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Body segment mass, radius and radius of gyration proportions of children.

The segment inertial parameters of children are fundamental to the analysis and simulation of their movements. Generally it has been recognized that adult parameters cannot be extrapolated and most of the anthropometric data on children are of little or no use for determining inertias. Consequently, there have been few studies of children's kinetics. In response to this problem a longitudinal investigation, the Laurentian Study of Biomechanical Development, was launched and in this paper the effects of growth on selected segmental size and inertial parameters are reported for boys between the ages of 4 and 15 yr. The twelve subjects, representing heterogeneous body types were followed over 3 yr for a total of 36 observations. Elliptical zones 2 cm wide were used to model the body and segment inertias calculated using segment densities from the literature. These inertias were the mass, moment of inertia and mass centroid location for a fourteen segment planar representation of the body. The general accuracy mean error based on body mass was 0.203% which is consistent with reports from similar studies and techniques. Plots of segment mass proportions with respect to age showed a decrease in the head proportion balanced by increases in the thigh, shank, foot and upper arm proportions in particular. The trends for each segment were consistent with the trends for linear measures reported in the anthropometry literature. Radius proportions to the mass centroid and radius of gyration proportions were also plotted and showed smaller but consistent changes with respect to age. Linear regressions were then fitted to the distributions and standard errors calculated. The magnitude and slope of the regressions were for the most part consistent with a reported cross-sectional study of Japanese children. Where data were available, predicted parameters were compared with the reported parameters for a 12 yr old analyzed using a different mathematical model. Comparisons were also made between the predicted parameters at 15 yr and the reported parameters for healthy young adults who had been scanned using a gamma-radiation technique. For most parameters there was either good agreement or differences could be explained logically. The traditionally used parameters from older cadavers were quite inconsistent with the above. The variances of the 36 observations about the regression lines as indicated by the standard errors were small. As an illustration of the effect of these variances, the trunk parameters for a 10 yr old performing a standing jump for distance were decreased by 1 S.E. and this matched by increases for the thigh, shank and head.(ABSTRACT TRUNCATED AT 400 WORDS)

Age Factors↗

Regional changes in adrenergic receptor status during hypocaloric intake do not predict changes in adipocyte size or body shape.

The anatomic distribution of fat is related to the risk for obesity-associated morbidity. Among individuals with equal degrees of relative adiposity, those with an upper-body preponderance of fat distribution (android) have higher rates of diabetes, stroke, ischemic heart disease, and early death than those with preferential deposition of adipose tissue in lower portions of the body (hips, thighs, buttocks; gynecoid. There are well-documented anatomic site-related differences in the relative activities of the adrenergic receptors (beta 1----lipolysis; alpha 2----antilipolysis) that control lipolysis. We assessed modifications of the status of alpha 2- and beta 1-adrenergic receptor and subreceptor function in small fragments of adipose tissue obtained by needle biopsy from the gluteal and abdominal subcutaneous regions of five android, seven gynecoid, and six uniformly obese women during a period of weight maintenance (4 weeks) (T1), and after 15% weight loss on an 840 kcal/d diet (T2). Measurements of body shape and adipocyte size were made and related to changes in the metabolism of these adipocytes. The waist-to-hip ratio (WHR) was used to define these three types of regional distribution of fat in these obese subjects: android = WHR greater than 0.86; gynecoid = WHR less than or equal to 0.76; uniform = WHR greater than 0.76 less than or equal to 0.86. WHR was not significantly altered by weight loss in any of the three groups. Although significant effects of time and/or anatomic site on in vitro responses to isoproterenol, norepinephrine, clonidine, forskolin, and dibutyryl cAMP were found, these did not correlate with intra-individual changes in anthropometry or adipocyte size.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗

Is obesity-related insulin status the cause of blunted growth hormone secretion in Turner's syndrome?

