E-ISSN:2456-3110

Research Article

Nutritional status

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 1 Jan-Feb
Publisherwww.maharshicharaka.in

Study of Anguli Pramana in individuals with different nutritional status with respect to its validity in the present era

Visave P.1*, Shukla D.2, Choudhari D.3
DOI: http://dx.doi.org/10.21760/jaims.7.1.10

1* Pratibha Visave, Professor, Dept. of Rachana Sharir, Siddhakala Ayurved College, Sangamner, Ahmendnagar, Maharashtra, India.

2 Deepnarayan Shukla, H.O.D. & Professor, R. A. Podar Ayurved Medical College, Worli, Mumbai, Maharashtra, India.

3 Deepali Choudhari, Associate Professor, Dept. of Dravyagun Vidnyan, S.S.T. Ayurved College, Sangamner, Ahmednagar, Maharashtra, India.

Introduction: Anguli Pramana is an ancient form of Anthropometry put forth by sages. It mainly deals with the measurements of the human body. Literature search revealed that, not a single study was being carried out for assessing the validity of Anguli Pramana in the present era. Therefore, the present study was planned. Method: After ethical clearance, 770 participants between 18-50 years were selected from Ahmednagar and Nashik region. Measurements were taken for selected parameters and converted into Swa-Anguli Pramana. Body Mass Index of each participant was calculated and categorized according to the nutritional status. The data analyzed with Student’s t-test using Systat 13.0 version software. Result: Comparative data of standard and measured value was found statistically different in all nutritional status groups. Discussion: Anguli Pramana may not be considered valid in the present era may be due to evolutionary changes and lifestyle changes in the human being.

Keywords: Anguli Pramana, Anthropometry, Body mass index, Normal nutrition, Under nutrition, Over nutrition

Corresponding Author How to Cite this Article To Browse
Pratibha Visave, Professor, Dept. of Rachana Sharir, Siddhakala Ayurved College, Sangamner, Ahmendnagar, Maharashtra, India.
Email: 		Pratibha Visave, Deepnarayan Shukla, Deepali Choudhari, Study of Anguli Pramana in individuals with different nutritional status with respect to its validity in the present era. J Ayu Int Med Sci. 2022;7(1):67-75.
Available From
https://jaims.in/jaims/article/view/1682

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-01-17 2022-01-19 2022-01-26 2022-02-02 2022-02-09
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2022by Pratibha Visave, Deepnarayan Shukla, Deepali Choudhariand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Description of Anguli Pramana is mainly found in Brihatrayi in Ayurveda. Charaka has described the same in the context of Dashavidha Pariksha. He has emphasized the usefulness of Anguli Pramana as a tool to assess the Ayu and Bala of the Atura.[1] Sushruta has explained it as the tool to get the assessment of Ayu and the economic condition of the patient. According to  him  a  person  with appropriate Pramana of Anga-Pratyanga is bestowed with good health, long life span and prosperity. He has further explained that it is beneficial to examine the Ayu of the patient before proceeding with the treatment.[2] Later on, Vagbhata rearranged their perceptions.[3] In Ayurveda, the term ‘Anguli’ has been accepted as the smallest unit for measuring body parts.[4] Anthropometry is the modern counterpart of an ancient Anguli Pramana. It is a branch of Anthropology which deals with the quantitative measurements of the human body. “It is the single most portable, globally acceptable, inexpensive and non- invasive technique for assessment of the size, proportions and compositions of the human body”.[5] Body Mass Index is one of the anthropometric parameters for assessing the nutritional status of individuals. BMI is used as it is cost effective and easy for calculation.[6] On reviewing the previous work, it was observed that, no study was carried out for the validation of Anguli Pramana in the present era on the basis of nutritional status. There was only one study found stating correlation between arm span in terms of Anguli Pramana and BMI.[7] Hence, the present study was conducted to study Anguli Pramana in individuals with different nutritional status.

Methodology

Study design: Observational (Survey) study design was preferred for the present study. The measurements were taken for selected parameters and the data recorded on case record form.

Sampling technique: Samples were taken by opting Non-probability sampling technique. The study was conducted with voluntary participation along with their informed written consent.

Sample size: Total 770 participants of age group 18-50 years were selected from Ahmednagar and Nashik region. The sample size was calculated

by referring Census 2011. Considering 50% response rate for the survey, 5% error margin in 95% confidence level and using Rao soft tables estimated sample size was derived.

