Assessment of Nutritional Status in Emergency-Affected Populations - Adults













Table of Contents


July 200

Steve Collins, Arabella Duffield & Mark Myatt

This report is issued on the general responsibility of the Secretariat of the UN ACC/Sub-Committee on Nutrition; the material it contains should not be regarded as necessarily endorsed by, or reflecting the official position of the ACC/SCN and its UN member agencies. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the ACC/SCN of its UN member agencies concerning the legal status of any country, territory, city or area of its authorities, or concerning the delimitation of its frontiers or boundaries.

This report was written by
Steve Collins, Valid International
Arabella Duffield, ACC/SCN Secretariat and
Mark Myatt, Institute of Ophthalmology, London

We are grateful to the following reviewers for their comments:

Monika Blösnner (WHO), Tim Cole (Institute of Child Health), Mary Corbett (Concern), Mercedes de Onis (WHO), Mike Golden (University of Aberdeen), Saskia van der Kam (Médecins Sans Frontières), Carlos Navarro-Colorado (Action Contre La Faim), Nick Norgan (University of Loughborough), Claudine Prudhon (Action Contre La Faim), Simon Strickland (London School of Hygiene and Tropical Medicine), Stanley Ulijaszek (Oxford University).


If you would like to request any of the ACC/Sub-Committee on Nutrition's publications please contact:

ACC/Sub-Committee on Nutrition, 20, avenue Appia, 1211 Geneva 27, SWITZERLAND
Tel: +(41 22) 791 04 56, Fax: +(41 22) 798 88 91, E-mail: accscn@who.int, Web: http://acc.unsystem.org/scn/

If you have any enquiries about this supplement please contact either the ACC/SCN or:

Steve Collins, Valid International, Oleuffynon, Old Hall, Llanidloes, Powys, SY18 6PJ, UK
E-mail: steve@validinternational.org

Funding support is gratefully acknowledged from CIDA, DFA (Ireland), NORAD, DFID (UK), UNHCR, UNICEF, WFP and Valid International.

This report was made possible through the support provided by the Food and Nutrition Assistance (FANta) Project by the Office of Health and Nutrition Bureau for Global Programs, Field Support and Research at the U.S. Agency for International Development, under the terms of Cooperative Agreement No. HNE-A-00-98-00046-00 awarded to the Academy for Educational Development (AED). The opinions expressed herein are those of the authors and do not necessarily reflect the views of the U.S. Agency for International Development.


Table of Contents


Summary

Introduction

Acute and chronic undernutrition

Measuring nutritional status in adults

Weight

Body Mass Index

Theoretical problems with BMI
Practical problems with BMI
Summary - the use of BMI

Mid-Upper Arm Circumference (MUAC)

Theoretical problems with MUAC
Practical problems with MUAC
Summary - the use of MUAC

Combination measures

Clinical signs for screening acute undernutrition

Famine oedema
Clinical models
Activities of daily living
Summary - the use of clinical models

Primary and secondary undernutrition

General summary - suggested indicators for assessing adult undernutrition in the field

Where do we go from here? Future research needs:

References

Appendix 1: Basic definitions