Growth hormone (GH) secretion is reduced in girls with Turner's syndrome (TS) at pubertal age. We have recently proposed that the impairment of GH release in TS girls might be secondary to obesity. In the present study, we assessed the influence of overweight-related insulin status on spontaneous GH secretion in a group of 15 TS girls. Eighteen age-matched short normal subjects and six short obese prepubertal children were chosen as controls. Anthropometry, spontaneous GH secretion, insulin-like growth factor-I (IGF-I) serum levels, basal fasting insulin, and glucose concentrations were determined. The percentage of ideal body weight (IBW) was used as an index of nutritional status. Baseline fasting glucose (milligrams per deciliter) to insulin (milliunits per liter) ratio (G/I) was chosen as an index of insulin resistance. GH secretion was significantly lower in TS girls than in non-obese children (P < .005), whereas no significant difference was seen between TS and obese subjects. IGF-I levels were not statistically different in all groups. GH secretion was confirmed to be related to the degree of overweight (r = -.52, P < .05 in TS girls and r = -.74, P < .0001 in control group). G/I was closely related to both the percentage of IBW (r = -.59, P = .02) and GH level (r = .57, P = .03) in TS patients. These results confirm that the blunted GH secretion in TS patients is dependent on nutritional status, and suggest that insulin resistance secondary to overweight might represent the pathophysiologic link between the obesity-related metabolic status and impaired GH secretion.

Anthropometry↗

Body size and neonatal hypoglycemia in intrauterine growth retardation.

The relationship between blood glucose and body physique of 233 (42 hypo-and 191 normologycemic) intrauterine growth-retarded neonates was analyzed using different body measurements and indices of body proportions. Classification by combination of weight and length deficit for fetal age revealed that the disproportionately retarded infants (deficit in weight for age > 30%; deficit in length for age less than equal to 15%) were particularly prone to hypoglycemia. The lowest incidence of hypoglycemia was observed in the group with severe proportionate retardation (weight deficit for age > 30%; length deficit for age > 15%). Among the indices of body proportions ponderal index (W/L3), and percentage deviation from the expected weight for length turned out to be a sensitive predictor of the risk of hypoglycemia. The majority of hypoglycemia neonates were underweight for length and a considerable number of normoglycemic infants were overweight for length. These findings point to the significance of soft tissue wasting rather than low birth weight for gestational age itself, in the development and diagnosis of neonatal hypoglycemia. The significance of anthropometry in the classification of different types of intrauterine growth impairment, as well as in predicting specific hazards after birth is discussed.

Anthropometry↗

Simple anthropometric indices associated with ischemic heart disease.

In a case-control study of 217 hospitalized incident cases of ischemic heart disease and 261 controls we compared various anthropometric indices for the strength of their associations to the outcome event. The ratio of supine sagittal abdominal diameter to midthigh girth ("abdominal diameter index"; ADI) was the simple index that best discriminated cases from controls for both men (standardized difference, 0.65; p < 0.0001) and women (standardized difference, 0.95; p < 0.0001). The waist-to-thigh ratio of girths (WTR) (standardized difference, 0.57 and 0.90; p < 0.0001) was nearly as strong as the ADI and stronger than the traditional waist-to-hip ratio (standardized difference, 0.34 and 0.68; p < 0.005). After adjustments for age and race, the men's odds ratio for ischemic heart disease (tertile 3 vs. tertile 1) was 5.5 (95% CI, 2.9-10) using ADI and 5.1 (2.6-10) using the WTR. The women's odds ratio was 6.3 (1.9-20) using ADI and 8.7 (2.3-33) using the WTR. Further adjustments for body mass index and cardiovascular risk factors did not substantially change these risk estimates. Similar odds ratios were estimated by analyses restricted to 169 neighborhood-matched case-control pairs. In contrast, increased midthigh girth and subcutaneous fat mass (sum of three skinfolds) were associated with a protective effect against ischemic heart disease. Anthropometry using the ADI or WTR could offer a low-cost, noninvasive method for the clinical or epidemiologic evaluation of ischemic heart disease risk.

Anthropometry↗

Concentrations of Lp(a) in black and white young adults: relations to risk factors for cardiovascular disease.

The purpose of this report is to compare the distribution of total lipoprotein(a) [Lp(a)] mass in a population-based sample of blacks and whites, and to investigate the association of Lp(a) with other cardiovascular risk factors. A cross-sectional study design was used. Black and white men and women (n = 4125), aged 23-35 from the Coronary Artery Risk Development in Young Adults Study had the following data collected: Lp(a), lipids and lipoproteins, other metabolic parameters, anthropometry, physical activity, dietary intake, cigarette use, and alcohol use. Blacks had concentrations of Lp(a) approximately three-fold higher than whites. Medians were: black men 21.5 mg/dL, black women 23.9 mg/dL, white men 6.1 mg/dL, and white women 6.4 mg/dL. Lp(a) concentrations were higher in women than in men. Lp(a) was not consistently associated with smoking, alcohol consumption, physical activity, dietary fat, or obesity. In stepwise regression analyses in both blacks and whites, Lp(a) was consistently associated with low-density lipoprotein (LDL) cholesterol, fibrinogen, and apoB; regression models explained about 7% of the variance in Lp(a). In whites, Lp(a) tended to be higher in those with a positive family history of myocardial infarction. The large differences in Lp(a) between blacks and whites, and the absence of association with many other variables are consistent with previous suggestions that Lp(a) concentration is in large part genetically determined. The association of Lp(a) with LDL and fibrinogen, two strong risk factors for cardiovascular disease (CVD), could represent part of the mechanism of the CVD risk associated with Lp(a) in other studies. Longitudinal data are needed to determine the extent to which Lp(a) will independently predict disease, especially in diverse ethnic groups.

