title: Mid-upper arm circumference as a screening tool for identifying children with obesity: a 12-country study.
abstract: No studies have examined if mid-upper arm circumference (MUAC) can be an alternative screening tool for obesity in an international sample of children differing widely in levels of human development.
  
  
  
  Our aim is to determine whether MUAC could be used to identify obesity in children from 12 countries in five major geographic regions of the world.
  
  
  
  This observational, multinational cross-sectional study included 7337 children aged 9-11 years. Anthropometric measurements were objectively assessed, and obesity was defined according to the World Health Organization reference data.
  
  
  
  In the total sample, MUAC was strongly correlated with adiposity indicators in both boys and girls (r > 0.86, p < 0.001). The accuracy level of MUAC for identifying obesity was high in both sexes and across study sites (overall area under the curve of 0.97, sensitivity of 95% and specificity of 90%). The MUAC cut-off value to identify obesity was ~25 cm for both boys and girls. In country-specific analyses, the cut-off value to identify obesity ranged from 23.2 cm (boys in South Africa) to 26.2 cm (girls in the UK).
  
  
  
  Results from this 12-country study suggest that MUAC is a simple and accurate measurement that may be used to identify obesity in children aged 9-11 years. MUAC may be a promising screening tool for obesity in resource-limited settings.
authors.affiliation: Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
authors.forename: J-P
authors.initials: JP
authors.lastname: Chaput
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, USA.
authors.forename: P T
authors.initials: PT
authors.lastname: Katzmarzyk
authors.affiliation: Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
authors.forename: J D
authors.initials: JD
authors.lastname: Barnes
authors.affiliation: Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Fogelholm
authors.affiliation: Pennington Biomedical Research Center, Baton Rouge, USA.
authors.forename: G
authors.initials: G
authors.lastname: Hu
authors.affiliation: St. Johns Research Institute, Bangalore, India.
authors.forename: R
authors.initials: R
authors.lastname: Kuriyan
authors.affiliation: St. Johns Research Institute, Bangalore, India.
authors.forename: A
authors.initials: A
authors.lastname: Kurpad
authors.affiliation: Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
authors.forename: E V
authors.initials: EV
authors.lastname: Lambert
authors.affiliation: Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Maher
authors.affiliation: CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Maia
authors.affiliation: Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS), Sao Paulo, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Matsudo
authors.affiliation: Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Olds
authors.affiliation: Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi, Kenya.
authors.forename: V
authors.initials: V
authors.lastname: Onywera
authors.affiliation: School of Medicine, Universidad de los Andes, Bogota, Colombia.
authors.forename: O L
authors.initials: OL
authors.lastname: Sarmiento
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: M
authors.initials: M
authors.lastname: Standage
authors.affiliation: Department of Kinesiology, University of Massachusetts Amherst, Amherst, USA.
authors.forename: C
authors.initials: C
authors.lastname: Tudor-Locke
authors.affiliation: Tianjin Women's and Children's Health Center, Tianjin, China.
authors.forename: P
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
authors.forename: M S
authors.initials: MS
authors.lastname: Tremblay
mesh_terms: D050154:Adiposity; D000886:Anthropometry / Q000379:methods*; D001132:Arm; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000175:diagnosis*; D012680:Sensitivity and Specificity
keywords: Adiposity; arm circumference; body mass index; children