Anthropometric Reference Data for Children and Adults ...

1 Number 10 n October 22, 2008. Anthropometric Reference data for Children and Adults : United States, 2003 2006. by Margaret A. McDowell, , , ; Cheryl D. Fryar, ;. Cynthia L. Ogden, ; and Katherine M. Flegal, Abstract Methods Objective This report presents national Anthropometric Reference data for National Health and Nutrition all ages of the population in 2003 2006, adding to results published Examination Surveys (NHANES) are previously from 1960 2002. conducted by the the Centers for Methods data are from the National Health and Nutrition Examination Disease Control and Prevention's Survey (NHANES), a complex, stratified, and multistage probability sample of National Center for Health Statistics the civilian, noninstitutionalized population. Anthropometry measurements (NCHS). NHANES data are the primary were obtained from 19,593 survey participants.

2 The Anthropometric measures source of body measurement and related included weight, height, recumbent length, circumferences, limb lengths, and health and nutrition data for the civilian, skinfold thickness measurements. noninstitutionalized population. Results The tables in this report include weighted population means, Surveys were conducted on a periodic standard errors of the means, and selected percentiles of body measurement basis from 1960 to 1994. NHANES. values. Because measurements varied by sex and age (as well as race and became a continuous survey in 1999. ethnicity in Adults ), results are reported by these subgroups. Each of the continuous NHANES. Conclusions These latest NHANES data add to the knowledge about trends annual survey samples is nationally in child growth and development and trends in the distribution of body representative; 2 or more years of data measurements, such as weight and height, in the population.

3 Are required for subgroup analyses (2). NHANES 1999 2006 data were released Keywords: anthropometry c body measures c nutrition surveys c National Health publicly in four data sets, each one and Nutrition Examination Survey (NHANES). spanning 2 years (1999 2000, 2001 . 2002, 2003 2004, and 2005 2006). (3 5). A combined 4-year dataset based Introduction Children reflect general health status, on 2003 2004 and 2005 2006 data was dietary adequacy, and growth and used for this report to improve the The field of anthropometry development over time. In Adults , body stability and reliability of the statistical encompasses a variety of human body measurement data are used to evaluate estimates (4 5). Additional 2-year data measurements, such as weight, height, health and dietary status, disease risk, sets will be released in the future as and size, including skinfold thicknesses, and body composition changes that more data become available.

4 Circumferences, lengths, and breadths. Anthropometry is a key component of occur over the adult lifespan. This report Household interviews and health nutritional status assessment in Children provides Anthropometric Reference data examinations are used to collect and Adults (1). Anthropometric data for for Children and Adults of all ages. NHANES data . All health examinations DEPARTMENT OF HEALTH AND HUMAN SERVICES. Centers for Disease Control and Prevention National Center for Health Statistics Page 2 National Health Statistics Reports n Number 10 n October 22, 2008. are conducted in mobile examination females were excluded from the participants; the distance from the centers. The examination centers are tabulations of weight, body mass index inguinal crease to the distal end of the staffed by full-time personnel, including (BMI), circumference measurements, femur was measured.

5 Maximal calf health technicians who obtain body and skinfold thickness data . circumference was also measured in a measurements from survey participants. seated position; a measurement tape was All of the NHANES health technicians Anthropometry examination positioned around the calf at the point completed a comprehensive body component of maximum circumference. Mid-thigh measurement training program that The NHANES 2005 2006 circumference was measured on utilized videotape, demonstration, and Anthropometry Training and Procedures standing participants with the practice exercises with an expert Manual describes the protocol, measurement tape placed around the examiner. Health technician performance equipment, quality control, and mid-thigh, perpendicular to the long axis was monitored by means of direct measurement procedures that were used of the femur bone.

6 Observation, data review, and expert during the NHANES anthropometry examiner evaluations. examination (6). An anthropometry Statistical analysis Although portions of the health methodology videotape that was Population means, standard errors examination component have varied produced during NHANES III (1988 of the means, and percentiles were during the surveys' history, much of the 1994) illustrates the NHANES weighted using the NHANES. anthropometry component methodology anthropometry methodology that was examination sample weights to produce has remained consistent over time. The used to collect the 2003 2006 data (7). national estimates. The NHANES. NHANES anthropometry examinations Weight was measured to the nearest examination sample weights incorporate are completed in a room that is kilogram.

7 Stature, length, and the differential probabilities of selection equipped with a digital scale, a wall- circumference measurements were made and include adjustments for mounted stadiometer, a bench, a wall to the nearest millimeter. Skinfold oversampling of selected populations, mirror, an infantometer, and a computer thickness measures were made to the noncoverage, and nonresponse. Standard workstation. A health technician nearest millimeter. Weight was errors were estimated using SUDAAN. performs the anthropometry exam and is measured using a digital floor scale, and by Taylor series linearization because of assisted by a recorder. NHANES an infantometer was used to measure the complex sample design (8). subjects wear socks and disposable recumbent length on infants and young The reliability of the estimates examination gowns during the Children .

8 Standing height was measured produced for this report was evaluated. examination. The use of consistent data with a wall-mounted stadiometer. Head The relative standard error (RSE), collection methods in representative circumference measurements were made calculated as the standard error divided population samples makes possible the using a plastic head circumference by the estimate, and minimum sample examination of trends in body measurement tape. Upper arm length size criterion were used. NCHS. measurements over time in the was measured with a tape measure from recommends that an estimate with an the posterior border of the acromion RSE greater than 30 percent be population. process to the tip of the olecranon considered unreliable (2). The process; during the measurement the recommended minimum sample sizes Sample description upper arm length midpoint was marked.

9 Were based on a combination of the NHANES is a complex, multistage The mid-arm circumference was average design effects and specified probability sample of the civilian measured with a tape measure. Triceps proportions (or percentiles) (9). The noninstitutionalized population. The and subscapular skinfolds were average design effects reflect the impact NHANES 2003 2006 sample included measured with a skinfold caliper. Waist of the complex sample design on participants of all ages. Adolescents circumference was measured with a tape variance estimates. They were calculated 12 19 years of age, persons 60 years of measure at the uppermost lateral border as the ratio of the variance of a statistic age and older, Mexican Americans, of the hip crest (ilium). Weight, (accounting for the complex sample black persons, and low-income persons recumbent length, and standing height design) to the variance of the same were oversampled to improve the values were recorded automatically.

10 The statistic based on a hypothetical simple precision of the statistical estimates for other body measurement data were random sample of the same size. these groups. Additional information recorded using computer-assisted data Average design effects were calculated pertaining to the NHANES 2003 2006 entry, and all results were based on a for each anthropometry variable over survey design, survey methodology, and single body measurement examination. sex for Children and adolescents and public-use data is available on the In addition to the measurements over sex and race-ethnicity for Adults NHANES website (4 5). above, three additional measurements aged 20 years and older. Minimum The analytic sample for this report were taken on participants aged 8 years sample sizes for a specified design was based on the 2003 2006 examined and older.