**Article 1** **A Fuzzy Logic Approach to Measure Underweight Among Kindergarten’s Kids** \*Balkiah Moktar, Nur Amalina Aziz, Muhamad Hasbullah Mohd Razali Faculty of Computer and Mathematical Sciences Universiti Teknologi MARA (UiTM) Cawangan Perlis \* , , *Abstract* Nowadays, being underweight during childhood is equally risky as being overweight. Underweight children lead to decrement in their academic performance, social problem as well as challenging attitudes. Underweight people are likely to be less fit and active, which would also increase their cardiovascular risk and health problem. Their mind also becomes inflexible while their concentration and ability to decide are markedly weak. The purpose of this study is to evaluate the chances of having underweight among the children by using Fuzzy Logic Approach. Besides that, the comparison of effectiveness result of underweight between Body Mass Index (BMI) method and Fuzzy Logic Approach using Mamdani method will be made. The data of weight and height of the children were collected from 3 kindergartens in Perlis. The result shows that 60 to 70 percent of children having an underweight in range between 79.1% to 91.2% compare to BMI method that is only 10 percent of children have underweight. It shows that Mamdani method was very effective compare to BMI Method because of the flexibility from the output control that is a smooth control function despite a wide range of input. *Keywords: Underweight kids, Fuzzy Logic Approach, BMI, Mamdani method* **Introduction** This research focuses on the measuring underweight of the kindergarten’s kids. Underweight is a weight that is below the normal, average, or requisite weight. During early stages and childhood, kids gain weight and grow more rapidly than at any other stage in life. However, some kids do not gain weight at normal rate, either because of being born prematurely, expected variations related to genes, or because of undernutrition, which may occur for a various cause. Undernutrition is defined as the outcome of insufficient food intake such as protein, calories, vitamin, minerals and so on (Martins et al., 2011). Sometimes undernutrition is defined as a failure to thrive or growth deficit problem. Measuring the growth of a kid is an important part of child’s health care. It can help to recognize underweight and overweight, short stature and faltering growth. It can also provide consolation about normality. The most common method used for measuring weight status of people is Body Mass Index. In addition, BMI is most commonly used for measuring obesity in adults (Must and Anderson, 2006) but to make a difference in this research, Fuzzy Logic Approach will be used to measure the weight status of the selected kids from three different kindergartens in Perlis. **Problem Statement** Nowadays, childhood obesity is one of the most severe conditions, posing many health risks among the young generation. However, being underweight during childhood is equally risky as being overweight. Underweight children lead to decrement in their academic performance, social problem as well as challenging attitudes. Furthermore, the risks affected by being underweight are often overlooked, and malnutrition leads to the increases of health problems among children. For example, bone diseases. Their mind also becomes inflexible while their concentration and ability to make decision are markedly weak. According to Lazzeri et al. (2008), underweight may also increases the risk of illness, harms the intellectual development and decreases the work productivity in future life. Thus, in this study, fuzzy logic approach method is proposed to measure underweight among the childhood. Fuzzy theory is adapted for analysing underweight as biologically by using MATLAB. **Objectives of the Study** This study aims i. To evaluate the chances of having underweight among the children by using Fuzzy Logic Approach. ii. To compare the effectiveness result of underweight between BMI method and Fuzzy Logic Approach **Literature Review** ***Fuzzy Logic Approach Method*** Dernoncourt (2013) conducted a study to identify what Fuzzy Logic is. He discovered that Fuzzy Logic is a method of computing based on "degrees of truth" rather than the normal "true or false" Boolean Logic on which the modern computer is based. The concept of fuzzy logic was first advanced by Dr. Lotfi Zadeh from the University of California on 1960s. He also stated that Fuzzy Logic has many theories. Example of Fuzzy Logic theories are Fuzzy set, the linguistic variable, reasoning in Fuzzy Logic and others. Spada (2009) also conducted a study to learn more about the Fuzzy Logic. He divided Fuzzy Logic to two parts which are Fuzzy Logic Broad sense and Fuzzy Logic in Narrow Sense. Thus, he explained that Fuzzy Logic Broad Sense is mainly as tools for fuzzy control, analysis of uncertainty in natural language and several other application fields. He also stated that soft computing is one of the technique in Fuzzy Logic Broad Sense and the example of this technique is computational methods tolerant for sub-optimality and impreciseness that giving simple, good and quick solution. For Fuzzy Logic in Narrow Sense, he defined that it is symbolic logic with a comparative notion of truth. ***Measuring Weight Status by Using Body Mass Index*** World Health Organization (2008) conducted a research for measuring a child growth whether the child is growing normal or not. Some objectives of this study were for people to learn how to recognize the signs of marasmus and kwashiorkor, determine child’s age today, weigh a child and record the weight, measure and record the length or height and BMI by referring to a table or using a calculator. In addition, Butte et al. (2006) had conducted a research that focused on feasibility of creating international growth standard with weight, height and Body Mass Index for measuring school-aged children and adolescent. In this study, the researchers included biological, theoretical and other issues relating to the development of an international growth reference for those children with representatives from WHO, World Food Program (WFP) and others organization. Onis (2009) proposed a study about growth curves for school-age children and adolescents which were very important to childhood period. These curves are necessary tool in pediatric practice. In addition, Patel et al. (2015) on the research of unhealthy weight among children and adults in India: urbanicity and the crossover in underweight and overweight, BMI was also used for categorizing weight status for each respondence. BMI was computed as the measured weight divided by the square of the measured height. Wang et al. (2017) studied on Preschool-Age Chinese Children's Weight Status: WHO Classification, Parent Ratings, Child/Family Characteristics to compare preschool-age Chinese child’s weight status according to the World Health Organization guidelines with parental ratings on their child’s body type, and child/family demographic representative. This study focusing most on the normal weight, underweight and overweight of the children by using BMI. In addition, the researchers used the Parents' Perception of Healthy Weight (PPHW) to find parents' ratings of their children's weight to examine the accuracy of children's current weight status. Similarly, to research conducted by Unnithan and Syamakumari (2007) that focused on measuring the occurrence of obesity, overweight and underweight between school children in the rural and urban areas of Thiruvananthapuram Educational District. In this study, BMI was used to calculate the body weight and IOTF cut-off values method was used to identify the overweight, obese and underweight of the 3886 selected children. **Methodology** ***Method of Data Collection*** The data that will be used in this study is the secondary data which was collected from teachers of each kindergarten that was mentioned before. This data includes the kids aged between four to six years old. Table 1: List of weight and height from 3 selected kindergarten in Perlis