Inclusion criteria: Age group 18-50 years of both genders, same geographical region (Ahmednagar and Nashik), same socio-economic status (middle class).

Exclusion criteria: Wheelchair bound individuals, persons having physical disability, persons who have difficulty in standing steady or straight, persons with hairstyle or turban.

Materials: Calculator, case record form, digital vernier caliper, informed consent form, measuring tape, stature meter, steel tape, weighing machine.

Assessment parameters: The parameters selected for assessment were as follows,

  1. Swa-anguli Pramana: Width of the middle finger of the right hand,
  2. Purush ayam (Standing height)
  3. Purush vistar (Arm span)
  4. Shir parinah (Head circumference)
  5. Bahu ayam (Length of arm)
  6. Prakoshtha ayam (Length of forearm)
  7. Prakoshtha parinah (Forearm circumference)
  8. Manibandha parinah (Wrist circumference)
  9. Hasta ayam (Length of hand)
  10. Hasta vistar (Width of hand)
  11. Uru ayam (Length of thigh)
  12. Uru parinah (Thigh circumference)
  13. Janu ayam (Length of knee)
  14. Janu parinah (Knee circumference)
  15. Jangha ayam (Length of leg)
  16. Jangha parinah (Leg circumference)
  17. Gulpha parinah (Ankle circumference)
  18. Pad ayam (Length of foot)
  19. Pad vistar (Width of foot)
  20. Pad parinah (Foot circumference)
  21. Kati vistar (Width of waist)
  22. Urdhwa shakha ayam (Length of upper extremity)

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  1. Adho shakha ayam (Length of lower extremity)

Parameters for assessment of Nutritional Status

  1. Height (in centimeters)
  2. Weight (in kilograms)
  3. Body Mass Index (BMI)

Nutritional status can be defined as the condition of the body in those respects influenced by the diet, the levels of nutrients in the body and the ability of those levels to maintain normal metabolic integrity”. (8) In adults, generally it is assessed by measuring the height and body weight and expressed as Body Mass Index (BMI). Body Mass Index of each participant was calculated as the ratio of weight (kg) to height (m2). The study was conducted after seeking ethical committee permission. Total 770 study subjects of age group 18-50 years from Ahmednagar and Nashik region were selected. Measurements were taken for selected parameters, recorded and converted into Swa-anguli Pramana. BMI of each participant was also calculated. The researcher wanted to study the Anguli Pramana in various nutritional status viz. Normal nutrition, Undernutrition and Overnutrition. For this purpose, all the 770 participants were segregated according to the nutritional status obtained through BMI. The sample size for each subgroup was less than 500, hence, Student’s t-test for single mean was applied at 95% confidence interval. For this purpose, Systat 13.0 version software was used. The normality of the data was also tested using the Shapiro Wilks normality statistics and it was found to be normally distributed. Standard values were the values quoted by Charaka and Sushruta in ancient literature whereas observed values were the values which were actually measured and noted on the case record form. To compare if there was any significant difference between average body measurements and the Anguli Pramana stated by Charaka, Student’s t-test for single mean was applied at 95% confidence level separately for each parameter. The results obtained for Normal nutrition, Undernutrition and Overnutrition groups are shown in Table-2, Table-4, Table-6 respectively. Likewise, to compare if there was any significant difference between average body measurements and the Anguli Pramana stated by Sushruta, once again Student’s t-test for single mean was applied at 95% confidence level separately for each parameter. The results obtained for Normal nutrition, Undernutrition

and Overnutrition groups are shown in Table-3, Table-5, Table-7 respectively.

Observations and Results

Table 1: Nutritional Status distribution of study population

Nutritional Status B.M.I. Number Percentage
Normal nutrition 18.5-25 432 56.10
Undernutrition < 18.5 143 18.57
Overnutrition > 25 195 25.33
Total   770 100.00

Maximum number of participants were having Normal nutritional status (56.10%). Percentage of Undernutrition and Overnutrition was 18.57% and 25.33% respectively.

