ArticleThe American journal of clinical nutrition2021
Calf circumference: cutoff values from the NHANES 1999-2006.
Article in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 118 papers, 1 of them a synthesis that pooled it.
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Who cites it
118 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Calf Circumference and All-Cause Mortality: A Systematic Review and Meta-Analysis Based on Trend Estimation Approaches.The journal of nutrition, health & aging · 2022Pooled it
- Effect of a new plant-based high-energy oral nutritional supplement in adult malnourished patients: an open-label, randomized clinical trial.Frontiers in nutrition · 2025Trial
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- Development and Validation of Estimation Equations for Appendicular Skeletal Muscle Mass in Chinese Community-Dwelling Older Adults.Clinical interventions in aging · 2024Trial
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- Smartphone prediction of skeletal muscle mass: model development and validation in adults.The American journal of clinical nutrition · 2023Trial
- Prevalence and Overlap of Malnutrition, Sarcopenia and Related Nutritional Syndromes in a Large Haemodialysis Population.Journal of cachexia, sarcopenia and muscle · 2026Article
- Concurrent Validity of Systematic Nutritional Clinical Assessment in Hospitalized Adults: Comparative Analysis of Patients With and Without Excess Body Weight.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026Article
- Article
- Prevalence of Sarcopenia in Patients with Hip Osteoarthritis Undergoing Total Hip Arthroplasty: A Cross-Sectional Study Based on EWGSOP2 Criteria.Journal of clinical medicine · 2026Article
- Different approaches of SARC-tools for Sarcopenia Screening in chronic obstructive pulmonary disease: A cross-sectional validation study.JPEN. Journal of parenteral and enteral nutrition · 2026Article
- Association between atrial fibrillation and systemic inflammation with muscle mass and strength trajectories in old age.GeroScience · 2026Article
- Correlation Between Hemoglobin Levels with Muscle Function and the Risk of Sarcopenia in Patients with Cancer of the Digestive System: A Cross-Sectional Study.Muscles (Basel, Switzerland) · 2026Article
- Global Leadership Initiative on Malnutrition as a predictor of mortality and prolonged hospitalization in emergency department patients: A prospective cohort study.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026Article
- Integrating Sperm Microscopy, Environmental Exposures, and Lifestyle Factors for Male Fertility Analysis: Protocol for the Nippon Semen and Environmental Exposure Database (N-SEED) Cross-Sectional Study.JMIR research protocols · 2026Article
- Predictive Model Development and Validation for Low Appendicular Skeletal Muscle Mass in Chinese Older Adults.Aging medicine (Milton (N.S.W)) · 2026Article
- Article
- Screening and Diagnosis of Malnutrition in Individuals With Obesity: A Scoping Review of Current Methods.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026Article
- Development and validation of a screening tool for sarcopenia in community-dwelling older adults: a diagnostic cross-sectional study.BMC geriatrics · 2026Article
- Evaluation of blood flow restriction combined with routine rehabilitation in incomplete thoracic and lumbar spinal cord injury after decompression: a retrospective study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
58 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors.
Funding
Abstract
backgroundCalf circumference (CC) is used in geriatric studies as a simple and practical skeletal muscle (SM) marker for diagnosing low SM and sarcopenia. Currently applied CC cutoff points were developed in samples including older participants; values representative of the full adult lifespan are lacking.
objectivesWe aimed to develop CC cutoff points and to identify relevant confounding factors from the large and diverse NHANES 1999-2006 population sample.
methodsDemographic, anthropometric, and imaging data (DXA, appendicular lean mass) from the adult (age ≥18 y) NHANES sample were partitioned into subgroups according to sex, age, ethnicity, and race. Adults aged 18-39 y and BMI (in kg/m2) 18.5-24.9 were set as a reference population; CC cutoff points were derived at 1 and 2 SDs below the mean.
resultsThe sample included 17,789 participants, 51.3% males and 48.7% females, with respective ages (mean ± SD) of 43.3 ± 16.1 y and 45.5 ± 16.9 y. CC was strongly correlated with appendicular lean mass, r = 0.84 and 0.86 for males and females (both P < 0.001), respectively. Significant differences in mean CC were present across sex, ethnic, self-reported race, and BMI groups. Adjusting CC for adiposity using BMI revealed a decrease in CC beginning after the second decade in males and third decade in females. Rounded CC cutoff values for moderately and severely low CC were 34 cm and 32 cm (males), and 33 cm and 31 cm (females), respectively. Our findings support the use of BMI-adjusted CC values for participants outside the normal-weight BMI range (18-24.9).
conclusionsThis study defined CC values in a diverse population sample along with a BMI-adjustment approach that helps to remove the confounding effects of adiposity and thereby improves CC as a useful clinical estimate of SM mass.
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