Annals of Human Biology, January–February 2010; 37(1): 70–75

ORIGINAL ARTICLE

The relationship between height and arm span, mid-upperarm and waist circumferences in children

NURCAN YABANCI1, SEL_IM KILIC2 & IS IL S _IMSEK1

1Gazi University Vocational Education Faculty, Department of Food and Nutrition Education, Ankara,Turkey, and 2GATA Public Health, Ankara, Turkey

(Received 3 November 2008; accepted 17 July 2009)

AbstractBackground: Height is a significant parameter in assessment of growth, development, and nutritionalstatus.Objective: The aim of this study was to assess the relationship between height and arm span, mid-upperarm and waist circumferences in Turkish children.Subjects and methods: Height, arm span, mid-upper arm and waist circumferences were measured in1145 boys and 1372 girls aged 7–14 years old from metropolitan Ankara schools in Turkey.Results: Among the children aged between 7 and 14 years old the arm span was determined to beshorter than height. The correlation coefficient between height and arm span of children aged7–10 years old was 0.92 for boys and 0.90 for girls, and was 0.89 for boys and 0.85 for girls aged11–14 years old. The correlation between height and arm span was high in both genders at the agegroup of 7–10 years old. Moreover, significant correlations were found between the height, themid-upper arm and waist circumferences.Conclusions: Arm span was found to be strongly correlated with height. Although mid-upper arm andwaist circumferences were moderately correlated, waist circumference was not detected as a predictorfor height in girls and boys.

Keywords: Height, arm span, mid-upper arm circumference, waist circumference, children

Introduction

Height measurement is required for assessment of children’s growth, calculation of nutri-tional indexes of children and adults, prediction and standardization of physiologicalparameters such as lung volumes, muscle strength, glomerular filtration, basal metabolicrate and for adjustment of drug dosage in patients (World Health Organization 1995).However in the situations where there is pain, weakness, compression fractures of vertebrae

Correspondence: Nurcan Yabanci, Gazi University Vocational Education Faculty, Department of Food and Nutrition Education,Besevler 06500, Ankara, Turkey. E-mail: nyabanci@gmail.com, yabanci@gazi.edu.tr

ISSN 0301-4460 print/ISSN 1464-5033 online � 2009 Informa UK Ltd.DOI: 10.3109/03014460903198517

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or paralysis, measuring height is either difficult or impossible (Brown et al. 2002). In suchsituations, the anthropometric measurements such as arm span, knee height, arm length,ulna length, sitting height can be used (Lohman et al. 1988; Chumlea et al. 1998; Mohantyet al. 2001; Hickson and Frost 2003; Gauld et al. 2004; Ozer et al. 2007).

Although there are many studies showing the correlation between height and arm span inthe literature (Engstrom et al. 1981; Steele and Mattox 1987; Kwok and Whitelaw1991; Yun et al. 1995; Reeves et al. 1996; Brown et al. 2000; Lucia et al. 2002; Ofluogluet al. 2008), there was no previous research examining the relations between height and mid-upper arm circumference (MUAC), and waist circumference. This study was carried out toassess the relationship between height and arm span, MUAC, and waist circumference inTurkish children aged 7–14 years old.

Methods

This study was conducted on 1145 boys and 1372 girls aged 7–14 years old (total of 2517children), free from physical deformities which could affect their height or arm span, frommetropolitan Ankara schools in Turkey. The children examined were separated into two agegroups based on the grouping applied on Turkey Demographic and Health Survey(Hacettepe University Institute of Population Studies 2004); as being 7–10 years old(n = 1196) and 11–14 years old (n = 1321) to be able to produce compatible groups.

After the required permissions were taken, recruited children had their height, arm span,MUAC and waist circumference measured.

Anthropometric measurements

Height and arm span were measured with a non-elastic tape. After removing their shoes,children were asked to stand with shoulders, buttocks, and heels against a wall, and theirheads were positioned in the Frankfort plane. After taking a deep breath and holding it, acarpenter’s square was placed against the head and wall to determine maximum height onthe wall, and a mark was made on the wall. Children were then told to breathe and to stepaway from the wall. Height was then measured from the floor to the mark on the wall with anon-elastic tape. Arm span was measured by positioning the children’s back against the wallwith their arms spread against the wall at shoulder level and parallel to the floor with palmsfacing forward. A non-elastic tape was used to measure from the tip of the middle finger onone hand, across the front of the chest, and to the tip of the middle finger on the other hand.When the measurement was completed, the child was asked to step away from the wall(Gibson 1990; Brown et al. 2000).

Measurements were taken of MUAC on the bare arms of the children, who stood in astraight position with left arm bent at a 90� angle. The distance between acromion andolecranon was measured with a tape and marked at the middle point. Later a measurementwas made with a non-elastic tape around the circumference at the mark with arms at sidesand inner palms towards the femur (Gibson 1990).

