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New norms of upper limb fat and muscle for assessment of nutritional status1





ABSTRACT ence States ofa Health and

Based cross-sectional


measurements sample of 19,097 Examination arm assessments direct tissues of skinfold replace those


triceps white Survey

skinfold subjects of aged

thickness 1 to 1974, on be made J. 74the

and yr. arm

upper derived muscle

arm from

circumferthe for evidence. of fat and recommended United circumference,

Nutritional of upper that

197 1 to Based



area. and arm

fat area were calculated.
were obtained. nutritional thickness currently

status and in arm

age- and sex-specific percentiles
empirical on Clin. the andbasis theoretical of areas

estimates rather new

it is recommended

areas ofmuscle
that 1981. KEY WORDS these

than should


It is also Nutr. 34:


use. Am.


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States, collected during 1971 and 1974. Therefore, the purpose of the present study is In recent years anthropometric evaluations to provide new percentiles for triceps skinof the upper limb have become valuable in folds, and estimates of upper arm fat and the assessment of nutritional status of chilmuscle area derived from anthropometric dren and adults. This is based on the evidence measurements of white samples of HANESthat the organism, when faced with nutri- I. tional restriction, utilizes its nutritional reserves stored in the form of skeletal muscle Materials and methods protein, visceral protein, and fat. It is assumed that the triceps skinfold thickness indicates Sample the calorie reserves stored in the form of fat This study is based upon a cross-sectional sample of 19.097 white subjects aged 1 to 74. ofwhom 8.204 were (1-4), and the arm muscle size reflects the and 10.893 were females derived from the Health reserves of muscle protein ( 1 , 2, 4), while the males and Nutritional Examination Survey I data sets. The levels of circulating protein, such as transfer- data were collected during April 1971 and June 1974 rin or albumin indicate the visceral protein and the sample was selected from theNational Probathat represented the civilian noninstitutionstatus (5). In a previous study, we have pub- bility sample alized population of whites. The sample size for blacks lished percentiles for triceps skinfolds and was too small to be included as part ofthe present norms. estimates of muscle area for whites derived The mean values for triceps skinfold of ages 1 to 17 for from the Ten-StateNutrition Survey (1). Al- yr of 1971 to 1972 have the been previously published though this survey included individuals from (6). However, neither the data for triceps skinfolds after skinfold measurements for any middle and upper income levels, the sample 17 yr old nor any triceps ages during the yr 1973 to 1974 have been published. was heavily weighted toward the lower inSimilarly. none of the datafor upper arm circumference come groups in each state (1). Hence, it did has been published before. not constitute a national population sample. Furthermore, this study did not give infor- Measurements to the mation for subjects older than 44 yr, and its Upper arm circumference (cm) was measured nearest cm with a steel tape with the night arm hanging applicability to older subjects is limited.For this reason, and in view of the wide spread use of these norms, we have decided to derive I From the Center for Human Growth and Developnew and more applicable standards from the ment and the Department of Anthropology. University data sets of the Health and Nutritional Ex- Michigan, Ann Arbor, of MI 48109. 2 Research Scientist. amination Survey I (HANES I) ofthe United
2540 The American...
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