Tabika Kemas Kampung

Surau Dato’ Sheikh Ahmad

Tabika Kemas

Kampung Darat

Tabika Kemas

Alor Gajah
Age

W

(kg)

H

(cm)

 Age

W

(kg)

 H (cm) Age W (kg) H (cm)
6 19.4 117.0 4 17 110 4 13.5 97.0
4 15.6 101.0 3 16 104 3 17.1 107.0
4 14.5 103.0 3 17 105 4 16.6 105.0
3 13.6 95.0 4 16 105 3 25.2 107.0
4 14.5 100.5 5 29 105 5 15.5 107.0
6 17.3 115.0 3 18 111 4 14.7 97.0
6 16.3 109.0 5 14 127 4 13.5 99.0
3 13.8 96.0 5 16 96 3 12.2 95.0
3 17.6 99.0 4 15 101 3 12.9 96.0
5 30 123.0 4 15 96 4 13.4 95.0
***Method of Data Analysis*** Fuzzy logic complies such applications perfectly as it relates human decision making with a skill to produce specific solutions from approximate information. Thus, fuzzy system has been used in this study. ***Fuzzy System*** Fuzzy system is an alternative to traditional notions of set membership and logic. A fuzzy system can be contrasted with a conventional (crisp) system in three ways: 1. *Linguistic Variable* > A linguistic variable is defined as a variable where the values are explained in a linguistic term. 2. *Fuzzy Conditional Statements* > Fuzzy conditional statements are definitions of the form IF A THEN B, where A and B have fuzzy meaning. 3. *Fuzzy Algorithm* > A fuzzy algorithm is an ordered sequence of instruction which involve conditional statements and fuzzy assignment. For an example, IF p is low THEN q is high. The procedure of fuzzy system includes: ***Fuzzy Variables*** A fuzzy variable is the language that will be used to elaborate a fuzzy concept such as weight, height, age and others. ***Fuzzification*** Fuzzifier is defined as a crisp point to a fuzzy set while fuzzification is defined as process of converting a crisp quantity into a fuzzy quantity. In fuzzification process, for each input and output variable selected, it will be defined into two or more membership functions, normally three but it can also be more than three. Then, it must be classified into a qualitative category for each of them. Example is low, medium or high. The shape of these functions can be varied but it normally works with triangular and trapezoidal by following their membership function formula which are 1. Triangular membership function \[\mu\left( x \right) = \begin{Bmatrix} 0\ ,\ \ x \leq a \\ \frac{x - a}{b - a},\ \ a \leq x \leq b \\ \frac{c - x}{c - b},\ \ b \leq x \leq c \\ 0,\ \ c \leq x \\ \end{Bmatrix}\] 2. Trapezoidal membership function \[\mu\left( x \right) = \begin{Bmatrix} 0,\ \ x \leq a \\ \frac{x - a}{b - a},\ \ a \leq x \leq b \\ 1,\ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ b \leq x \leq c \\ \frac{d - x}{d - c},\ \ c \leq x \leq d \\ 0,\ \ d \leq x \\ \end{Bmatrix}\] where *a, b, c* and *d* are defined as the range of *x*. ***Fuzzy Membership Functions*** There are two inputs variables include in the fuzzy set which are weight and height and they are classified into fuzzy set. For weight, the input is classified as low, medium and high. The same goes to the height. ***Fuzzy IF-THEN Rule*** A fuzzy rule base is a group of fuzzy IF-THEN rules. The basic function of fuzzy rule base is to express the high knowledge in a form of IF-THEN rule structure combined with AND and OR operators. Each fuzzy rule base produced an output of fuzzy set. Besides that, IF-THEN rule statements are used to formulate the conditional statements that comprise fuzzy logic. According to Castillo and Melin (2012), the general form of fuzzy IF-THEN rule is given as: IF \ and \ THEN \, where input and output are fuzzy sets defined in P is a proper subset