In addition, waist circumference, which is generally used in the identification of centralobesity, was also taken since it was thought to be an easy measurement. Waist circumferencewas measured with a non-elastic tape at a point midway between the lower border of the ribcage and the iliac crest at the end of normal expiration (Gibson 1990). Anthropometricmeasurements were taken by the same trained dietician. Height, arm span, MUAC and waistcircumferences were recorded in centimetres to the nearest millimetre.

Height and arm span, MUAC, waist circumference 71

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Statistical analysis

SPSS for Windows 11.5 (Chicago, IL, USA) was used in statistical analysis. Results aregiven as mean ± standard deviation. Pearson correlation coefficients were calculated toevaluate the relationships between height and age, arm span, MUAC and waist circumfer-ences. Then multiple linear regression analyses were performed to derive the estimate ofheight in terms of age, arm span, MUAC and waist circumferences. p values less than 0.05were considered as statistically significant.

Results

Table I shows the mean and standard deviations of age, height, arm span, MUAC and waistcircumferences and height–arm span difference of participants according to age group andgender.

In boys age groups 7–10 and 11–14, the average of arm span was measured as 129.2 ± 10.1cm, 149.0 ± 11.2 cm, respectively and in girls 128.1 ± 9.5 cm, 149.9 ± 9.3 cm, respectively.Between the two genders, there was a statistically significant difference of arm span(p = 0.048) at the age group 7–10, but there was no significant difference at age group11–14 (p = 0.097). Height was found to be higher than arm span at 7–14-year-old Turkishchildren of both genders. For 11–14-year-old boys, it was found to be higher (2.2 ± 5.1 cm)(Table I).

Arm span and height had the strongest association in two groups and genders. Theassociation was good. The correlation between height and arm span was stronger amongboys than among girls in each two groups. The correlation coefficients for each variable werefound higher in the 7–10 years age group than the 11–14 years age group for both genders.Although there were significant correlations between height and MUAC and between heightand waist circumference for both genders, the coefficients were lower than for height andarm span. The correlation between height and MUAC and between height and waistcircumference at age group 7–10 was moderate while it was found to be mild at age group11–14. On the other hand, the correlation between height and arm span was good for bothgenders (Table II).

Next, stepwise multiple linear regression was carried to determine the best model topredict the height. The coefficients of determination of the models were higher for boys thangirls. Besides, 7–10 years age groups have higher values of coefficients of determination than11–14 years age groups for both genders. The coefficients of determination of the modelswere 86.9%, 84.0%, 82.1% and 72.3%, respectively (Table III). Arm span, age and MUACwere statistically significant predictors of height in 7–10 years age groups for both genders.

Table I. Descriptive statistics for age and anthropometric measurements of study group. Values are given as means± SDs.

7–10 years old 11–14 years old

Variable Boys (n = 601) Girls (n = 595) Boys (n = 544) Girls (n = 777)

Age (years) 8.5 ± 1.0 8.6 ± 1.0 12.3 ± 0.9 12.5 ± 0.9Height (cm) 129.8 ± 10.3 129.6 ± 9.4 151.2 ± 9.7 151.8 ± 8.8Arm span (cm) 129.2 ± 10.1 128.1 ± 9.5 149.0 ± 11.2 149.9 ± 9.3MUAC (cm) 18.2 ± 2.5 18.2 ± 2.5 20.9 ± 3.2 21.9 ± 3.5Waist circumferences (cm) 56.1 ± 2.5 53.9 ± 6.3 62.6 ± 8.2 63.2 ± 7.9Height–arm span difference (cm) 0.64 ± 4.4 1.5 ± 4.2 2.2 ± 5.1 1.9 ± 5.0

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In the 11–14 years old groups, these three variables were statistically significant predictorsof height for boys, but MUAC was not statistically significant predictor for girls. Waistcircumference was not a statistically significant predictor of height in any of the models. Itwas found that arm span was a very good predictor for height measurements in bothgenders and age groups (Table III).

Discussion

While there have been quite a number of studies on the relation between height and armspan in adults (Steele and Chenier 1990; Kwok and Whitelaw 1991; Manonai et al.2001; Mohanty et al. 2001; Zverev 2003; Ofluoglu et al. 2008), there have been only a

Table III. Results of linear regression analysis of various anthropometric measurements and age as predictors ofheight.

