructose corn syrup and diabetes prevalence: A global perspective

Abstract The overall aim of this study was to evaluate, from a global and ecological perspective, the relationships between availability of high fructose corn syrup (HFCS) and prevalence of type 2 diabetes. Using published resources, country-level estimates (n =43 countries) were obtained for: total sugar, HFCS and total calorie availability, obesity, two separate prevalence estimates for diabetes, prevalence estimate for impaired glucose tolerance and fasting plasma glucose. Pearsons correlations and partial correlations were conducted in order to explore associations between dietary availability and obesity and diabetes prevalence. Diabetes prevalence was 20% higher in countries with higher availability of HFCS compared to countries with low availability, and these differences were retained or strengthened after adjusting for country-level estimates of body mass index (BMI), population and gross domestic product (adjusted diabetes prevalence=8.0 vs. 6.7%, p=0.03; fasting plasma glucose=5.34 vs. 5.22 mmol/L, p=0.03) despite similarities in obesity and total sugar and calorie availability. These results suggest that countries with higher availability of HFCS have a higher prevalence of type 2 diabetes independent of obesity.

Anthropometry : the individual and the population

Preface 1. The place of anthropology in human biology G. W. Lasker 2. Asymmetry and growth P. H. Dangerfield 3. Intra- and inter-observer error in anthropometric measurement S. J. Ulijaszek and J. A. Lourie 4. Statistical issues in anthropometry C. G. N. Mascie-Taylor 5. Statistical constructs of human growth: new growth charts for old T. J. Cole 6. Growth monitoring and growth cyclicities in developed countries S. J. Ulijaszek 7. Growth monitoring, screening and surveillance in developing countries A. Tomkins 8. Variability in adult body size: uses in defining the limits of human survival C. J. K. Henry 9. Anthropometry and body composition P. S. W. Davies 10. Anthropometry and physical performance N. G. Norgan 11. Anthropometry and physical fitness R. M. Malina 12. Anthropometry in the U.S. Armed Forces C. C. Gordon and K. E. Friedl Index.

Human eating behaviour in an evolutionary ecological context

Present-day human eating behaviour in industrialised society is characterised by the consumption of high-energy-density diets and often unstructured feeding patterns, largely uncoupled from seasonal cycles of food availability. Broadly similar patterns of feeding are found among advantaged groups in economically-emerging and developing nations. Such patterns of feeding are consistent with the evolutionary ecological understanding of feeding behaviour of hominids ancestral to humans, in that human feeding adaptations are likely to have arisen in the context of resource seasonality in which diet choice for energy-dense and palatable foods would have been selected by way of foraging strategies for the maximisation of energy intake. One hallmark trait of human feeding behaviour, complex control of food availability, emerged with Homo erectus (1.9 x 10(6)-200000 years ago), who carried out this process by either increased meat eating or by cooking, or both. Another key trait of human eating behaviour is the symbolic use of food, which emerged with modern Homo sapiens (100000 years ago to the present) between 25000 and 12000 years ago. From this and subsequent social and economic transformations, including the origins of agriculture, humans have come to use food in increasingly elaborate symbolic ways, such that human eating has become increasingly structured socially and culturally in many different ways.

Age at menarche of European, Afro-Caribbean and Indo-Pakistani schoolgirls living in London

Age at menarche is reported for 1,365 European, 530 Afro-Caribbean and 282 Indo-Pakistani schoolgirls taking part in a cross-sectional anthropometric survey in the London Area Health Authorities of Kensington, Chelsea and Westminster, and Brent and Harrow, in 1980-81. Mean ages at menarche are 13.59 +/- 0.37 years (European), 13.18 +/- 0.11 years (Afro-Caribbean) and 13.06 +/- 0.20 years (Indo-Pakistani). The European value is significantly higher than those for Afro-Caribbean and Indo-Pakistani girls, and for Europeans living in the same areas of London in 1966. Social class has an effect on age at menarche in Afro-Caribbean and European girls, but not Indo-Pakistani girls, whilst family size has an effect on age at menarche in Europeans and Indo-Pakistanis.

The International Growth Standard for Children and Adolescents Project: Environmental Influences on Preadolescent and Adolescent Growth in Weight and Height

