THE FIRST SOUTH AFRICAN THE FIRST SOUTH AFRICAN THE FIRST SOUTH AFRICAN THE FIRST SOUTH AFRICAN THE FIRST SOUTH AFRICAN THE FIRST SOUTH AFRICAN NATIONAL HEALTH AND NATIONAL HEALTH AND THE FIRST SOUTH AFRICAN THE FIRST SOUTH AFRICAN NATIONAL HEALTH AND NATIONAL HEALTH AND NUTRITION EXAMINATION NUTRITION EXAMINATION SURVEY SURVEY NUTRITION EXAMINATION NUTRITION EXAMINATION SURVEY SURVEY (SANHANES (SANHANES-1) (SANHANES (SANHANES-1) Anthropometry Anthropometry Anthropometry Anthropometry Dr Theo Nell Dr Whadi ah Parker Dr Zulfa Abrahams Dr . Theo Nell Level 3 Anthropometrist Physiological Sciences Stellenbosch University Dr . Whadi-ah Parker Dr . Zulfa Abrahams Social science that makes a difference
Transcript
THE FIRST SOUTH AFRICANTHE FIRST SOUTH AFRICANTHE FIRST SOUTH AFRICANTHE FIRST SOUTH AFRICANTHE FIRST SOUTH AFRICAN THE FIRST SOUTH AFRICAN NATIONAL HEALTH AND NATIONAL HEALTH AND THE FIRST SOUTH AFRICAN THE FIRST SOUTH AFRICAN NATIONAL HEALTH AND NATIONAL HEALTH AND NUTRITION EXAMINATION NUTRITION EXAMINATION SURVEYSURVEYNUTRITION EXAMINATION NUTRITION EXAMINATION SURVEYSURVEY(SANHANES(SANHANES--11))(SANHANES(SANHANES--11))
AnthropometryAnthropometryAnthropometryAnthropometryDr Theo Nell Dr Whadi ah Parker Dr Zulfa AbrahamsDr. Theo NellLevel 3 AnthropometristPhysiological SciencesStellenbosch University
Dr. Whadi-ah Parker Dr. Zulfa Abrahams
Social science that makes a difference
Training ProgrammeTraining ProgrammeTraining ProgrammeTraining ProgrammeBase MeasurementsBase Measurements CircumferencesCircumferences
• Weight & height measurements of adults &
• Hip and waist circumference
children of various ages• Practice weight & height
• Practice hip and waist circumferenceg g
measurements • Head and upper arm circumference
• Practice head and upper arm circumference
• Practice and assessment of all circumferences
Social science that makes a difference
Training ProgrammeTraining Programme
Ski F ldSki F ld
Training ProgrammeTraining Programme
Skin FoldsSkin Folds
• Biceps, triceps, sub-scapular and supra-iliac skinfold p p p pmeasurements
• Practice and assessment of all skinfold measurements
Social science that makes a difference
Social science that makes a difference
D 1 T d 6 M hDay 1: Tuesday 6 March08h00 10h00
Weight and height measurements of adults and children of various ages08h00 – 10h00
g g g
10h15 13h00 P ti i ht d h i ht t10h15 – 13h00 Practice weight and height measurementsAssessment Hip and waist circumferenceHip and waist circumferencePractice hip and waist circumference
14h00 – 16h00 Head and upper arm circumference Practice head and upper arm circumference
16h15 – 17h30 Practice and assessment of all circumferences
Social science that makes a difference
D 2 W d d 7 M hDay 2: Wednesday 7 March
10h15 – 13h00 Biceps, triceps, sub‐scapular and supra‐iliac skinfold measurements
14h00 – 17h00 Practice and assessment of all skinfold measurements
Social science that makes a difference
P f A th t i• Collect high quality body measurements
Purpose of Anthropometricsg q y y
• Standardized methods• Accurate data – trends over time (true differences)( )• Used to tract growth and weight trends• Nutritional and health status (children/adults)Nutritional and health status (children/adults)
Social science that makes a difference
Purpose of Anthropometrics
• Pre-exam procedures
Purpose of Anthropometrics
p• Prepare the room• Check all suppliespp• When participant enters room
• Introduce yourself & recorderIntroduce yourself & recorder• Close curtain/door• Confirm the participant idConfirm the participant id• Briefly explain procedures• Explain “please remove your clothes and shoesExplain please remove your clothes and shoes
and loosen your hair”
Social science that makes a difference
General Guidelines for measuring/recording
• Always tell the participant what you are going to do
g g
y p p y g gbefore you do it!
