Mid-upper arm circumference for identifying adult overweight in large-scale population-based surveys: Empirical evaluation using data of the EAT Addis study, Ethiopia

Abstract

Objectives The present study evaluates body circumferences as a nutrition screening tool for women of reproductive age with children less than 5 years of age to improve the detection of overweight and obesity in a community setting. Design This study draws data from a community-based cross-sectional study conducted between July-August 2017 and January-February 2018 to account for seasonality in Addis Ababa, Ethiopia. Setting One hundred and sixteen districts were included in Addis Ababa, Ethiopia. Participants A total of 4914 women of reproductive age with children less than 5 years of age were participated in this study. Primary and secondary outcome measures Primary outcome measures included anthropometric indices. There were no secondary outcomes. Results The optimal cut-off points to identify overweight women of reproductive age were >87.5 cm for waist circumference (WC), >31.7 cm for neck circumference (NC) and >28.0 cm for mid-upper arm circumference (MUAC) based on the highest corresponding Youden index. The area under the receiver operating characteristics curve was 0.92 (95% CI: 0.91 to 0.93) for WC, 0.83 (95% CI: 0.82 to 0.84) for NC and 0.91 (95% CI: 0.89 to 0.92) for MUAC. Conclusions Our result shows that WC and MUAC are alternative tools to body mass index. Both WC and MUAC are effective in identifying overweight women. We recommend using MUAC in large-scale population-based assessments to identify overweight and obesity in low-income settings as it is logistically simpler and operationally feasible.