Adult↗

Dynamic assessment of pelvic floor and bony pelvis morphologic condition with the use of magnetic resonance imaging in a multiethnic, nulliparous, and healthy female population.

OBJECTIVE: The purpose of this study was to determine dynamic pelvic floor and bony pelvis morphologic condition in asymptomatic multiethnic women. STUDY DESIGN: Pelvic floor anthropometry, at rest and after the Valsalva maneuver, and pelvimetry were compared with the use of magnetic resonance imaging in nulliparous young volunteers from 5 ethnic groups (n=11 x 5 volunteers: Emirati, other Arab, Filipino, Indian/Pakistani, and European/white volunteers), with the white volunteers as the reference group. RESULTS: The white volunteers were significantly taller (P <.0001) than the other women. Their levator hiatus was significantly longer than the Emirati women (P=.03) and wider than the Filipino women (P=.04). The bladder neck descent on straining was also significantly greater than the other groups (P <.00001). The white women also had the longest transverse diameter of the pelvic inlet (P=.002). Their sagittal outlet diameter was significantly longer than the Emirati and Arab women (P=.02), and their interspinous diameter was significantly longer than the Arab women (P=.002). CONCLUSION: Nulliparous, healthy white women have larger levator hiatus and bony pelvis with greater bladder neck descent on straining than non-white women.

Adult↗

Exercise effects on bone mineral density relationships to changes in fitness and fatness.

BACKGROUND: Weight loss typically reduces bone mineral density (BMD). Exercise may preserve or increase BMD even while reducing fatness. We examined the relationships among exercise-induced changes in fitness and fatness with BMD. DESIGN: Randomized controlled trial conducted between July 1999 and November 2003. PARTICIPANTS: Men and women (n =115) aged 55 to 75 years. INTERVENTION: Six months of exercise training. MAIN OUTCOME MEASURES: Fitness measured as peak oxygen uptake and muscle strength, body composition by anthropometry, dual-energy x-ray absorptiometry, and magnetic resonance imaging. RESULTS: A total of 51 men and 53 women completed the trial. Exercise increased aerobic and strength fitness and lean body mass, and reduced general and abdominal obesity. BMD did not change among men in either group. Among women exercisers, there were reductions in total skeleton BMD (p =0.02) and greater trochanter BMD (p =0.02). By bivariate correlation, among women, increased femoral neck BMD was associated with increased aerobic fitness (p =0.01) and with reduced body weight (p =0.02) and BMI (p =0.02). In the final regression model, 13% of the change in femoral neck BMD was explained by the change in aerobic fitness (p <0.01). Among the men, increased total hip BMD and femoral shaft BMD were associated with increased lean mass and lower-body strength. In the final regression models, the change in lean mass explained 9% of the variance in total hip BMD (p =0.04). The change in lean mass explained 20% of the change in femoral shaft BMD (p <0.01), and the change in lower-body strength explained an additional 6% (p <0.04). CONCLUSIONS: When examined by group assignment, 6 months of exercise had no effect on BMD among men, and reduced BMD among women. When examined by change in fitness and fatness, women who had the greatest increases in aerobic capacity and men who had the greatest increases in strength and lean mass were more likely to increase their BMD. Exercise-induced reductions in fatness did not lead to bone loss.

Absorptiometry, Photon↗

Prevalence of the hypertriglyceridemic waist phenotype in Iranian adolescents.