Beta p-value 95% Confidence interval

7–10 years Intercept 9.86 < 0.001 5.96–13.77Boys (n = 601) Arm span 0.74 < 0.001 0.69–0.78

MUAC 0.29 0.007 0.08–0.49R2 = 0.869 Waist circumference 0.03 0.41 -0.04–0.10SEE = 3.74 Age 2.13 < 0.001 1.73–2.527–10 years Intercept 16.61 < 0.001 12.38–20.84Girls (n = 595) Arm span 0.70 < 0.001 0.66–0.75

MUAC 0.43 < 0.001 0.23–0.63R2 = 0.840 Waist circumference 0.008 0.83 -0.07–0.08SEE = 3.79 Age 1.69 < 0.001 1.29–2.0911–14 years Intercept 25.92 < 0.001 20.41–31.43Boys (n = 544) Arm span 0.67 < 0.001 0.63–0.71

MUAC 0.29 < 0.001 0.14–0.44R2 = 0.821 Waist circumference 0.023 0.44 -0.04–0.082SEE = 4.13 Age 1.43 < 0.001 0.993–1.8711–14 years Intercept 26.42 < 0.001 20.51–32.29Girls (n = 777) Arm span 0.78 < 0.001 0.74–0.80

MUAC 0.08 0.18 -0.04–0.20R2 = 0.723 Waist circumference -0.001 0.98 -0.05–0.05SEE = 4.67 Age 0.53 0.004 0.17–0.90

SEE = standard error of estimate.

Table II. Correlation coefficients between height and the other variables.

7–10 years old 11–14 years old

r R2 p-value r R2 p-value

BoysHeight and arm span 0.92 0.84 < 0.001 0.89 0.80 < 0.001Height and MUAC 0.58 0.34 < 0.001 0.51 0.26 < 0.001Height and waist circumferences 0.54 0.29 < 0.001 0.48 0.23 < 0.001Height and age 0.74 0.55 < 0.001 0.53 0.28 < 0.001GirlsHeight and arm span 0.90 0.81 < 0.001 0.85 0.72 < 0.001Height and MUAC 0.57 0.32 < 0.001 0.33 0.11 < 0.001Height and waist circumferences 0.49 0.24 < 0.001 0.34 0.12 < 0.001Height and age 0.72 0.51 < 0.001 0.35 0.13 < 0.001

Height and arm span, MUAC, waist circumference 73

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few studies carried out on children. Additionally, no other research has been found on therelationship between height and arm span in children in Turkey. Besides, no research hasbeen reported on height and MUAC and waist circumferences. In this study, the relation-ships between height and arm span, MUAC and waist circumferences were investigatedamong Turkish children.

Height is an important clinical indicator to derive body mass index, creatinine heightindex and also to estimate basal energy expenditure, basal metabolic rate and vital capacitythrough lung function. However, in some cases, a proper measurement of height is notpossible. It has been shown that arm span was a reliable criterion in such situations (Steeleand Chenier 1990; Brown et al. 2000, 2002; Mohanty et al. 2001).

In a study carried out on Malawian children, the height and arm span correlationcoefficient was determined as 0.983 for boys and 0.986 for girls (Zverev and Chisi2005). In this study, the height and arm span correlation coefficient was determined as0.92 for boys and 0.90 for girls for the age group 7–10 years while it was 0.89 and 0.85 forboys and girls, respectively, at the age group 11–14 years. The height and arm spancorrelation was found to be higher for boys and girls for the age group 7–10 years thanfor children of the age group 11–14 years. Moreover, the correlation coefficient betweenheight and arm span was higher in boys than in girls. There are also conflicting findingsregarding the contribution of gender to the relationship between height and arm span.Zverev and Chisi (2005) have shown that correlation coefficient was higher for boys whileEngstrom et al. (1981) have indicated that it was higher for girls. The difference among thedata showing the effect of gender on height and arm span is thought to relate to ethnicity.

Moreover, certain studies carried out on children (Engstrom et al. 1981; Yun et al.1995; Tores et al. 2003; Zverev and Chisi 2005) demonstrated that arm span was higherthan height. In this study, however, the arm span of children in our study groupwas found to belower than height. Similar to the conclusion indicated above, the difference between the datareported here and that reported previously in the literature is might be caused by ethnicity.

There was a strong correlation between height and arm span, however between height andMUAC and waist circumference not strong but significant correlations were detected.

In the next step of this study, multiple linear regression analysis was used to identify whichvariables are significant predictors of height estimation. Arm span was found to be the bestpredictor. While waist circumference was not found to be a significant predictor in themodels for both genders and age groups, MUACwas an important predictor for boys of bothage groups and 7–10-year-old girls. Even though MUAC was used to obtain weight withknee height in a study carried out on Chinese (Jung et al. 2004), there has been no studyshowing the correlation between MUAC and height.

In conclusion, arm span was found to be strongly correlated with height, as reported in manystudies. On the other hand, MUAC and waist circumference were found to be moderatelycorrelated with height but waist circumference was not found as a predictor in girls and boys.

Declaration of interest: The authors report no conflicts of interest. The authors alone areresponsible for the content and writing of the paper.

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This paper was first published online on Early Online on 20 November 2009

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