Triceps skin fold and upper arm muscle size norms for assessment of nutritional status1,2

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Abstract
Based on a cross-sectional sample of 12,396 white subjects aged 0 to 44 years, derived from the United States Ten-State Nutrition Survey of 1968-1970, percentiles for right upper arm circumference and triceps skin fold are reported. From these measurements for each individual, the arm muscle diameter, arm muscle circumference, and arm muscle area were calculated. Thereafter, age- and sex-specific percentiles for all three estimates of muscle size were obtained. The development of subcutaneous fat, as indicated by the triceps skin fold, in males is characterized by slow apposition, while in females, is continuous throughout childhood, adolescence, and adulthood. Sexual dimorphism in triceps skin fold is defined by the age of 3 years, and by adulthood, females exceed males by 83%. The muscle area in the upper arm during childhood exhibits considerable changes with age. Sexual dimorphism is defined by the age of 13 years, and by adulthood, males exceed females by about 56%. The amount of subcutaneous fat and degree of muscularity in children reflects the individual calorie and protein reserve. However, measurements of subcutaneous fat among populations characterized by a low degree of fatness may not be a sensitive indicator of nutritional status and growth. On the other hand, measurements of muscularity in children do serve as an adequate general index of nutritional status and growth in size.

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