WEIGHT: It indicates the body mass & it is a composite of all body constituents like water minerals

fat proteins and bones. It reflects more recent nutritional status than does height.
Measurement of weight in infants and children
In field surveys, a suspended scale & a weighing sling may be used for weighing infants and children
less than two years of age. They should be weighed with minimum clothing. After slipping the subject
into the sling, the weight is recorded as soon as the indicator on the scale has stabilized. Alternatively,
a paediatric pan or scale may be used. Care must be taken to ensure that the infant is placed on the pan
scale so the weight is distributed equally about the centre of the pan. Once the infant is lying quietly,
weight is recorded to the nearest 10g. If there is no alternative, the mother & subject can be weighed
together, & then the mother alone, using a beam balance. The subjects weight can then be calculated
by subtraction.
Measurement of weight in older children and adults
A beam balance with no detachable weights should be used. Body weight can also be obtained by
using an electronic scale.
Precautions to be taken while measuring the body weight:
1)
2)
3)
4)
5)
6)
7)
8)

The examiner or investigator should be well familiar with use of instrument.

The scale should be placed on flat and hard surface.
The scale should be calibrated to zero.
Subjects should be at rest, in light clothing without shoes.
Subjects should stand quietly.
Measurements should be noted & recorded accurately.
The subjects should not lean against or hold anything while the weight is recorded.
The reference should be used to assess the interpretation.

HEIGHT: In the older children & adults, height is measured with a vertical measuring rod
(anthropometric rod or stadiometer) & for infants & children below the age of 2 years recumbent
length is measured, generally with a wooden measuring board. The subjects who cannot stand erect
knee height is taken which is measured with a calliper consisting of an adjustable measuring stick
with a blade attached to each end at a 90angle.
Precautions to be taken while measuring the body height:
1) The subject should stand straight with the head positioned such that the Frankfurt plane
(imaginary line joining the tragus of the ear and eye) is horizontal, without shoes with heels
together & toes apart.
2) The anthropometric rod should be placed behind the subject in the centre of the heels
perpendicular to the ground.
3) Arms should be hanging loosely at the sides with palms facing the thighs.
4) The moving head piece of the anthropometric rod should be placed over the head of the
subject applying a slight pressure to reduce thickness of the anthropometric rod still in the
position.
WEIGHT FOR AGE: In the children from 6 months to 7 years is an index of acute malnutrition, and
is widely used to assess protein-energy malnutrition & over nutrition, especially in infancy when the
measurement of length is difficult. It does not take into account height differences. Child with low
weight for age is called underweight. This is a very sensitive measure for short duration malnutrition.

Wt for age=

Actual wt for age

100
Expected wt for age

Gomez Classification, 1956: It is based on weight for age. The observed weight of a child is
expressed as a % of the expected weight of a child of that age, using the 50th percentile as the
reference point. The selection of the cut off points was made by reviewing weight for age
characteristics of children hospitalised with clinically severe malnutrition. This classification does not
differentiate between wasting and stunting, because height is not taken into account.
% Expected Weight for Age
>90%
76-90%
61-75%
60%

Classification
Normal
Mild malnutrition
Moderate malnutrition
Severe malnutrition

HEIGHT FOR AGE: Height for age index helps to know whether or not the child is growing
normally. It is not a very sensitive measure for short duration malnutrition (condition of the body
resulting within a short time interval due to relative or absolute deficiency of one or more nutrients).
This index is a measure of long term malnutrition. The child with low height for age is called stunted.
Certain genetic factors must be considered when evaluating height for age.

Ht for age=

Actual height for age

100
Expected height for age

WEIGHT FOR HEIGHT: By relating the height of a child with his/her weight, the childs degree of
thinness can be obtained. A child with low wt. for ht. is called wasted. As wt. for ht. is age
independent, children with poor linear growth but adequate wt. for ht. would be classified as perfectly
normal using weight for height index.
Waterlow Classification, 1972: This classification uses both height for age and weight for height as
indices, & the 50th percentile as the reference point. By using this system distinction can be made
between children who are thin (wasted), those who are short (stunted) and those who are both stunted
and wasted.
% Weight for age
>90
>90
<90
<90

%Weight for height

>80
<80
>80
<80

Category
Normal
Wasted
Stunted
Stunted & wasted

SKINFOLD THICKNESS: Skinfold measurements are best using precision skinfold thickness
callipers, they measure the compressed double fold of fat plus skin. The site commonly used for
skinfold thickness measurement is the triceps skinfold thickness which is measured at the midpoint of
the back of the upper left arm. Three types of precision callipers can be used: Harpenden, Lange &
Holtain.
The measurement of the triceps skinfold is performed at the midpoint of the upper left arm, with the
arm hanging relaxed. To mark the midpoint, the left arm is bent 90 at the elbow, & the forearm is
placed palm down across the body. The examiner grasps a vertical fold of skin plus the underlying fat
1 cm above the marked midpoint, using the thumb and forefinger. The skinfold is gently pulled away
from the underlying muscle tissue, & then the calliper jaws applied at the right angles, exactly at the
marked midpoint.

BODY MASS INDEX [Wt (kg)/Ht(m2)]

According to the classification given by WHO (2004) adults with a BMI > 25 are considered
overweight and of 25-29.9 are considered pre obese. Whilst individuals with a BMI of 30 or
over are considered obese.
International classification of adult underweight, overweight, and obese according to
BMI
Classification
Principal

BMI (kg/m2)
cut off Additional cut off

points

points

Underweight

<18.50

<18.50

Severe thinness

<16.00

<16.00

Moderate thinness

16-16.99

16-16.99

Mild thinness

17-18.49

17-18.49

18.50-24.99

18.50-22.99

Normal Range

23-24.99
Overweight
Pre obese
Obese
Obese class I

25

25

25-29.99

27.50-29.99

30

30

30-34.99

30-32.49
32.50-34.99

Obese class II

35-39.99

35-37.49
37.50-39.99

Obese class III

Source: WHO 2004

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