Commentary: Measuring nutritional status of children

Leg length has been suggested as a proxy for nutritional and environmental
exposures in childhood given the associations observed in some Western
populations. Sanjay Kinra et al. present a careful assessment of this
hypothesis in an Indian population in this issue of the International Journal of
Epidemiology and observe no association between nutritional supplementation and relative leg length, and relative lower leg length, among adolescents in the Hyderabad cohort. Although intriguing, given previous findings and the proposed sensitivity of ‘lower’ leg length as a marker for nutritional status, the null finding reported by Kinra and colleagues is in accord with other studies in non-Western populations. A number of alternative anthropometric, body compositional and biochemical methods are available for ascertaining nutritional status in children. Depending on the setting and the objective (individual clinical impression vs population nutritional assessment), these methods may have important advantages and disadvantages that we briefly consider.