BACKGROUND: No evidence exists regarding the prevalence of the hypertriglyceridemic waist phenotype in adolescents. We aimed to evaluate the prevalence of this phenotype in a representative sample of Tehranian adolescents. METHODS: Anthropometry and serum triglyceride concentration were assessed in a population-based cross-sectional study of 3036 Tehranian adolescents (1413 male and 1623 female) aged 10 to 19 years in 1998. Hypertriglyceridemic waist phenotype was defined as concurrently having serum triglyceride concentration>or=110 mg/dL and waist circumference equal to or greater than the 90th percentile for age and gender. Overweight (>or=95th percentile) and at risk for overweight (>or=85th to <95th percentile) was defined based on the standardized percentile curves of body mass index suggested for Iranian adolescents. RESULTS: The prevalence of the hypertriglyceridemic waist phenotype was 6.4% (95% confidence interval [CI]=5.5-7.2) among Tehranian adolescents (males 7.3%, CI=5.9-8.7; females 5.6%, CI=4.4-6.7). When examined by body mass index category, 38.7% of overweight adolescents had a hypertriglyceridemic waist compared to 7.7% of adolescents at risk for overweight and 0.7% of adolescents at normal weight (p=0.001). CONCLUSIONS: This study provides evidence showing that the hypertriglyceridemic waist phenotype is prevalent among 6.5% of Tehranian adolescents, and particularly among overweight adolescents.

Adolescent↗

Gender differences in familial aggregation of obesity-related phenotypes and dietary intake patterns in Korean families.

PURPOSE: To investigate familial influences on obesity-related phenotypes and dietary intake patterns, and to examine gender differences in Korean families with adolescent children. METHODS: A cross-sectional observational study was conducted on 134 biologically related families composed of 260 parents and 231 adolescent children aged 11 to 19 years. Anthropometric measurements, including total fatness and fat distribution, were measured. Dietary intake was assessed by the semi-quantitative food frequency questionnaire (FFQ). RESULTS: The odds ratio and 95% confidence intervals for overweight were 6.6 (range, 1.5-29.7) in the sons and 13.7 (range, 2.5-76.4) in the daughters of overweight parents. Obesity and fat distribution in the adolescents were more significantly correlated with mothers than fathers. Daughters had more significant familial aggregations with their parents than did sons. The dietary intake patterns of both sons and daughters correlated more strongly with their mothers than their fathers. We observed significant correlations in anthropometric variables and dietary intake patterns between spouses and between siblings. CONCLUSIONS: In the contemporary Korean nuclear family, maternal anthropometry and dietary behavior have a greater impact on children than do paternal contributions, and daughters resemble their parents more than sons. Genetics and environmental factors within the family infrastructure may provide strategies for the prevention and treatment of adolescent obesity.

Adolescent↗

Representing older and disabled people in virtual user trials: data collection methods.

A database was developed to support the creation of a computer-based tool which will support design teams in evaluating the usability of a design during early prototyping and indicate which individuals are effectively excluded or designed out. Methods are described for the collection of multivariate data on 100 real individuals covering a range of physical characteristics and capabilities. These data were tested to ensure a breadth of representation of individuals (particularly older and disabled people) in terms of anthropometry, joint constraints, postural capabilities and task behaviours. The concept of the design tool itself is explored by conducting virtual user trials in the computer-aided design environment. The novel approach of the research encourages empathy with individual users and allows generic abilities, such as bending, reaching and lifting to be assessed.

Adolescent↗

Osteogenesis imperfecta in childhood: impairment and disability. A prospective study with 4-year follow-up.

OBJECTIVES: To study (1). changes in anthropometrics, joint range of motion (ROM), muscle strength, functional ability, caregiver assistance, and level of ambulation in children with osteogenesis imperfecta (OI) and (2). the prediction of clinical characteristics at the level of ambulation at follow-up and the prediction of clinical characteristics on progression or regression at the level of ambulation over time. DESIGN: Prospective study with follow-up of 4 years. SETTING: A children's hospital that serves a nationwide center for treatment and research in children with OI in the Netherlands. PARTICIPANTS: At follow-up, 49 children (24 boys, 25 girls; mean age +/- standard deviation, 11.3+/-3.8y; range, 5.2-19.4y) participated. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Anthropometry, joint ROM, muscle strength, fracture frequency, intramedullary rodding, level of ambulation, functional ability, and caregiver assistance. RESULTS: In type I OI, total joint ROM decreased significantly over time, especially in the lower extremities, with a significant decrease in generalized joint hypermobility according to Bulbena (median start, 7.5; interquartile range [IQR], 4-9; median end, 6; IQR, 2-7; P<.001). In types III and IV, a severe decrease in total joint ROM was present without significant changes over time. No significant changes in total muscle strength (upper or lower extremities) in the different types of OI were measured at follow-up. In OI type I, a significant increase in self-care (P=.003) and social function (P=.008) was measured; in type III, a significant increase in self-care (P=.003), mobility (P=.004), and social function (P=.005) was measured, with a significant decrease in parental assistance in self-care (P=.02) and mobility (P=.005). In type IV, a significant increase was observed in the self-care (P=.01) and social function domains (P=.02). Type of OI (regression coefficient=-1.0; 95% confidence interval [CI], -1.64 to -0.47) and total muscle strength were the only significant predictors for level of ambulation (regression coefficient=.01; 95% CI,.17-.32). Body weight was significantly lower in the group that progressed in level of ambulation (P=.03), whereas children with a decline in level of ambulation had significantly higher body weight (P=.05). CONCLUSIONS: Ours is the first study with a long-term follow-up that provides information concerning the natural course of developmental outcome parameters of OI in childhood. Joint ROM and muscle strength did not change significantly over time, possibly because of the biomechanical skeletal properties of the different OI types. Functional ability improved significantly over time, but, especially in types III and IV, did not reach normative values, possibly because of a plateau phase in functional ability. Knowledge of the natural course of the disease is essential to interpret the results from intervention studies.