Table 2: Comparison of actual average value with the value stated by Charaka in Normal nutrition group

SN Parameter Std. Value Actual Mean S.D. S. E. t Value p Value
1. Purush Ayam 84 95.8725 6.7816 0.3263 36.3451 0.0000*
2. Purush Vistar 84 97.3921 6.9325 0.3335 40.1049 0.0000*
3. Shir Parinah 32 32.6985 2.6830 0.1292 5.4051 0.0000*
4. Bahu Ayam 16 18.9406 1.6958 0.0819 35.9993 0.0000*
5. Prakoshtha Ayam 15 15.6618 1.3994 0.0671 9.8182 0.0000*
6. Hasta Ayam 12 10.6269 0.9443 0.0458 -30.1901 0.0000*
7. Uru Ayam 18 27.1374 2.8160 0.1356 67.3641 0.0000*
8. Uru Parinah 30 27.4656 3.1272 0.1503 -16.8248 0.0000*
9. Janu Ayam 4 4.8231 0.6846 0.0332 24.9599 0.0000*
10. Janu Parinah 16 21.3158 2.2328 0.1072 49.4272 0.0000*
11. Jangha Ayam 18 21.7437 2.4204 0.1166 32.1104 0.0000*
12. Jangha Parinah 16 19.6689 2.0947 0.1010 36.3585 0.0000*
13. Pad Ayam 14 13.7984 1.1332 0.0548 -3.6934 0.0003*
14. Pad Vistar 6 5.9301 1.0755 0.0520 -1.3490 0.1780**
15. Kati Vistar 16 23.0444 3.1966 0.1539 45.7502 0.0000*

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* - Significant, ** - Not Significant

From Table 2 it can be observed that there was a significant difference between the average actual value recorded and the standard value stated by Charaka for specific parameter in terms of Anguli Pramana except for parameter ‘Pad Vistar’.

Table 3: Comparison of actual average value with the value stated by Sushruta in Normal nutrition group

SN Parameter Std. Value Actual Mean S. D. S. E. t Value p Value
1. Purush Ayam 120 95.8725 6.7816 0.3326 -73.8616 0.0000*
2. Bahu Ayam 16 18.9406 1.6958 0.0819 35.9993 0.0000*
3. Prakoshtha Ayam 16 15.6618 1.3994 0.0671 -5.0168 0.000013*
4. Prakoshtha Parinah 12 11.8493 1.4113 0.0678 -2.2171 0.0000*
5. Manibandha Parinah 12 9.1622 0.6958 0.0332 -84.6660 0.0000*
6. Hasta Ayam 6 10.6269 0.9443 0.0458 101.7263 0.0000*
7. Hasta Vistar 4 4.8963 0.3891 0.0200 47.8246 0.0000*
8. Uru Ayam 18 27.1374 2.8160 0.1356 67.3641 0.0000*
9. Uru Parinah 32 27.4656 3.1272 0.1503 -30.1020 0.0000*
10. Janu Parinah 14 21.3158 2.2328 0.1072 68.0234 0.0000*
11. Jangha Ayam 18 21.7437 2.4204 0.1166 32.1104 0.0000*
12. Jangha Parinah 16 19.6686 2.0947 0.1010 36.3585 0.0000*
13. Gulpha Parinah 14 13.5961 1.5807 0.0762 -5.3043 0.0000*
14. Pad Ayam 14 13.7984 1.1332 0.0548 -3.6934 0.0030*
15. Pad Vistar 5 5.9301 1.0755 0.0520 17.9545 0.0000*
16. Pad Parinah 14 13.8166 1.3727 0.0663 -2.7733 0.0058*
17. Kati Vistar 18 23.0444 3.1966 0.1539 32.7610 0.0000*
18. Urdhwa Shakha Ayam 32 42.6442 3.1353 0.1510 70.4804 0.0000*
19. Adho Shakha Ayam 50 55.5331 5.0298 0.2421 22.8379 0.0000*

* - Significant, ** - Not Significant

From Table 3 it can be observed that there was a significant difference between the average actual value recorded and the standard value stated by Sushruta for specific parameter in terms of Anguli Pramana.

