Estimation of true height: a study in population-specific methods among young South African adults Christen Renée Lahner*, Susanna Maria Kassier and Frederick Johannes Veldman University of KwaZulu-Natal, Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, College of Agriculture, Engineering and Science, Pietermaritzburg, KwaZulu-Natal, South Africa Submitted 19 April 2016: Final revision received 2 July 2016: Accepted 25 July 2016 Abstract Objective: To investigate the accuracy of arm-associated height estimation methods in the calculation of true height compared with stretch stature in a sample of young South African adults. Design: A cross-sectional descriptive design was employed. Setting: Pietermaritzburg, Westville and Durban, KwaZulu-Natal, South Africa, 2015. Subjects: Convenience sample (N 900) aged 18–24 years, which included an equal number of participants from both genders (150 per gender) stratified across race (Caucasian, Black African and Indian). Results: Continuous variables that were investigated included: (i) stretch stature; (ii) total armspan; (iii) half-armspan; (iv) half-armspan ×2; (v) demi-span; (vi) demi-span gender-specific equation; (vii) WHO equation; and (viii) WHO- adjusted equations; as well as categorization according to gender and race. Statistical analysis was conducted using IBM SPSS Statistics Version 21.0. Significant correlations were identified between gender and height estimation measurements, with males being anatomically larger than females (P < 0·001). Significant differences were documented when study participants were stratified according to race and gender (P < 0·001). Anatomical similarities were noted between Indians and Black Africans, whereas Caucasians were anatomically different from the other race groups. Arm-associated height estimation methods were able to estimate true height; however, each method was specific to each gender and race group. Conclusions: Height can be calculated by using arm-associated measurements. Although universal equations for estimating true height exist, for the enhancement of accuracy, the use of equations that are race-, gender- and population-specific should be considered. Keywords Anthropometry Arm-associated height estimation methods Population-specific methodology Vitruvius theory Maximal height theory For the assessment of true height, an individual is required to be in a compos mentis state and should be able stand up straight unaided without constraints such as medical equipment, physical disabilities and/or space limita- tions (1–3) . However, certain environments serve as a barrier to such an idealistic situation (2) . As a result, body- part measurements are used in the calculation of estimated height (1,3) . Arm-associated height estimation methods are more commonly used as arm long bones are not affected by ageing (4) . Height or estimations thereof are useful in various set- tings, as an accurate height measurement forms part of the BMI equation ([weight (kg)]/[height (m)] 2 ) to evaluate weight status (5) . In addition, accurate height measurements are essential when determining resting energy expenditure or BMR (3) as calculated for inclusion in the Harris–Benedict equation (6) , for spirometry (3,7) , calculating cardiac function indices (8) , drug dose adjustments (8) and the creatinine height index (3) . Therefore, use of an inaccurate height measure- ment v. an accurate one may have adverse outcomes (see online supplementary material, Supplemental Fig. 1). Inaccurate anthropometric values can occur when the measurement technique used was not validated for the population in question v. the study population for which the equation was developed or if technical errors of measurement occurred (9) . Inaccurate height measure- ments result in the inaccurate calculation and misinterpretation of an individual’s nutritional status and hence nutrient requirements (10) . This can lead to over- feeding (10) or underfeeding (10) . Underfeeding initiates the malnutrition cycle, which in turn increases the risk for medical complications such as poor wound healing, Public Health Nutrition Public Health Nutrition: page 1 of 10 doi:10.1017/S1368980016002330 *Corresponding author: Email lahnerchristen@gmail.com © The Authors 2016. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:// creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. http://dx.doi.org/10.1017/S1368980016002330 Downloaded from http:/www.cambridge.org/core. IP address: 197.89.212.88, on 14 Sep 2016 at 10:47:49, subject to the Cambridge Core terms of use, available at http:/www.cambridge.org/core/terms.