Activities of Daily Living↗

Effect of growth hormone therapy and puberty on bone and body composition in children with idiopathic short stature and growth hormone deficiency.

The state of bone health and the effect of growth hormone (GH) therapy on bone and body composition in children with idiopathic short stature (ISS) are largely unknown. A direct role of GH deficiency (GHD) on bone density is controversial. Using dual-energy X-ray absorptiometry, this study measured total body bone mineral content (TB BMC), body composition, and volumetric bone mineral density (vBMD) at the lumbar spine (LS) and femoral neck (FN) in 77 children (aged 3-17 years) with ISS (n = 57) and GHD (n = 20). Fifty-five children (GHD = 13) receiving GH were followed over 24 months including measurement of bone turnover. At diagnosis, size-corrected TB BMC SDS was greater (P <or= 0.002) and LSvBMD SDS lower (P < 0.03) than zero in both prepubertal ISS and GHD subjects, but FNvBMD SDS was reduced only in the GHD group (P < 0.05). The muscle-bone relation, as assessed by the BMC/lean mass (LTM) ratio SDS was not different between groups. During GH therapy, prepubertal GHD children gained more height (1.58 [0.9] SDS) and LTM (0.87 [0.63] SDS) compared to prepubertal ISS children (0.75 [0.27] and 0.17 [0.25] SDS, respectively). Percent body fat decreased in GHD (-5.94% [4.29]) but not in ISS children. Total body BMC accrual was less than predicted in all groups accompanied by an increase in bone turnover. Puberty led to the greatest absolute, but not relative, increments in weight, LTM, BMI, bone mass, and LSvBMD. Our results show that children with ISS and GHD differ in their response to GH therapy in anthropometry, body composition, and bone measures. Despite low vBMD values at diagnosis in both prepubertal groups, size-corrected regional or TB bone data were generally within the normal range and did not increase during GH therapy in GHD or ISS children. Growth hormone had great effects on the growth plate and body composition with subsequent gains in height, LTM, bone turnover, and bone mass accrual, but no benefit for volumetric bone density over 2 years.

Absorptiometry, Photon↗

The effect of cumulative energy and protein deficiency on anthropometric parameters in a pediatric ICU population.

BACKGROUND AND AIMS: Nutritional support is essential in the care of critically ill children since inadequate feeding increases morbidity and negatively affects growth. We aimed to compare cumulative energy and protein intakes with recommended dietary intakes (RDA) and examine relationships between accumulated balances and anthropometric parameters. METHODS: Prospective, observational study. Total daily energy and protein intakes were determined during a maximum of 14 days in 261 children admitted to our multidisciplinary tertiary pediatric ICU. Actual intakes were subtracted from RDA and cumulative balances were calculated. Relations between cumulative balances, various clinical factors and changes in anthropometry (weight, arm and calf circumference) were analyzed using regression analysis. RESULTS: At 14 days after admission children showed significant cumulative nutritional deficits compared to RDA. These deficits were on average 27, 20, 12 kcal/kg and 0.6, 0.3, and 0.2 g protein/kg per day for preterm neonates (n = 103), term neonates (n = 91) and older children (n = 67), respectively. Age at admission, length of ICU-stay and days on mechanical ventilation were negatively related to cumulative balances. Cumulative energy and protein deficits were associated with declines in SD-scores for weight and arm circumference. CONCLUSIONS: Children admitted to the ICU accumulate substantial energy and protein deficits when compared to RDA. These deficits are related to decreases in anthropometric parameters.

