EXPERIMENT-1

AIM: Anthropometric identifications for nutrition related diseases.

MATERIALS REQUIRED: Measuring tape, weighing scale, and vernier calliper.

THEORY:

World Health Organisation(WHO) has defined obesity as a condition wit abnormal or excessive
fat accumulation in the body that presents various health risks. Obesity is fast replacing more
traditional problems such as under nutrition and infectious diseases as most significant causes of
ill health.
Health risks associated with obesity include coronary heart disease, hypertension, stroke, non-
insulin dependent diabetes mellitus, and certain types of cancer, dyslipidemia, osteoarthritis and
pulmonary diseases, including sleep apnea. Obesity may differ in individuals based on the
distribution of fat within bod, ethnicity, gender, etc.

Obesity can be classified into two types on the basis of its body distribution amongst males and
females:

Android Obesity: It is central obesity(apple shape) with fat access primarily in the abdominal
wall and visceral mesentery; associated with glucose tolerance, diabetes, decreased sex hormone-
binding globulin, increased levels of testosterone and increased cardiovascular risk. The android
fat distribution is generally found in men. However it has been found that as females age, bear
children and approach menopause, this distribution shifts towards the android pattern of fat
distribution. Android fat has more of a survival role and is utilised by the body as an energy
source when energy supplies are low.

Gynoid Obesity: A state of being overweight with fat distribution in a pear shape pattern that is
generally characteristic of a woman, with the largest amount around the hips and thighs. Gynoid
fat in women is to provide nourishment for offspring, and is often referred to as ‘reproductive
fat’. This is because it contains long-chain polyunsaturated fatty acids(PUFAs), which are
important in the development of fetuses.

Timely assessment and awareness is essential for prevention and management of obesity and
associated diseases. It is typically assessed using the body mass index (BMI)

Anthropometry refers to the measurement of human body dimensions, such as height, weight,
and skinfold thickness, and is used to assess body size and composition. Anthropometric method
of nutritional assessment is a non-invasive and relatively correct way of identifying nutritional
status in the population.

Anthropometric measurements used for adults invariably include height, weight, body mass
index(BMI),waist to hip ratio and percentage of body fat. These measurements are used to access
weight status and the risk of various diseases.
BODY MASS INDEX:

Body mass index BMI) is a value derived from the mass( weight) and height of a person. The
BMI is defined as the body mass divided by the square of the body height, and is expressed in
units of kg/m2, resulting from mass in kilograms (kg) and height in metres (m).

Body Mass Index= Weight of the Individual(in kg)/Height of the Individual(in metres)
(BMI)

Due to its reliance solely on height and weight, this calculation provides a cost-effective and
pragmatic means of evaluating weight, making it a widely used screening tool in clinical
settings. Additionally, it offers a convenient way for the average individual to estimate their
overall body composition. However, it does have limitations. The BMI method does not consider
muscle mass and does not directly measure fat, rendering it less accurate for individuals engaged
in strength training.

Research indicates that it may be less precise for males with higher lean mass and for older
individuals with elevated fat percentages. While not a diagnostic tool, BMI provides a general
overview of body composition, offering a starting point for goal-setting and an uncomplicated
method for monitoring progress. Moreover,BMI appears to be more co-related with various
metabolic and disease outcome as its a more direct measureof body fatness.Hence, it has been
employed as a basic approach for assessing the risk of various diseases.

In adult major BMI classifications are as follows:

Underweight : Under 18.5 kg/m2

Normal Weight : 18.5-25 kg/m2

Overweight : 25-30 kg/m2

Obese : over 30 kg/m2

m If the value of BMI is over 25,the condition is known as Overweight and physically inactive
and associated with an increased risk of morbidity and mortality. The person may develop
Cardiovascular(heart and blood circulation disease), gall bladder disease, high blood
pressure(hypertension),Type 2 diabetes, Osteoarthritis, Certain types of cancer such as colon
and breast cancer, depression and other mental health disorder.
m If the value of BMI is less than 18.5,the condition is known as underweight or malnourished.
Such person may develop compromised immune function, respiratory disease, digestive
disease, osteoporosis and cancer.
m Person with BMI level greater than 30 indicating obesity.
BMI in children( aged 2 to 20):

For children and teens, BMI is calculated in the same way but must be interpreted differently.
Body fat changes with age and varies according to biological sex, so that has to be taken into
account. That is why the instead of comparison against fixed thresholds for underweight and
overweight, the BMI is compared against the percentile for children of the same age. These
percentiles help clinicians determine whether a child’s weight is healthy.