• Measure the right side of the body• Turn the participant in the direction needed for a given
measure• Position the zero (0) end of the tape measure BELOW
measurement value• Avoid parallax• Record all measurements to nearest 0.1cm (except skin
f ld )folds)• Latter to nearest 0.1mm
Social science that makes a difference
Ethical Issues in AnthropometryEthical Issues in AnthropometryAnthropometryAnthropometry
• technique assess presence & degree PEM
• measurement of body parameters - indicate
n tritional stat snutritional status.
• measure an individual to determine if he or she needs
nutrition intervention
• measure many individuals to determine if malnutrition
is a problem in a population.
Social science that makes a difference
Ethical Issues in Anthropometry• Act professional and confident
Ethical Issues in AnthropometryAct professional and confident
• Explain in detail what will be expected from participant
• Make sure they understand (repeat if needed!)
• Explain personal space and private space
• Read participant’s body language
• Respect culture and religionRespect culture and religion
• Do not make jokes (or laugh) about body shapes!
• Step back when they indicate they wish not to take part!
• Refer all cases to PI’s!
Social science that makes a difference
R ti Ch kRoutine Checks• Once the Clinic Assistant receives the envelope from the p
Clinic Administrator, • checks that the right participant is being seen • asking the participant their name and checking that it
is the same as the name listed on the clinical examination form and appointment card.
• The Clinic Assistant then checks that the details of the ti i t f ll l t d i th f d th t thparticipant are fully completed in the form and that the
unique barcode appears on the form. • The Clinic Assistant then removes the clinical• The Clinic Assistant then removes the clinical
examination form, records and writes her name, staff number and the starting time on the form.
Social science that makes a difference
u be a d t e sta t g t e o t e o
Morning Session: 6 March 2012o g Sess o 6 a c 0
Social science that makes a difference
Base MeasurementsBase Measurements
W i ht
Base MeasurementsBase Measurements
Weight
Who will be measured?Who will be measured?
• Everyone
Equipment
Ad lt l• Adult scale
• Paediatric scale
Equipment calibration
Social science that makes a difference• Total weight = 80kg
WeighingWeighingWeighingWeighing• Make sure scale is calibrated!• Switch on• Zero indicator + stable indicator
• Weigh participants after voiding (NO shoes!)Weigh participants after voiding (NO shoes!)• Minimum clothing
• Young children – dry nappiesYoung children dry nappies• Older children – under clothes• Adolescents/Adults – exam gownAdolescents/Adults exam gown
• Paediatric scales• 0-24 months
Social science that makes a difference
• 0-24 months
Scale CalibrationScale CalibrationWhy so important?
Scale CalibrationScale Calibrationy p• ensure that a weight scale is accurate. • calibration may be necessary every few weeks/or y y y
months, to confirm that the scales are still weighing accurately
• Scales begin to show inaccurate weights for a variety of reasons.
• components of the scale become worn out• environmental factors can play a role as well. • many scales do not perform well in temperature• the more likely it is that inaccuracies will arise.
Social science that makes a difference
Scale CalibrationScale Calibration
• perform scale calibration - use a known weight to see if
Scale CalibrationScale Calibration
• perform scale calibration - use a known weight to see if
the scale returns the correct measurement.
• To calibrate the scale, the weight is set on the scale and
the reading is notedthe reading is noted.
• Next, the scale can be adjusted until it yields a correct
weight measurement.
Social science that makes a difference
WeighingWeighingProcedure
WeighingWeighing
• Step or place on scale• Standing/sitting/lying stillg g y g• Upright in middle of platform• Face forwardFace forward• Feet flat and slightly apart• Take reading in kg’s (to nearest 100g) (clinicTake reading in kg s (to nearest 100g) (clinic
assistant) on examination form• Step off/removed from scalep• Zero then repeat• Two readings – not vary by more than 100g
Social science that makes a difference
o ead gs ot a y by o e t a 00g• Larger than 200kg – no measurement
Data EnteringData Entering
Social science that makes a difference
Height/LengthHeight/LengthHeight/LengthHeight/LengthWho will be measured?
