NSCB Resolution No. 10
Series of 2008
APPROVING AND ADOPTING THE OFFICIAL CONCEPTS AND DEFINITIONS FOR STATISTICAL PURPOSES FOR THE HEALTH AND NUTRTITION SECTOR – BATCH 2
Annex BR-10-2008-01a
Note: Metadata for the concepts for health and nutrition statistics, which are defined below, are provided in Annex BR-10-2008-01b.
I. ANTHROPOMETRY
- Body Mass Index (BMI) – an indicator of nutritional status for adolescents 11-19 years old and adults 20 years old and over, which provides a measure of body mass ranging from thinness to obesity and is expressed as body weight (Wt) in kilograms divided by the square of the height (Ht) in meters
Formula:
The cutoff points used in classifying subjects 11-19 years old based on BMI-for-age (Must's Table for BMI, 1991) are as follows, where P refers to percentile:
| Classification | Cutoff points |
| Underweight | <P5 |
| Mildly underweight | P5 to < P15 |
| Normal | P15 to P85 |
| Overweight | >P85 |
The cutoff points used in classifying subjects 20 years old and over based on BMI from the National Center for Health Statistics (NCHS)/World Health Organization (WHO) Standards, 1978 are as follows:
| Classification | Cutoff points |
| Chronic Energy Deficient (CED) | <18.5 kg/m2 |
| Normal | 18.5 to <25.0 kg/m2 |
| Overweight | 25.0 to <30.0 kg/m2 |
| Obese | >30.0 kg/m2 |
1.1 Underweight or Chronic Energy Deficient (CED) – a condition of the body characterized by low body weight and low energy stores and possibly limited physical capacity due to deprivation of food over a long period of time, with BMI of less than P5 (5th percentile) for adolescents or less than 18.5 kg/m2 for adults
1.2 Overweight – a condition where a person’s weight is greater than that of a normal person of the same age (in case of adolescents) or height (in case of adults), with BMI of more than P85 (85th percentile) for adolescents or between 25 and 30 kg/m2 for adults
1.3 Obese – a condition where a person’s weight is much greater than that of a normal person of the same height (for adults), with BMI of greater than or equal to 30.0 kg/m2
- Height-for-Age – an indicator that is used to determine past or chronic nutritional status of children 0-10 years old where each child’s actual height/length is compared with the standard or reference height/length for his/her age
The cutoff points used in classifying the height-for-age status of children based on NCHS/WHO International Reference Standards (IRS), 1995 are as follows, where SD refers to standardized score of the individual:
| Classification | Cutoff points |
| Underweight | SD < -2 |
| Normal | SD = -2 to +2 |
| Overweight | SD > +2 |
2.1 Underheight or Stunted – a condition where the child’s height is lower than that of a normal person of the same age and is measured using height-for-age as the index
- Low Birthweight – a condition where the weight of an infant at birth is less than 2.5 kilograms or 2500 grams
- Weight-for-Age – an index for the assessment of growth of children 0-10 years old which compares the weight of each child to a standard or reference weight for his/her age
The cutoff points used in classifying the weight-for-age status of children based on IRS, 1995 are as follows, where SD refers to standardized score of the individual:
| Classification | Cutoff points |
| Underweight | SD <-2 |
| Normal | SD = -2 to +2 |
| Overweight | SD > +2 |
4.1 Underweight – a condition where the child’s weight is lower than that of a normal person of the same age and is measured using weight-for-age as the index
- Weight-for-Height or Weight-for-Length – an index for the assessment of growth of children 0-10 years old which compares the weight of each child to the weight of a reference population of the same height or length
The cutoff points used in classifying the weight-for-height/length status of children based on IRS, 1995 are as follows, where SD refers to standardized score of the individual:
| Classification | Cutoff points |
| Wasting or thin | SD <-2 |
| Normal | SD = -2 to +2 |
| Overweight | SD > +2 |
5.1 Wasting or Thin – a condition where the child’s weight is lower relative to his/her height or length than that of a normal child and is measured using the weight-for-height as the index
II. BIOCHEMICAL ASSESSMENT
- Iodine Deficiency Disorder (IDD) – a range of health consequences or abnormalities of the body resulting from a prolonged lack or insufficient intake of iodine, ranging from simple goiter to cretinism, which is a condition of severely stunted physical and mental growth
The epidemiological criteria for assessing iodine nutrition based on median urinary iodine concentrations in school-aged children (WHO/UNICEF/ICCIDD, 2001) are as follows:
| Median Value (ug/L) | Iodine Intake (ug/d) | Iodine Nutrition |
| <20 | Insufficient | Severe iodine deficiency |
| 20 – 49 | Insufficient | Moderate iodine deficiency |
| 50 – 99 | Insufficient | Mild iodine deficiency |
| 100 – 199 | Adequate | Optimal |
| 200 - 299 | More than adequate | Risk of iodine-induced hyperthyroidism within 5-10 years following introduction of iodized salt in susceptible groups |
| > 300 | Excessive | Risk of adverse health consequences (iodine induced hyperthyroidism, autoimmune thyroid diseases) |
- Iron Deficiency Anemia (IDA) – a condition that occurs when the amount of iron absorbed by the body is too small to meet the body’s demands, which may be due to insufficient iron intake, reduced bioavailability of dietary iron, chronic blood loss, and/or increased iron requirements, as occurring during pregnancy or the period of growth, and is measured using the hemoglobin level
The normal hemoglobin levels by sex, age and physiological state based on WHO cutoff points, 1972 are as follows:
| Age/Sex/ Physiological State | Normal Hemoglobin Level (g/dL) |
| Children: | |
| 6 mos. – 6 yrs. | 11.0 |
| 6.1 – 14 yrs | 12.0 |
| Adult: | |
| Males | 13.0 |
| Females | 12.0 |
| Pregnant | 11.0 |
| Lactating | 12.0 |
- Vitamin A Deficiency (VAD) – a condition that covers all physiological disturbances caused by low vitamin A level, including subclinical and clinical signs and symptoms and is measured using the plasma retinol level
The cutoff points used for the interpretation of plasma retinol data based on WHO/UNICEF/HKI/IVACG, 1982 are as follows:
| Level | Plasma Retinol | |
| µg/dL | µmol/L | |
| Deficient Low Acceptable High | <10 10 – 19 20 – 29 ≥ 50 | <0.35 0.35 - 0.69 0.70 – 1.74 ≥ 1.75 |
III. DIETARY
- Energy/Nutrient Adequacy – the level of intake of energy or essential nutrient in relation to the energy/nutrient requirement for adequate health, which is expressed as percentage of recommended energy and nutrient intake (RENI)
- Malnutrition – a pathological state, general or specific, resulting from a relative or absolute deficiency or excess in the diet of one or more essential nutrients, which may be manifested clinically or detectable by physical, biochemical and/or functional signs
- Micronutrient Malnutrition – a condition resulting from a deficiency of supply to the tissues of micronutrients, notably vitamin A, iron, and iodine, arising from a deficiency in the diet, losses from the body, or improper utilization of food
- Nutritional Status – the condition of the body resulting from the intake, absorption, and utilization of food
- Per Capita Food Consumption – the ratio of household food consumption over the food consumption unit, wherein actual food consumption refers to a whole day’s consumption of all household members and visitors, while consumption unit refers to the household size adjusted by the number of meals eaten outside by the household members and the number of meals shared by visitors
Formula:
- Protein Energy Malnutrition – a condition arising from inadequate intake of food rich in energy and protein, characterized by marked weight loss and failure to grow
- Undernutrition – an abnormal state resulting from the consumption of an inadequate quantity of food over an extended period of time