In children major BMI classifications are as follows:

Underweight : Less than 5th percentile

Normal Weight : between 5th and 84th percentile

Overweight : between 85th and 95th percentile

Obese : above 95th percentile

For example, a 10-year-old boy of average height (56 inches) who weighs 102 pounds would
have a BMI of 22.9. This would place the boy in the 95th percentile for BMI, meaning that his
BMI is greater than that of 95% of similarly aged boys, and his range would be considered to be
obese.

Factors affecting BMI:

1)Controlling BMI through Diet and Exercise: Achieving a healthy BMI is closely tied to diet
and exercise. A diet focused on nutrient-dense foods—such as fruits, vegetables, whole grains,
and lean proteins—supports weight control by supplying essential nutrients while managing
calorie intake.

Regular physical activity, encompassing aerobic exercises, strength training, and flexibility
exercises, is crucial for weight management as it burns calories and enhances overall fitness.

2)BMI and Hormonal Imbalances:BMI is influenced by hormonal factors, includingthyroid

hormones, sex hormones like testosterone, insulin, cortisol, and leptin, which regulate appetite,
metabolism, and fat storage. Disruptions in hormonal balance, as seen in conditions like
polycystic ovary syndrome (PCOS) or hypothyroidism, can lead to weight challenges.

3)Impact of Genetics on BMI:Genetics also play a role in determining an individual’s BMI.

While genetics may influence factors such as metabolism, body shape, and fat distribution, it’s
important to remember that they do not entirely dictate our fate. A healthy lifestyle, including a
balanced diet and regular exercise, can still positively impact BMI, regardless of genetic
predispositions.
4)Smoking and alcohol: The metabolic rate is increased after smoking and it can limit the
intake of food. This results in increased BMI. Consuming alcohol has also an impact on body
weight. Energy consumed in the form of alcohol is converted to fat and stored in the body.

5)Medication: Many drugs are one of the factors affecting BMI.

These drugs include: Hypoglycemic agent (insulin),Antihypertensive agents, Anti-allergens and
Anti-psychotic drugs.

6)Prenatal influences: Early life is also important. Children of pregnant women who smoke and
are obese are more likely to be overweight adults. It is also documented that females who are
severely malnourished during early pregnancy have kids with a higher risk of obesity, diabetes,
resistance to insulin, and high blood pressure later in life.

7)Age: Adult body size, shape and composition vary with age. Adult tend to loose fat free mass
and increase fat mass with age. These changes may alter the functional significance of BMI at
different ages.

Clinical Limitations of BMI: The clinical limitations of BMI should be considered. BMI is a
surrogate measure of body fatness because it is a measure of excess weight rather than excess
body fat. Factors such as age, sex, ethnicity, and muscle mass can influence the relationship
between BMI and body fat. Also, BMI does not distinguish between excess fat, muscle, or bone
mass, nor does it provide any indication of the distribution of fat among individuals.

The following are some examples of how certain variables can influence the interpretation of
BMI:

On average, older adults tend to have more body fat than younger adults for an equivalent
BMI.
On average, women have greater amounts of total body fat than men with an equivalent BMI.
Muscular individuals, or highly-trained athletes, may have a high BMI because of increased
muscle mass.

BASAL METABOLIC RATE(BMR):

The basal metabolic rate (BMR) denotes the amount of energy expended per unit time by resting
endothermic animals. This measurement is expressed in energy units per unit time, spanning
from watts (joules/second) to millilitres of oxygen per minute or joules per hour per kilogram of
body mass (J/(h·kg)). Accurate measurement necessitates adherence to specific criteria, which
involve maintaining a state of physical and psychological tranquillity and being in a thermally
neutral environment while in the post-absorptive state, i.e., not actively digesting food.

