Adjustments for weighing clothed babies at high altitude or in cold climates

Public health nutritionists rely on anthropometry for nutritional assessment, program planning, and evaluation. Children are usually heavily clothed at high altitudes and in cold climates. Failing to adjust for clothing weight could underestimate malnutrition prevalence. The objective of this paper...

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Bibliographic Details
Published in:Global public health 2015-11, Vol.10 (10), p.1227-1237
Main Authors: Roche, Marion L., Gyorkos, Theresa W., Sarsoza, Julieta, Kuhnlein, Harriet V.
Format: Article
Language:English
Subjects:
Adjustment
Altitude
Anthropometry
Babies
Body Weight - physiology
Child, Preschool
Children
Climate
Clothes
Cold
Cold Climate
Cold weather
Ecuador
Female
Health care policy
High altitude
Humans
Infant
Infants
Male
Malnutrition
Maternal and infant welfare
Modelling
Nutritional status
Planning
Program evaluation
Public health
Sensitivity
Underweight
Weighing
Weight
Weights and Measures - standards
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Summary:Public health nutritionists rely on anthropometry for nutritional assessment, program planning, and evaluation. Children are usually heavily clothed at high altitudes and in cold climates. Failing to adjust for clothing weight could underestimate malnutrition prevalence. The objective of this paper is to validate an adjustment process for estimating clothing weight and quantify potential misclassification error. In March and September 2009, 293 and 272 children under 2 years of age, respectively, were measured for weight and length in 14 highlands communities in Ecuador. Weight-for-age z-scores (WAZ) and weight-for-height z-scores (WHZ) were compared using clothing-unadjusted weights and two types of clothing-adjusted weights: individual clothing-weights and population-mean clothing-weights. Modelling showed up to 24% of children's nutritional status and degree of malnutrition were misclassified for WAZ, and 13% for WHZ, when clothing was not taken into account in this cold climate. Compared with the more time-intensive individual clothing-weight adjustment, the population-mean clothing-weight adjustments had high specificity and sensitivity for WAZ. In cold climates, adjusting for population mean clothing weight provides a better estimate of the prevalence of malnutrition to inform appropriate program decisions for addressing underweight. An individual clothing weight adjustment may also be essential to classify a specific child's nutritional status when acute malnutrition is a concern.
ISSN:1744-1692
1744-1706
DOI:10.1080/17441692.2015.1037326