Relationship between mid-upper arm circumference and BMI for identifying maternal wasting and severe wasting: a cross-sectional assessment

Objective: To assess the strength of correlation and agreement between mid-upper arm circumference (MUAC) and BMI, and determine suitable MUAC cut-offs, to detect wasting and severe wasting among non-pregnant adult women in India. Design: Cross-sectional studies were conducted in five high-burden pockets of four Indian states. Setting: Prevalence of malnutrition among women and children is very high in these pockets and the government plans to implement community-based pilot projects to address malnutrition in these areas. Participants: Anthropometric measurements were carried out on 1716 women with children <5 years of age. However, analyses were conducted on 1538 non-pregnant adult women. Results: The results showed a strong correlation between MUAC and BMI in the non-pregnant women, with correlation coefficient of 0 center dot 860 (95 % CI 0 center dot 831, 0 center dot 883; P < 0 center dot 001). Cohen's kappa of 0 center dot 812 and 0 center dot 884 also showed good agreement between MUAC and BMI in identifying maternal wasting and severe wasting, respectively. The univariate regression model between MUAC and BMI explained 0 center dot 734 or 73 % of the variation in BMI. The MUAC cut-offs for wasting (BMI < 18 center dot 5 kg/m(2)) and severe wasting (BMI < 16 center dot 0 kg/m(2)) were calculated as 232 and 214 center dot 5 mm, respectively. Conclusions: MUAC is a strong predictor of maternal BMI among non-pregnant women with children <5 years in high-burden pockets of four Indian states. In a resource-constrained setting where BMI may not be feasible, the MUAC cut-offs could reliably be used to screen wasting and severe wasting in non-pregnant women for providing appropriate care.