14 MASS. EXPERIMENT STATION BULLETIN 310 



as indicated b\' the medical examination. It would seem, then, that de\iation 

 from the average weight for height is not a dependable criterion of nutritional 

 status even from the quantitative standpoint. 



This inadequacy of the weight-height, or weight-height-age tables for measur- 

 ing the nutritional condition of children is not a new finding but has been pointed 

 out by man}' previous observers. A nuinber of studies ha\e been reported 

 recently in which attemps were made to work out standards by which the child's 

 condition can be evaluated with greater accuracy. 



Skeletal Measurements 



The general assumption that weight varies with the body build as well as with 

 stature and with the mass of soft tissues seems logical. Franzen (7) emphasizes 

 the importance of skeletal dimensions in determining weight, and of the size 

 of muscles and the amount of subcutaneous tissue as indicating the nutritional 

 condition of children. He found that the correlation of height with weight was 

 much less than that of other skeletal measures with weight, and pointed out 

 that to base nutrition conclusions on weight-height ratios may cause great errors 

 because of hip and chest variations. He also found that the multiples of eleven 

 factors, including skeletal measures, girths, and amount of subcutaneous tissues, 

 showed a correlation with weight which approached unity. At the time of this 

 writing only the preliminary report of Franzen's study has been published. 

 In this he gives formulae and tables necessary for estimating the relative nutri- 

 tional status for 11-year-old boys only. Consequently, it has not been possible 

 to use this method in evaluating the nutritional condition of our subjects as 

 had been hoped. 



Height-Width Index 



Lucas and Pryor in San Francisco (12) have worked out a much simpler stand- 

 ard of "ideal weight" for height and width (hip breadth) at each age.- Hip breadth 

 was chosen as the single measure of width to be used because it is easily obtained 

 and is constant. Using the tables compiled by these observers the deviations of 

 actual from "ideal" weight was computed in all cases in which hip breadth had 

 been taken as well as height and weight. To our surprise the values found seemed 

 to be no more trustworthy an indication of the child's condition than those ob- 

 tained when the Baldwin-Wood scale had been used. Again in a large percentage 

 of cases, perhaps in a majority, the deviation of the child's weight from the ex- 

 pected weight probably gave a quite accurate picture of his nutritional status, 

 but in others it obviously did not. In the instances in which the discrepancy 

 was most evident, the children varied decidedly from the average in some skeletal 

 measurement. For example, some had broad hips but narrow shoulders, or vice 

 versa; others had long slender bones and still had broad shoulders or hips or 

 both; and still others had large heavy bones but were narrow hipped. This is 

 well illustrated by an extreme example. Girl 209 was a very narrow-hipped child 

 but had broad shoulders and fairly large bones. She was quite well padded 

 with fat, although she gave tha impression of tending toward thinness rather 

 than fatness. Not by any flight of fancy would one have called her obese although 

 she weighed 28 per cent more than her "ideal" weight. 



In a large proportion of cases, particularly when the child was of average 

 build, the expected weight as estimated by the two scales (Baldwin-Wood and 

 Lucas-Pryor) did not differ greatly. \\ hen the child was slenderh built, the 

 latter standard seemed to gi\e the more reasonable evaluation. 



