Article Text

Download PDFPDF
Is mid-upper arm circumference in Dutch children useful in identifying obesity?
  1. Henk Talma1,
  2. Paula van Dommelen2,
  3. Joachim J Schweizer3,
  4. Boudewijn Bakker4,
  5. Joana E Kist-van Holthe1,
  6. J Mai M Chinapaw1,
  7. Remy A Hirasing1
  1. 1 Department Public and Occupational Health, Amsterdam Public Health, Child Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
  2. 2 Statistics, Netherlands Institute of Applied Sciences TNO, Leiden, The Netherlands
  3. 3 Department of Paediatric Gastroenterology, Willem-Alexander Children’s Hospital/Leiden University Medical Centre, Leiden, The Netherlands
  4. 4 Department of Pediatrics, Reinier de Graaf Gasthuis, Delft, The Netherlands
  1. Correspondence to MD Henk Talma, Department Public and Occupational health, Child Health & Care Research, VU University Medical Centre, Amsterdam Public Health, Amsterdam, 1007 MB, The Netherlands; h.talma{at}


Background Mid-upper arm circumference (MUAC) is suggested as being a valid measure in detecting overweight/obesity in children and adolescents, due to the strong relation with weight. We examined this relation and compared MUAC to body mass index (BMI) according to the International Obesity Task Force (IOTF) in children.

Methods Anthropometric data including MUAC were collected in 2009 by trained healthcare professionals in the context of the fifth Dutch Nationwide Growth Study, in a sample of 6167 children (2891 boys and 3276 girls) aged 2–18 years of Dutch origin. We propose MUAC SDS cut-off values for overweight and obesity, and compared MUAC with BMI IOTF in sex-specific and age-specific categories (2–5, 6–11, 12–18 years).

Results The area under the curve is used as a measure of diagnostic accuracy; the explained variance (R²) is good to excellent (0.88–0.94). Sensitivity ranges from 51.8% to 95.3% and specificity from 71.4% to 93.8%. Across age and gender groups, 65.1% to 89.0% participants are classified by both MUAC and BMI as normal weight, overweight or obese. We constructed three equations to predict weight using MUAC, with small differences between observed and predicted weight with an explained variance ranging from 0.88 to 0.94.

Conclusions Compared with BMI, MUAC is a valid measure for detecting overweight and obesity and thus a good alternative for BMI. When weight has to be estimated, it can be accurately predicted using MUAC. Based on our observations, we recommend developing diagrams with international (IOTF) cut-offs for MUAC SDS similar to BMI.

  • comm child health
  • epidemiology
  • health services research
  • obesity
  • adolescent health

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors HT wrote the manuscript and performed basic statistics. PvD analysed the data, wrote the statistical paragraph, critical reviewer. JJS conceived part of the study, critical reviewer. BB: critical reviewer. JEK-vH: supervisor, critical reviewer. JMMC: manager CH and CR, final approval, critical reviewer. RAH: conceived the study, critical reviewer.

  • Funding The Dutch Ministry of Health, Welfare and Sport (grant nos. 310434, 312617 and 315319).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by the Medical Ethical Review Board of Leiden University Medical Centre.

  • Provenance and peer review Not commissioned; externally peer reviewed.