The basal metabolic rate (BMR) signifies the quantity of energy required per unit of time for the
body to sustain basic functions at rest. These functions encompass essential processes such as
breathing, blood circulation, temperature regulation, cell growth, brain and nerve operations, and
muscle contractions. BMR plays a crucial role in determining the calorie-burning rate for an
individual, ultimately impacting whether they maintain, gain, or lose weight. Approximately 60
to 75% of an individual's daily calorie expenditure is attributed to BMR. This rate is subject to
various influencing factors. In humans, BMR typically diminishes by 1–2% per decade after
reaching the age of 20, primarily due to the loss of fat-free mass. However, there is considerable
variability among individuals in this regard.

Significance of BMR:

1. The determination of BMR is the principal guide for diagnosis and treatment of thyroid
disorders.
2. If BMR is less than 10% of the normal, it indicates moderate hypothyroidism. In severe
hypothyroidism, the BMR may be decreased to 40 to 50 percent below normal.
3. BMR aids to know the total amount of food or calories required to maintain body weight.
4. The BMR is low in starvation, under nutrition, hypothalamic disorders, Addison’s disease and
lipoid nephrosis.
5. The BMR is above normal in fever, diabetes insipidus, leukaemia and polycythemia.

Physiology:

The primary regulator of metabolism is the hypothalamus, situated in the diencephalon and
composing the floor and a portion of the lateral walls of the third ventricle of the cerebrum. The
key roles of the hypothalamus include:

Management and coordination of activities within the autonomic nervous system (ANS).
The ANS oversees the contractions of smooth and cardiac muscles, as well as the secretions
of numerous endocrine organs, such as the thyroid gland (linked to various metabolic
disorders).
Through the ANS, the hypothalamus acts as the primary controller of visceral activities, such
as heart rate, movement of food through the gastrointestinal tract, and contraction of the
urinary bladder.
Generation and regulation of feelings of rage and aggression.
Regulation of body temperature.
Oversight of food intake through two centers:
The feeding or hunger center induces sensations prompting the search for food. When
ample food or substrates are received, and leptin levels are high, the satiety center is
activated, sending impulses that inhibit the feeding center. Insufficient food in the
stomach and elevated ghrelin levels trigger hunger sensations via receptors in the
hypothalamus.
The thirst center operates similarly, with specific cells in the hypothalamus
responding to the increasing osmotic pressure of the extracellular fluid. When thirst is
quenched, osmotic pressure decreases.

Collectively, these functions constitute a survival mechanism that ensures the maintenance of the
body processes assessed by BMR.

Measurement of BMR:
BMR is assessed in a dimly lit room immediately after awakening from a minimum of 8 hours of
sleep. The individual should refrain from eating for at least 12 hours and maintain a reclined
position during the measurement. The heat emanating from the body is quantified over a specific
duration and is denoted as calories burned per unit mass of the body per unit time. In instances
where this protocol cannot be followed, alternative equations have been devised as substitutes.

BMR Estimation formula:

The BMR formulas majorly use the variables of height, weight, age and gender to calculate the
basal metabolic rate. Two most notable formulas include:

P is total heat production at complete rest,

m is mass (kg),
h is height (cm),
a is age (years).

According to The original Harris–Benedict equation,

for female, P =(9.56 X m)+(1.85 X h)-(4.68 X a) + 66 kcal/day

for male, P =(13.75 X m)+(5 X h)-(6.76 X a) + 65 kcal/day

According to Miffilin St Jeor Equation,

for female, P =(9.56 X m)+(1.85 X h)-(4.68 X a) + 66 kcal/day

for male, P =(13.75 X m)+(5 X h)-(6.76 X a) + 65 kcal/day

Factors Affecting BMR:

.
1.Gender: Men have a greater muscle mass and a lower body fat percentage. Thus men have a
higher basal metabolic rate than women. The BMR of females declines more rapidly between the
ages of 5 and 17 than that of males.

2.Age: BMR reduces with age i.e. it is inversely proportional to age. Children have higher BMR
than adults. After 20 years, it drops about 2 per cent, per decade.

3.Body fat percentage: The lower the body fat percentage, the higher the BMR. The lower body
fat percentage in the male body is one reason why men generally have a 10-15% higher BMR
than women.