of R and Q is a proper subset of R. As for example, the fuzzy logic applies to measure underweight among kindergarten’s kids in the following form: IF height of the kid is less and the weight of the kid is less THEN the chances of the kid getting underweight is high. In composition-based inference, all rules in the fuzzy rule base are aggregated into a single fuzzy relation that is fuzzy IF-THEN rule by using the Mamdani Combination equation as stated in Eq. 3. (3) ***Defuzzification*** Defuzzification is a method where membership functions are used to retranslate the fuzzy output into a crisp value. It is also known as a process to convert the fuzzy output values of a fuzzy inference to a real crisp value. There are four methods of defuzzified which are: 1. Weight average method 2. Centroid method/ centre of gravity 3. Maximum membership principle or height method 4. Mean-max membership principle or middle of maxima method In this study, centroid method is used to process defuzzification. This method is regularly used because it has well performance in terms of continuity, counting and computer complexity. Eq. 4 shows the equation of centroid method. (4) ***Mamdani Fuzzy Inference System*** In this study, Mamdani Fuzzy Inference System in Fuzzy Logic was used by applying the data that was collected in MATLAB software. The Mamdani system is suitable when there is a small number of variables or input. The advantages of using this method are well suited to human input, has widespread acceptance and instinctive. ***Steps in application of the Mamdani Fuzzy Inference System Method in MATLAB software*** Table 2: Range for weight (column 2) and height (column 3) | Very low | 13 16 19 | 95 101 107 | | --------- | -------- | ----------- | | Low | 16 19 21 | 101 107 113 | | Medium | 19 22 25 | 107 113 119 | | High | 22 25 28 | 113 119 125 | | Very high | 25 28 31 | 119 125 131 | *(Sources from Info Kehamilan, Kelahiran, Bayi, Anak dan Keluarga, 2014)* Table 3: Range for chances of having underweight | Obese | 0 0 25 | | ----------------- | ---------- | | Overweight | 0 25 50 | | Normal | 25 50 75 | | Underweight | 50 75 100 | | Risky underweight | 75 100 100 | ***Body Mass Index (BMI) Calculation*** Body Mass Index formula stated by Nuttall (2015) was weight in kilograms divided by height in meters squared. Then, the weight status of those kids by using BMI calculation is based on BMI percentile range as shown in Figure 1 and Table 4. | | | | ------------------------------------------------- | ------------------------------------------------- | | ![](76-1-141-1-4-20180802_media/media/image3.png) | ![](76-1-141-1-4-20180802_media/media/image4.png) | Figure 1: BMI children’s chart *(Sources from National Center for Health Statistics in collaboration with the National Center for Chronic Disease Prevention and Health Promotion, 2000)* Table 4: Weight status category for kids | **Weight status category** | **Percentile range** | | -------------------------- | ---------------------------------------------------------- | | Underweight | Less than the 5th percentile | | Normal/Healthy weight | 5th percentile to less than the 85th percentile | | Overweight | 85th to less than the 95th percentile | | Obese | Equal to or greater than the 95th percentile | *(Sources from Khalaf et al., 2012)* **Results and Findings** Table 5: Chances of having an underweight on selected kids from 3 Tabika Kemas (bold shows underweight status)
No. Kampung Surau Dato’ Sheikh Ahmad Kampung Darat Alor Gajah
BMI

