Norms for nutritional assessment of American adults by upper arm anthropometry

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Abstract
Age- and sex-specific percentile distributions for the mid-upper arm circumferences, triceps skinfold thicknesses, and mid-upper arm muscle circumferences of American adults were developed from cross-sectional data collected by the National Center for Health Statistics during the Health and Nutrition Examination Survey of 1971 to 1974. For both sexes, comparisons of percentiles for different age cohorts revealed marked variations apparently related to aging in all three parameters: 1) for men, both arm circumferences and arm muscle circumferences generally increased with aging until middle-age (35 to 44 yr), and then, steadily decreased: 2) for women, all three parameters increased progressively until age was well advanced (45 to 64 yr), and then stabilized, or declined, with the onset of senescence: and, 3) triceps skinfold thicknesses in men showed large fluctuations but no consistent trends with advancing age. These data (Health and Nutrition Examination Survey) were examined with reference to other data obtained from the right arms of adults in a similarly conducted large-scale cross-sectional survey of the American population, the Health Examination Survey of 1960 to 1962. Comparisons of comparable age- and sex-specific medians derived from the two surveys revealed that 1) the median arm circumferences of men and women were larger in 1972 than in 1961 for every age group examined, 2) the median skinfold thicknesses for women were as large or larger in 1972 than in 1961 except for women aged 65 to 74 yr, and, 3) the median skinfold thicknesses for men were nearly identical in both surveys. From these comparisons, it was deduced that secular and age-related influences produced the variations apparent with advancing age in the percentile distributions developed from the Health and Nutrition Examination Survey for the mid-upper arm circumferences of both men and women, and for the triceps skinfold thicknesses of women. Secular influences, however, did not contribute to the comparable variations in percentile distributions developed from the Health and Nutrition Examination Survey for the skinfold thicknesses of men. Due to the magnitude of these secular and/or age-related variations, no single value for each parameter could be considered as “normal” for either sex. The validity of currently used sex-specific norms for nutritional assessment of adults is therefore questioned.

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