Adolescent↗

Food choice, socio-economic characteristics and health in 4-year olds in a well-educated urban Swedish community.

BACKGROUND AND AIMS: Dietary habits founded early in life might influence development of welfare diseases. The aim was to analyse food choice, socio-economic characteristics and health by questionnaires in healthy 4-year olds. METHODS: Two hundred and thirty children were invited and 79% completed all questionnaires. Anthropometry was measured in 131 subjects. RESULTS: The sample was characteristic for Swedish children except that more parents had university education. Most children attended pre-school; 52% >30 h/week. Almost all had been breast-fed until a mean age of 5 months. Fifteen per cent were overweight and 2% obese according to the IOTF cut-offs. A, D vitamin supplementation was not given to a third. Full fat dairy products, minced meat and sausages predominated, and only a fourth was served fat fish. Olive or rape seed oil was consumed regularly by 40% and a third consumed "junk food" regularly. Maternal immigrant status influenced the food choice. CONCLUSION: In a Swedish urban community of 4-year olds, 17% were overweight or obese. The intake of vegetables, oils and "junk food" seemed to have increased, while the intake of dairy products, fruit, meat and fish seemed to be similar to earlier studies. Food choice was influenced by maternal origin.

Anthropometry↗

Isoprostanes, a marker of lipid peroxidation, may not be involved in the development of glucose intolerance.

We investigated whether isoprostanes, as a marker of lipid peroxidation, may be involved in the development of impaired glucose tolerance (IGT) or diabetes. Using a nested case-control study, we tracked the changes in isoprostane levels, insulin sensitivity (IS) and beta-cell function (BCF) in Afro-Jamaicans who progressed to IGT and diabetes over 3.9 years. Anthropometry, glucose tolerance, insulin levels, blood pressure and urinary isoprostane concentration were measured at baseline and follow-up. IS and BCF were estimated by the method of homeostasis assessment. Fifty-two individuals who progressed to IGT or diabetes and 44 age, sex and body mass index (BMI) matched controls were studied. Progression to glucose intolerance was significantly related with baseline BCF (p< or =0.01), but not isoprostane levels or IS. Glucose concentrations (fasting and 2 h) on follow-up were significantly correlated to baseline IS, baseline BCF, follow-up IS and follow-up BCF (p-values<0.05). In multiple regression analysis, only follow-up IS and BCF (p-values< or =0.001) independently predicted fasting glucose and 2h glucose levels at follow-up. Isoprostanes were not significantly associated with IS or BCF (p-values>0.1). We concluded that isoprostanes may not be causally involved in the development of glucose intolerance, insulin resistance or deteriorating BCF.

Adult↗

Toward generation XL: anthropometrics of longevity in late 20th-century United States.

All-cause and cause-specific mortality among white U.S. men and women are analyzed using the NHANES I data (1971-1975) and epidemiologic follow-up to 1992, to examine the effect of physical stature on mortality, controlling for other confounding variables within a discrete-time framework. We find an association between mortality and both body mass index (BMI) and height, but the height effect is sensitive with respect to the age range under consideration. Although the resulting minimum-mortality BMI is higher than the widely accepted healthy range, the recent increase in weight implies that further gains in life expectancy are unlikely to derive from the anthropometry-mortality relationship.

Adult↗

Nutritional screening and assessment in cancer-associated malnutrition.

Up to 85% of all patients with cancer develop clinical malnutrition, which negatively affects patients' response to therapy, increases the incidence of treatment-related side effects and can decrease survival. Early identification of patients who are malnourished or at risk of malnutrition can promote recovery and improve prognosis. In addition, early nutritional intervention is cost effective, as it reduces complication rates and length of hospital stay. The development and use of screening and assessment tools is essential for effective nutritional intervention and management of patients with cancer. Nutritional screening aims to identify patients who are malnourished or at significant risk of malnutrition. Patients identified through screening require referral to a dietician or specialist in nutrition for an in-depth nutritional assessment, involving examination of medical, dietary, psychological and social history, physical examination, anthropometry and biochemical testing. Interventions initiated after nutritional assessment should be tailored to the individual and take into consideration the patient's prognosis. Nutritional care is a fundamental aspect of nursing practice and nurses are ideally placed to play an essential role in the early detection and screening of malnutrition in patients with cancer.

Anthropometry↗