{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:44:38Z","timestamp":1783975478548,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,1,11]],"date-time":"2018-01-11T00:00:00Z","timestamp":1515628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"the New England Pediatric Device Consortium"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nut in Clin Prac"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Mid\u2010upper arm circumference (MUAC) z\u2010score, has recently been listed as an independent indicator for pediatric malnutrition. This investigation examined the relationship between MUAC z\u2010score and the z\u2010scores for conventional indicators (ie, weight\u2010for\u2010length and body mass index) to expand the available evidence for nutrition classification z\u2010score threshold ranges in U.S. practice settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center study of children through 18 years of age seen between October 2015 and September 2016. Height and weight were obtained on intake. MUAC was measured at midpoint of the humerus, between the acromion and olecranon. Age\u2010specific and gender\u2010specific z\u2010score values were calculated using published \u03bb, \u03bc, and \u03c3 values derived from Centers for Disease Control and Prevention reference data. Nutrition status was determined from biochemical data; prior history; anthropometrics; weight gain velocity; weight loss, if present; and nutrient intake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>5,004 children (7.5 \u00b1 5.7 years, 53% boys) were evaluated. As expected, MUAC z\u2010scores were significantly correlated with body mass index (r = 0.789, <jats:italic>P<\/jats:italic> &lt; .01) and weight\u2010for\u2010length (r = 0.638, <jats:italic>P<\/jats:italic> &lt; .01) z\u2010scores. There was a large degree of overlap in z\u2010scores for all indicators between nutrition status groups; however, MUAC z\u2010scores spanned a narrower range of values such that mean MUAC z\u2010scores are lower in children classified as overweight\/obese and higher in children who were severely malnourished than the corresponding body mass index or weight\u2010for\u2010length z\u2010scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These data are the first to suggest that the z\u2010score ranges used to define various stages of malnutrition may not be the same for all indicators.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ncp.10018","type":"journal-article","created":{"date-parts":[[2018,1,11]],"date-time":"2018-01-11T09:34:01Z","timestamp":1515663241000},"page":"124-132","source":"Crossref","is-referenced-by-count":37,"title":["Evaluating Mid\u2010Upper Arm Circumference Z\u2010Score as a Determinant of Nutrition Status"],"prefix":"10.1002","volume":"33","author":[{"given":"Karen","family":"Stephens","sequence":"first","affiliation":[{"name":"Department of Nutrition Services Children's Mercy Hospital  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Escobar","sequence":"additional","affiliation":[{"name":"Department of Nutrition Services Children's Mercy Hospital  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika Nicole","family":"Jennison","sequence":"additional","affiliation":[{"name":"Department of Nutrition Services Children's Mercy Hospital  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Vaughn","sequence":"additional","affiliation":[{"name":"Department of Nutrition Services Children's Mercy Hospital  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Nutrition Services Children's Mercy Hospital  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Abdel\u2010Rahman","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology Medical Toxicology and Therapeutic Innovation Children's Mercy Hospital  Kansas City Missouri USA"},{"name":"Department of Pediatrics University of Missouri\u2010Kansas City School of Medicine  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the CMH Nutrition Services Z\u2010Score Research Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607113479972"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607113512154"},{"key":"e_1_2_7_4_1","volume-title":"Household Food Security in the United States in 2012","author":"Coleman\u2010Jensen A","year":"2013"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607116633800"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2014.08.026"},{"key":"e_1_2_7_7_1","volume-title":"Community\u2010based management of severe acute malnutrition","author":"A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and United Nations Children's Fund","year":"2007"},{"key":"e_1_2_7_8_1","unstructured":"SadlerK PuettC MothabbirG MyattM.Community case management of severe acute malnutrition in southern Bangladesh.http:\/\/fic.tufts.edu\/assets\/Community-Case-Mgt.pdf. 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