Efficacy of Subjective and Objective Nutritional Assessment in Children: A Cross-sectional Study

Introduction: Globally, malnutrition represents a critical health concern, particularly among children. Research has consistently shown that undernutrition is highly prevalent in children admitted to hospitals, with reported rates ranging from 21-80%. This widespread issue significantly affects children and their families, impacting their physical, social and economic wellbeing, while also posing serious challenges for healthcare systems. Aim: To measure the nutritional status of children aged 2 to 12 years using both objective and subjective global nutritional assessments. Materials and Methods: This cross-sectional study was conducted to assess the nutritional status of children aged 2 to 12 years at ACS Medical College and Hospital, Chennai, Tamil Nadu, India between January 2024 and March 2024. Using both objective and subjective global nutritional assessments, the study evaluated children’s nutritional status through anthropometric measurements and physical examinations. The objective assessment included measurements of height, weight, Mid-Arm Circumference (MAC) and Triceps Skinfold Thickness (TSF), while the subjective global assessment involved a physical examination and a review of medical history. These methods were chosen based on a literature review comparing subjective and objective nutritional assessments in children. Data were analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0 to compare nutritional indicators between well-nourished and malnourished children, with significance set at p-value <0.05. Results: The study included 250 children (mean age: 5.61±2.89 years). According to the subjective global assessment, 52% of the children were malnourished, while the objective assessment identified 66.4% as malnourished. Well-nourished children had higher measurements in height (109.9±20.6 cm vs. 106.8±19.26 cm), weight (19.6±9.4 kg vs. 17.51±10.4 kg), Body Mass Index (BMI) (15.69±3.03 vs. 15.1±3.85), TSF (11.05±3.62 mm vs. 10.17±3.14 mm), and MAC (17.28±2.59 cm vs. 15.87±2.52 cm). The subjective global assessment showed fair agreement with the objective measures (k=0.317, p-value <0.0001). These findings emphasise the necessity of using both subjective and objective assessments for a comprehensive evaluation of paediatric nutritional status. Conclusion: The study highlights significant differences in growth and body composition between well-nourished and undernourished children. The objective markers reflect the impact of malnutrition, while the fair agreement (k=0.317) between subjective global assessment and objective assessments underscores their complementary value. This emphasises the need for an integrated approach to assess nutritional status and guide targeted interventions accurately.