Table 4: Comparison of actual average value with the value stated by Charaka in Undernutrition group


SN Parameter Std. Value Actual Mean S.D. S. E. t Value p Value
1. Purush Ayam 84 97.5107 12.6022 1.0576 12.7304 0.0000*
2. Purush Vistar 84 100.6635 7.2315 0.6069 27.3620 0.0000*
3. Shir Parinah 32 33.0711 2.8939 0.2428 4.3948 0.000022*
4. Bahu Ayam 16 19.2365 1.8318 0.1537 20.9798 0.0000*
5. Prakoshtha Ayam 15 15.9102 1.3169 0.1105 8.2072 0.0000*
6. Hasta Ayam 12 10.7009 0.8099 0.0680 -19.0472 0.0000*
7. Uru Ayam 18 28.3165 3.0131 0.2529 40.6563 0.0000*
8. Uru Parinah 30 25.8463 2.9410 0.2468 -16.7706 0.0000*
9. Janu Ayam 4 4.8792 0.7644 0.0642 13.6561 0.0000*
10. Janu Parinah 16 20.0318 2.2433 0.1883 21.3416 0.0000*
11. Jangha Ayam 18 22.3113 2.1640 0.1816 23.6565 0.0000*
12. Jangha Parinah 16 18.5255 2.0046 0.1682 14.9602 0.0000*
13. Pad Ayam 14 14.0220 1.1251 0.0944 0.2319 0.8169**
14. Pad Vistar 6 5.8884 0.5802 0.0487 -2.2845 0.0238*
15. Kati Vistar 16 22.2715 3.0932 0.2596 24.0757 0.0000*

* - Significant, ** - Not Significant

From Table 4 it can be observed that there was a significant difference between the average actual value recorded and the standard value stated by Charaka for specific parameters in terms of Anguli Pramana except for parameter ‘Pad Ayam’.



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Table 5: Comparison of actual average value with the value stated by Sushruta in Undernutrition group

SN Parameter Std. Value Actual Mean S. D. S. E. t Value p Value
1. Purush Ayam 120 97.5107 12.6022 1.0576 -21.1904 0.0000*
2. Bahu Ayam 16 19.2365 1.8318 0.1537 20.9798 0.0000*
3. Prakoshtha Ayam 16 15.9102 1.3169 0.1105 8.2072 0.0000*
4. Prakoshtha Parinah 12 11.2458 1.5149 0.1271 -5.9118 0.0000*
5. Manibandha Parinah 12 8.9088 0.7976 0.0669 -46.0179 0.0000*
6. Hasta Ayam 6 10.7009 0.8099 0.0680 68.9250 0.0000*
7. Hasta Vistar 4 4.9200 0.5174 0.0434 21.1153 0.0000*
8. Uru Ayam 18 28.3165 3.0131 0.2529 40.6563 0.0000*
9. Uru Parinah 32 25.8463 2.9410 0.2468 -24.8456 0.0000*
10. Janu Parinah 14 20.0318 2.2433 0.1883 31.9281 0.0000*
11. Jangha Ayam 18 22.3113 2.1640 0.1816 23.6565 0.0000*
12. Jangha Parinah 16 18.5255 2.0046 0.1682 14.9602 0.0000*
13. Gulpha Parinah 14 13.4008 1.4812 0.1243 -4.8038 0.0000*
14. Pad Ayam 14 14.0220 1.1251 0.0944 0.2319 0.8169**
15. Pad Vistar 5 5.8884 0.5802 0.0487 18.1822 0.0000*
16. Pad Parinah 14 13.7068 1.5652 0.1314 -2.2241 0.0277*
17. Kati Vistar 18 22.2715 3.0932 0.2596 16.3979 0.0000*
18. Urdhwa Shakha Ayam 32 43.2650 3.2287 0.2709 41.4297 0.0000*
19. Adho Shakha Ayam 50 57.4994 4.9255 0.4133 18.0797 0.0000*

* - Significant, ** - Not Significant

From Table 5 it can be observed that there was a significant difference between the average actual value recorded and the standard value stated by Sushruta for specific parameters in terms of Anguli Pramana except parameter ‘Pad Ayam’.

From Table 6 it can be observed that there was a significant difference between the average actual value recorded and the standard value stated by Charaka for specific parameter in terms of Anguli Pramana except for parameter ‘Shir Parinah’.

