The estimation of body height from ulnar length in adults from different ethnic groups
Authors: Madden A.M. , Tsikoura T. , Stott D.J. 
Published: July 2008

Background:  In nutritional assessment, ulnar length has been proposed as an alternative to height where this is difficult to measure (Elia, 2003). However, the relationship between ulnar length and height has not been examined in an ethnically diverse population. The aim of this study was to evaluate the prediction of height from ulnar length in adults from different ethnic groups.

Methods:  Ulnar length and standing height were measured using standardized procedures (Elia, 2003; Ruston et al., 2004) in a gender‐stratified sample of 60 Asian, 69 Black and 65 White healthy adults aged 21–65 years. Ethnicity was defined using Office of National Statistics (2006) criteria. Predicted height was determined from ulnar length using the Malnutrition Universal Screening Tool (MUST) equations (Elia, 2003). Pearsons’ correlation coefficient was used to examine the relationship between ulnar length and height according to gender and ethnicity. The difference between measured and predicted height was examined in each sub‐group using paired t‐tests to identify any systematic biases and assess the reliability of the prediction. Ethical permission was obtained from the London Metropolitan University.

Results:  Ulnar length and height were significantly correlated among Asian, Black and White men and Black and White women at moderate levels with correlation coefficients between 0.68 and 0.43. Among the sample of Asian women the correlation was low (r = 0.11) and not significant. The means (SD) of the difference between predicted and measured height showed significant overestimates for all subgroups except White men and women (Table 1).

 Difference between measured height and height predicted using MUST equations

Ethnicity
Number
Mean height (SD) cm
P value

Measured
predicted

Men

Asian
30
170.9 (5.2)
175.0 (3.5)
<0.001

Black
34
178.1 (7.3)
184.8 (5.2)
<0.001

White
30
176.3 (7.7)
178.2 (4.4)
0.104

Women

Asian
30
157.7 (4.7)
164.0 (2.1)
<0.001

Black
35
164.0 (5.9)
168.4 (4.9)
<0.001

White
35
163.7 (6.2)
164.1 (4.0)
0.611

Discussion:  Simple predictions of height based on the application of MUST equations to ulnar measurements produced elevated estimates of height for Asian and Black groups. The wide standard deviation of the differences suggest relatively wide 95% limits of agreement using conventional analyses and, therefore, predicted values may be unreliable in individuals.

Conclusions:  MUST equations should be used with some caution among ethically diverse populations and probably not used at all among Asian females.

References  Elia, M. (2003) The ‘MUST’ Report. Nutritional Screening of Adults: A Multidisciplinary Responsibility. Development and Use of the ‘Malnutrition Universal Screening Tool’ (‘MUST’) for adults. Redditch: BAPEN.

Office of National Statistics. (2006) Census 2001. A guide to comparing 1991 and 2001 Census ethnic group data. Available at http://www.statistics.gov.uk/cci/article.asp?id=1471 (accessed on 2 January 2008).

Ruston, D., Hoare, J., Henderson, L., Gregory, J., Bates. C.J., Prentice, A., Birch, M., Swan, G. & Farron, M. (2004) National Diet and Nutrition Survey: adults aged 19 to 64 years. Vol 4: Nutritional status (anthropometry and blood analytes), blood pressure and physical activity. London: The Stationery Office.