latest tips on MUAC Arine Valstar 17.03.2000
MUAC Abdulkadir Egal 20.03.2000
Re: Re: MUAC Pirkko Heinonen 25.03.2000
Re[2]: Re: MUAC Rafah Aziz 27.03.2000

Date: Fri, 17 Mar 2000 14:27:44 +0100

From: "Egal, Florence (ESNP)" <>

Subject: latest tips on MUAC


I am leaving next week to Somalia where we are planning to promote the use of MUAC at community level as a first screening tool. What is the latest on cut-off points (including pregnant women)? Thanks for your help.


Arine Valstar

Associate Professional Officer, Nutrition Programme Service, FAO


Date: Mon, 20 Mar 2000 17:14:46 +0000

From: "Abdulkadir Egal" <>

Subject: Re: MUAC


Dear Arine,

As you might be aware of Somalis are physical tall and have lean body mass (70% in rural areas).

To the best of knowledge and experience, MUAC surveys had had always flaws.

Weight-for-height seemed always to produce good results.

MUAC might be less expensive but results could be misleading. WHO/UNHCR have good data about this development.

For practical purpose, we used Weigh-for-height as good indicator(=or> 85%).

Furthermore, in each community you will find weighing scale, specially beam Balance (for adults).

For infants you might probably need portable a pan scale with movable weights for sensitivity measures.

I served with WFP Somalia in refugee/displaced feeding programs as well developmental feeding programs both pre and post civil war (1986-96) and was involved many practical screening operations. Therefore, to my humble opinion w-for-h deserves a consideration.


Montreal, Canada.



Note added by Mike Golden.

There is a problem with all anthropometric measurements of body wasting in tall thin people - this applies equally to W/H, and BMI. Wasting will be overestimated. An analysis we have done with adults showed that the BMI was about 2 points lower than it would have been if the subjects legs were not so long! (they adults had about 7cm longer legs than expected from a Caucasian population with the same torso length) there are not data, to my knowledge on the siting-height:standing-height ratios (crown-rump:crown-heel length) in infants, children, juveniles or adolescents from tall thin pastoralist societies. Until the data is collected and analysed there is no basis for a decision about which is the "best method". Particularly as, in these societies, none of the measurements have, to my knowledge, been related to meaningful outcomes such as mortality risk, cognitive development, susceptibility to infection etc.

The reverse is also a problem - in populations who are stunted the stunting often disproportionately affects the long bones, so that the body is to long for the legs - in this situation malnutrition will be underestimated.

It would be a very good idea if agencies conducting surveys in such communities could add in the measurement of sitting height as well as total height (length), so that we could examine these effects more closely. I would be happy to help any agency analyse such data.

Date: Sat, 25 Mar 2000 10:06:52 -0800

From: (Pirkko Heinonen)

Subject: Re: Re: MUAC


Dear Arine

I fully agree with Abdulkadir.

I served four years in Somalia as Unicef Programme officer health/nutrition, MUAC gave extremely unreliable results if compared with W/H. Please contact SACB health Coordiantor Dr Imanol befor field travel Regards from Yangon

Dr Pirkko Heinonen

Date: Mon, 27 Mar 2000 07:46:58 -0800

From: (Rafah Aziz)

Subject: Re[2]: Re: MUAC


Dear all,

This is an extremely intresting point for discussion. In countries like Iraq, where stunting is a problem, it was observed that if you use the W/H criteria alone one would be missing a good proportion of malnourished children who need help. Is it possible to know more about the sitting height interpretation? We are planning to carry out nutritional status survey in Sudan, would appreciate receiving more info on the subject.

Best regards