Table 6: Comparison of actual average value with the value stated by Charaka in Overnutrition group


SN Parameter Std. Value Actual Mean S.D. S. E. t Value p Value
1. Purush Ayam 84 91.8147 6.3419 0.4553 17.1186 0.0000*
2. Purush Vistar 84 93.3256 6.7029 0.4812 19.3282 0.0000*
3. Shir Parinah 32 32.0213 2.2134 0.1589 0.1339 0.8936**
4. Bahu Ayam 16 18.0288 1.7238 0.1238 16.3501 0.0000*
5. Prakoshtha Ayam 15 15.3190 1.2658 0.0909 3.5012 0.0006*
6. Hasta Ayam 12 10.2193 0.7628 0.0548 -32.4293 0.0000*
7. Uru Ayam 18 25.6611 3.0237 0.2171 35.1992 0.0000*
8. Uru Parinah 30 29.1896 3.7117 0.2665 -3.0331 0.0028*
9. Janu Ayam 4 5.0731 3.5129 0.2522 4.2437 0.0000*
10. Janu Parinah 16 22.3201 2.9935 0.2149 29.3305 0.0000*
11. Jangha Ayam 18 20.4825 2.2250 0.1597 15.5005 0.0000*
12. Jangha Parinah 16 20.7447 2.5800 0.1852 25.5484 0.0000*
13. Pad Ayam 14 13.3595 1.1894 0.0854 -7.4805 0.0000*
14. Pad Vistar 6 5.8223 0.5506 0.0395 -4.4833 0.0000*
15. Kati Vistar 16 24.4223 3.0880 0.2217 37.8909 0.0000*

* - Significant, ** - Not Significant

From Table 7 it can be observed that there was a significant difference between the average actual value recorded and the standard value stated by Sushruta for specific parameter in terms of Anguli Pramana.



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Table 7: Comparison of actual average value with the value stated by Sushruta in Overnutrition group

SN Parameter Std. Value Actual Mean S. D. S. E. t Value p Value Remark
1. Purush Ayam 120 91.8147 6.3419 0.4553 -61.7417 0.0000* Significant
2. Bahu Ayam 16 18.0288 1.7238 0.1238 16.3501 0.0000* Significant
3. Prakoshtha Ayam 16 15.3190 1.2658 0.0909 -7.4736 0.0000* Significant
4. Prakoshtha Parinah 12 12.434 1.3252 0.0951 4.5499 0.0000* Significant
5. Manibandha Parinah 12 9.3794 0.7491 0.0538 -48.5977 0.0000* Significant
6. Hasta Ayam 6 10.2193 0.7628 0.0548 76.8417 0.0000* Significant
7. Hasta Vistar 4 4.8231 0.3885 0.0279 29.4339 0.0000* Significant
8. Uru Ayam 18 25.6611 3.0237 0.2171 35.1992 0.0000* Significant
9. Uru Parinah 32 29.1896 3.7117 0.2665 -10.5188 0.0000* Significant
10. Janu Parinah 14 22.3201 2.9935 0.2149 38.6123 0.0000* Significant
11. Jangha Ayam 18 20.4825 2.2250 0.1597 15.5005 0.0000* Significant
12. Jangha Parinah 16 20.7447 2.5800 0.1852 25.5484 0.0000* Significant
13. Gulpha Parinah 14 13.4548 1.7108 0.1228 -4.4270 0.0000* Significant
14. Pad Ayam 14 13.3595 1.1894 0.0854 -7.4805 0.0030* Significant
15. Pad Vistar 5 5.8223 0.5506 0.0395 20.7489 0.0000* Significant
16. Pad Parinah 14 13.6795 1.3766 0.0988 -3.2346 0.0014* Significant
17. Kati Vistar 18 24.4223 3.0880 0.2217 28.8932 0.0000* Significant
18. Urdhwa Shakha Ayam 32 41.0898 2.9726 0.2134 42.4814 0.0000* Significant
19. Adho Shakha Ayam 50 53.0381 4.2092 0.3022 10.0272 0.0000* Significant

* - Significant, ** - Not Significant

Discussion

The nutritional status of each participant was assessed on the basis of modern anthropometric parameter Body Mass Index (BMI).[6]

The researcher compared the nutritional status and Anguli Pramana for various body parameter measurements. To carry out this comparison, the original data of 770 participants was segregated according to the nutritional status into three subgroups viz. Normal nutrition, Undernutrition and Overnutrition with sample sizes 432, 143 and 195 respectively. (Table 1)

Anguli Pramana in Normal Nutrition Group

The variation was found in the average actual value recorded and the standard value stated by Charaka for specific parameters in terms of Anguli Pramana except for the parameter ‘Pad Vistara’ (Table 2). Considering these observations for a normal nutrition status group of participants, Anguli Pramana stated by Charaka may not be taken valid in the present era. May be only Pad Vistara is comparable.

