2.4. Anthropometric Measurements

Each child underwent an anthropometric assessment at the kindergarten while wearing light clothes. Height was measured using a stadiometer and weight was measured to the nearest tenth decimal with a calibrated Omron BF511 diagnostic scale (Omron, Kyoto, Japan). Non-stretchable, flexible body-measuring tape was used to measure the mid-upper arm circumference (MUAC) and waist circumference (WC). For each study participant, a BMI-to-age z-score was calculated with WHO AnthroPlus software [16]. Because of its ability to describe nutritional status, including at the extreme ends of the distribution and the ability to derive summary statistics, this classification system is recommended by WHO (for, i.e., means and SDs of z-scores (WHO, 1995)). Z-scores are derived using the exact age in days for the WHO standards and months for the WHO reference of 2007 [16]. Anthropometric measurements were performed in a playful manner to lessen the anxiety levels of children. No child was forced to participate in anthropometric measuring if unwilling, regardless of parental consent.