• Standing height• Remove shoes• Release tied-up hairPositioning:Positioning:• Place head in Frankfort plane• Relaxed arms and shouldersRelaxed arms and shoulders• Shoulders, buttocks, heels• Straight legs & kneesStraight legs & knees• Feet flat & together
Social science that makes a difference
Social science that makes a difference
UnitsUnits
Repeated measures
Social science that makes a difference
CircumferencesCircumferencesCircumferencesCircumferencesWho will be measured?
• All participants ≥ 3 months
What circumferences will be measured?• Mid-upper arm• Head• Waist• Hip
Equipment
N t t h tSocial science that makes a difference
• Non-stretch tape measure
Social science that makes a difference
Circumferences: MidCircumferences: Mid--Upper ArmUpper ArmLocation of mid-upper arm landmark
Positioning:g• Head in Frankfort plane (stand erect)• Relaxed armsRelaxed arms• Palms facing inward• Wrap tape measure around midpoint (touching skin andWrap tape measure around midpoint (touching skin and
not too tight!)• Take measurement at mid-point of upper-arm to nearest p pp
0.1cm• Repeat measurements if not within 0.1cm
Social science that makes a difference
Circumferences: HeadCircumferences: HeadWho will be measured?
Circumferences: Head Circumferences: Head
• All participants birth to 36 months
Equipment
• Non-stretch tape measure
Social science that makes a difference
Circumferences: HeadCircumferences: HeadLocation of Head Circumference landmarks
Circumferences: Head Circumferences: Head
• Above supra-orbital ridge• Occiput at back of skullp• Ensure head in Frankfort plane
Social science that makes a difference
Circumferences: HeadCircumferences: HeadCircumferences: Head Circumferences: Head
• Stand erect, abdomen relaxed, arms at sides, feet together, weight distributed evenly
• Locate lowest rib (10th) and mark with pen• Locate iliac crest - on mid axillary line markedy• Define mid-point between 10th rib and iliac crest• Breath normallyy• Ensure tape is not compressed too tightly!• Take measurement to nearest 0.1cm• Repeat measurement
Circumferences: HipCircumferences: HipCircumferences: HipCircumferences: HipWho will be measured?
• All participants >3 months
Equipment
• Non-stretch tape measure
• Eye liner
Social science that makes a difference
Circumferences: HipCircumferences: Hip
f C f
Circumferences: HipCircumferences: Hip
Location of Hip Circumference landmark
M i i f b tt k• Maximum circumference over buttocks
Social science that makes a difference
Circumferences: HipCircumferences: HipCircumferences: HipCircumferences: Hip
Procedure:Procedure:
• Stand erect, arms at sides, feet together, weight
distributed evenly
Locate point ielding largest circ mference• Locate point yielding largest circumference
• Place tape horizontally
• Ensure tape is not compressed too tightly!
• Take measurement to nearest 0.1cm
• Repeat measurement
Social science that makes a difference
• Repeat measurement
Skin foldsSkin folds
• Used to estimate size of subcutaneous fat
Skin foldsSkin folds
• Used to estimate size of subcutaneous fat
• Total storage fat in body
Social science that makes a difference
Skin foldsSkin foldsSkin foldsSkin foldsWho will be measured?
All ti i t 3 th• All participants >3 months• Children: ≥ 3 months
• Triceps, subscapular• Adults: ≥18 yrs
• All 4 sitesWhat skin folds will be measured?What skin folds will be measured?
• Biceps• Triceps• Sub Scapular• Supra Iliac (iliac crest)
Equipment
• Harpenden Calliper
Social science that makes a difference
• Eye liner
Skin foldsSkin foldsMeasuring Technique
Skin foldsSkin foldsg q
• Right side measurement for ALL skin folds!• Caliper measure compressed double fold fat + skinp p• Parallel fold
Social science that makes a difference
Skin foldsSkin folds• Measuring Technique
Skin foldsSkin foldsg q
• Grasp skin fold at marked site• Index finger and thumbg• Hold skin all the time!• Open caliperOpen caliper• Place caliper in parallel• Release caliper gripRelease caliper grip• Read within 2-3s• Grasp caliper gripGrasp caliper grip• Open and release skin