4.Diet: Starvation or serious abrupt calorie-reduction can dramatically reduce BMR by up to

30%. Restrictive low-calorie weight loss diets may cause BMR to drop as much as 20%. BMR of
strict vegetarians is 11% lower than that of meat eaters

5.External temperature: Temperature outside the body also affects basal metabolic rate.
Exposure to cold temperature causes an increase in the BMR, so as to create the extra heat
needed to maintain the body’s internal temperature. A short exposure to hot temperature has little
effect on the body’s metabolism as it is compensated mainly by increased heat loss. But
prolonged exposure to heat can raise BMR.

6.Pregnancy:
The BMR is not changed during pregnancy. The higher value of BMR in late pregnancy is due to
the BMR of the foetus.

Terminologies:

 Body Mass Index (BMI)- It is the ratio of a person’s weight (in kg) divided by his/her
height (in m2) and calculated by using the following formula:

BMI= Weight of a person in kilograms/Height of a person in meters square

It is expressed in the units of kilogram (kg)/meters square (m2).

Its normal reference range is 18.5-24.9, underweight (< 18.5 kg/m2), overweight (>
25 kg/m2) and obese (> 30 kg/m2).

 Mid-Upper Arm Circumference (MUAC)- It is the circumference of the upper left arm
measured at the midpoint between the tip of the shoulder and the tip of the elbow.
It can be expressed in the units of centimetres (cm) and millimetres (mm).
Its normal reference range is > 13.5 cm, mild malnutrition or “at risk” (12.5-13.5
cm), moderate acute malnutrition (11.5-12.5 cm) and severe acute malnutrition (<
11.5 cm).

 Mid-Arm Area (MAA)- It is an estimation of the area of the upper arm which is derived
from mid-upper arm circumference (MUAC) using the formula:

MAA= (MUAC)2/ 4ℼ
It can be expressed in the units of centimetres square (cm2) and millimetres square
(mm2).

 Triceps Skin Fold (TSF)- It is the width of a fold of the skin taken over the triceps
muscle measured with the skinfold calliper. The measurement is taken at the standardized
portion at the midpoint of the back of the upper arm.
It is expressed in the units of millimetres (mm).
Its standard adult value (mm) in males is 12.5 and that in females is 16.5.

 Mid-Arm Muscle Circumference (MAMC)- It is an estimation of the circumference of

the bone and the muscle portion of the middle arm. The standard formula for calculating
Mid-Arm Muscle Circumference (MAMC) is derived from the MUAC and the TSF
 (thickness of the subcutaneous fat which is measured by triceps skinfold) that surrounds
the muscle measured in millimetres:
MAMC= MUAC- (ℼ x TSF/10)
It can be expressed in the units of centimetres (cm) and millimetres (mm).
Its standard adult value (cm) in males is 25.3 and that in females is 23.2.

 Mid-arm muscle area (MAMA)- It is an estimation of the area of the bone and muscle
portions of the upper arm. It is derived from the MAMC (Mid-Arm Muscle
Circumference) by using the following formula:

MAMA= (MAMC)2/ 4ℼ

 Mid-Arm Fat Area (MAFA)- It is an estimation of the fat portions of the upper arm
which is the difference between MAA and MAMA.

MAFA=MAA-MAMA

Inference:

These numbers can help you understand your body’s metabolism and consider the strategies that
will help you manage your energy balance. The food you consume on a daily basis can help or
harm you in this process.
 *****TO BE HANDWRITTEN ON LHS *****

Observation/Result:

For BMI

SI WEIGHT HEIGHT GENDER AGE(yrs) BMI RESULT

No. (Kg) (cm)
1 46 152.3 F 21 19.9 Normal
2 65 162.56 M 20 24.6 Healthy Weight
3 67 162.56 M 20 25.4 Healthy Weight
4 60 165.1 M 20 22 Normal
5 52 154.94 F 20 21.7 Normal

For BMR

SI WEIGHT HEIGHT GENDER AGE(yrs) CALORIES

No. (Kg) (cm) BURN/DAY
1 46 152.3 F 21 1146
2 65 162.56 M 20 1571
3 67 162.56 M 20 1591
4 60 165.1 M 20 1537
5 52 154.94 F 20 1227