This review has two aims. The first is to identify important environmental influences on the growth of children aged 1 to 9 years and of adolescents, defined as those aged 10 to 19 years. The second is to identify possible environmentally based criteria for the selection of individuals and populations for data collection in the development of an international growth reference for these age ranges. There are many common environmental influences on the growth of children between the ages of 1 and 19 years; the examination and description of these forms the main body of this review. Subsequently, environmental factors influencing adolescent growth only are considered. In both cases, possible selection criteria are put forward. The most important inclusion criteria for both preadolescence and adolescence are good nutrition, lack of infection, and socioeconomic status that does not constrain growth. Additionally, low birthweight, catch-up growth, breastfeeding, and early adiposity rebound have impacts on growth and/or body composition into puberty. Exclusion of children born at low birth and/or experiencing catch-up growth could be most realistically operationalized if populations in which secular trends in growth were either completed or minimal were selected. Although an effect of hypoxia on child and adolescent growth, independent of nutrition, is small at most, many high-altitude populations have high prevalances of low birthweight and should be excluded on this basis. Since all populations are exposed to pollutants, contaminants, and toxicants in varying degrees, they cannot be realistically excluded from the sample frame. However, it may be desirable to exclude populations that are habitually exposed to extremely high levels of environmental pollution, including air pollution, and those living in close proximity to toxic waste. It is impossible to exclude populations and individuals on the basis of their exposure to aflatoxin contamination of food. However, exclusion on the basis of low socioeconomic status or poverty may well act as a proxy for this. There are a small number of populations that show extreme patterns of growth in body size and proportion in preadolescence and adolescence, and these should be excluded from the sample frame.

Obesity: a disorder of convenience

This paper was commissioned by the Foresight programme of the Office of Science and Innovation, Department of Trade and Industry

Changing patterns of social variation in stature in Poland: effects of transition from a command economy to the free-market system?

The aim of this analysis was to examine the effects on stature in two nationally representative samples of Polish 19-year-old conscripts of maternal and paternal education level, and of degree of urbanization, before and after the economic transition of 1990. Data were from two national surveys of 19-year-old Polish conscripts: 27,236 in 1986 and 28,151 in 2001. In addition to taking height measurements, each subject was asked about the socioeconomic background of their families, including paternal and maternal education, and the name of the locality of residence. The net effect of each of these social factors on stature was determined using four-factor analysis of variance. The secular trend towards increased stature of Polish conscripts has slowed down from a rate 2.1 cm per decade across the period 1965-1986 to 1.5 cm per decade between 1986 and 2001. In both cohorts, mean statures increase with increasing size of locality of residence, paternal education and maternal education. The effect of each of these three social factors on conscript height is highly significant in both cohorts. However, the effect of maternal education has increased substantially while that of size of locality of residence and paternal education diminished between 1986 and 2001. These results imply that the influence of parental education on child growth cannot be due solely to a relationship between education and income, but is also perhaps a reflection of household financial management which benefits child health and growth by better educated parents, regardless of level of income. In addition they suggest that, irrespective of whether there are one or two breadwinners in the family, it is the mother, more so than the father, who is principally responsible for the extent to which such management best favours child health and growth. The asymmetry between the importance of maternal as against paternal education for child growth, clearly seen in the 1986 cohort, became more accentuated in 2001, after the abrupt transition from a command to a free-market economy in the early 1990s.

Energetic cost of standard activities in Gurkha and British soldiers

Measurements of basal metabolic rate and energy expenditure at lying, sitting, standing, and performing a step test at four levels of exercise, were made on Gurkha soldiers stationed in Britain and on British controls matched by body weight and occupational background. There was no significant difference in basal metabolic rate (BMR), nor in the energy cost of lying, sitting and standing between the two groups. Gurhas showed significantly lower gross and net energy expenditure, and so significantly greater net mechanical efficiency, at the lower levels of step exercise. The ratio of gross energy expenditure to BMR was lower in Gurkhas at the lowest rates of stepping compared with the British controls. These results suggest that the energy cost of some physical activities expressed as multiples of BMR may not be constant across populations.

Body frame dimensions are related to obesity and fatness: lean trunk size, skinfolds, and body mass index

We explore relationships between BMI and skinfolds and anthropometric variables reflecting variation in lean body frame. Data on the middle class adult Australian women (n = 1260) collected in 2002 during a National Body Size and Shape Survey were used. Standard measurements of stature, weight, skeletal dimensions (shoulder width, hip width, chest width, and depth, limb lengths), circumferences of head, trunk, limbs and triceps, subscapular and abdominal skinfolds were taken. Techniques for measurements of skeletal frame minimized the inclusion of adipose tissue thickness. Analysis of variance and parametric and nonparametric correlations were used. Vertical dimensions show weak correlations with fatness, while body frame circumferences and transverse dimensions are consistently, significantly, and substantially correlated with fatness, each explaining from 3 to 44% of variation in skinfold thickness. Skeletal dimensions explain up to 50% of variation in skinfold thickness (multiple regression). Especially high correlations with skinfold thickness occur for chest width, depth, and hip width (r range from 0.42 to 0.66). Body frame dimensions reflect largely trunk volume and the trunk/limb proportions. Larger lean trunk size is associated with greater fatness. Since the size of the abdominal cavity, and thus the gastrointestinal system (GI), is reflected in the trunk size, we speculate that larger frame may predispose to obesity in two ways: (1) larger stomachs require greater bulk of food to produce feeling of satiety as mediated through antral distension, (2) larger GIs may absorb more nutrients. Frame size may help to detect the risk of obesity among young adults. Am. J. Hum. Biol. 2010.