The average actual value recorded and the standard value stated by Sushruta for specific parameters in terms of Anguli Pramana found significantly different from each other (Table 3). This pattern suggested that, for a Normal nutrition status group of participants, Anguli Pramana stated by Sushruta may not be taken valid in the present era.

Anguli Pramana in Undernutrition Group

The difference was found between the average actual value recorded and the standard value stated by Charaka for specific parameters in terms of Anguli Pramana except for the parameter ‘Pad Ayam’ (Table 4). Thus, it can be inferred that for the Undernutrition status group of participants, Anguli Pramana stated by Charaka may not be taken valid in the present era. May be Pad Ayam is comparable.

In the same way, the difference was found between the average actual value recorded and the standard value stated by Sushruta for specific parameters in terms of Anguli Pramana except parameter ‘Pad Ayam’ (Table 5). It suggested that for the Undernutrition status group of participants, Anguli Pramana stated by Sushruta may not be taken valid in the present era. May be Pad Ayam is comparable.

Anguli Pramana in Overnutrition Group

The average actual value recorded and the standard value stated by Charaka for specific parameters in terms of Anguli Pramana found statistically different from each other except for the parameter ‘Shir Parinah


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’ (Table 6). Hence, it can be said that for the Overnutrition status group of participants, Anguli Pramana stated by Charaka may not be taken valid in the present era. May be Shir Parinah is comparable.

Similarly, the difference was found between the average actual value recorded and the standard value stated by Sushruta for specific parameters in terms of Anguli Pramana (Table 7). Hence, for the Overnutrition status group of participants also, Anguli Pramana stated by Sushruta cannot be taken valid in the present era.

Over all the results of the study revealed that the ancient Anguli Pramana stated by Charaka and Sushruta may not be taken valid in the present era except for few parameters. Pad Vistar (width of foot), Pad Ayam (length of foot) and Shir Parinah (head circumference) were the exceptionally comparable parameters in these subgroups. This may be due to less spread of data because of comparatively small sample sizes in these subgroups.

Considering the previous work done, it was observed that not a single study was carried out for the validation of Anguli Pramana in the present era on the basis of nutritional status. There was only one study found stating correlation between arm span in terms of Anguli Pramana and BMI.[7] But, it was not relevant to the present study.

Conclusion

From the study it can be concluded that the concept of Anguli Pramana mentioned in ancient literature may not be considered valid in the present era probably because of evolutionary changes and the changes in lifestyle of the human being. The research could further be carried out using larger sample size to arrive at generalization while narrowing the scope of age group.

Reference

  1. Vaidya Yadavji Trikamji Acharya. Charaka Samhita of Agnivesha, revised by Charaka and Dridhabala with Ayurveda Dipika commentary of Chakrapanidatta. 5th Varanasi; Choukhambha Sanskrit Sansthan; 2008. p.738.
  2. Vaidya Yadavji Trikamji Acharya. Sushruta Samhita of Sushruta with Nibandha
  1. Sangraha commentary of Dalhana. 8th Varanasi; Choukhambha Orientalia; 2008. p. 824.
  2. Sharma S P. Ashtanga Sangraha of Vriddha Vagbhata with Shashilekha commentary of Indu. 1st Varanasi; Chowkhambha Sanskrit Series office; 2006. p. 965.
  3. Thatte D. G. Sharir Rachana Vigyan, 2nd edition, Varanasi: Chaukhambha Sanskrit Series Office, 2008, p. 637.
  4. Ramesh R. Basic anthropometry ppt. [Internet] Published on Oct 12, 2012. Available from: https://www.slideshare.net/reinaramesh/basic-anthropometry-ppt-2-728. Accessed on January 24, 2021 time 07:00 IST.
  5. Body Mass Index. International Encyclopedia of Social Sciences. [Online] Retrieved October 16, 2020. Available: https://www.encyclopedia.com/social-sciences/applied-and-social-sciences-magazines/body-mass-index. Accessed December 15, 2020 time 07:46 IST.
  6. Nanote K, Tawalare K, “Assessing Health and Nutritional Status in Diseases of Civilization in perspective of Anguli Pramaan and BMI”, Rasamruta, Article 9.php, p.1-7, 2013.
  7. Nutritional status. [Internet]  A  Directory of Food and Nutrition. Retrieved January 12, 2021. Available:https://www.encyclopedia.com/education/dictionaries-thesauruses-pictures-and-press-releases/nutritional-status.

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