FL

Approach (%)

 BMI FL Approach (%) BMI FL Approach (%)
1 14.2 60.8 14.3 88.8 14 67.5
2 15.3 91.8 14.9 80.3 14.8 90.5
3 13.7 90.5 15.1 83.3 15.4 80.9
4 15.1 50 22.0 24.9 14.5 91.2
5 14.4 90.5 13.5 91.8 26.3 8.76
6 13.2 66.4 15.6 89.7 14.6 61
7 13.7 79.1 13.8 88.8 8.7 89.7
8 15.0 88.8 13.5 50 17.4 88.8
9 18.0 90.7 14.3 37.5 14.7 91.2
10 19.8 10.3 14.8 50 16.3 88.8
From Table 5, result of *Tabika Kemas Kampung Surau Dato’ Sheikh Ahmad* and *Tabika Kemas Kampung Darat* shows that 6 out of 10 kids having the underweight problem based on Fuzzy Logic Approach and only 2 out of 10 kids having the underweight based on BMI calculation. For *Tabika Kemas Alor Gajah*, 7 out of 10 kids having the underweight problem based on Fuzzy Logic Approach but only 1 out of 10 kids having underweight based on BMI calculation. Thus, the result from 3 selected kindergarten as shown in Table 5 can be concluded as in Figure 2. There is about 60% to 70% of children are underweight in range between 79.1% to 91.2% compared to BMI method that is only 16.67% of children are having underweight. It shows that Fuzzy Logic Approach is more effective compare to Body Mass Index Method in identifying the underweight status of the children. | | | ------------------------------------------------- | | ![](76-1-141-1-4-20180802_media/media/image5.png) | > Figure 2: Comparison of percent underweight status between BMI and Fuzzy Method **Conclusion** The result shows that there are more than half kids having underweight problem from each kindergarten by using Fuzzy Logic Approach but only 1 to 2 kids having underweight by using Body Mass Index calculation. Therefore, it can be concluded that Fuzzy Logic Approach is more effective compared to Body Mass Index. This is because the output control is a smooth control function despite a wide range of input and this method is flexible. For future studies on the subject, several recommendations for improvements are suggested. The fuzzy model calculator should be developed for measuring body weight of people at different range of age because of its effectiveness in calculation and parents need to ensure their children take healthy food and always get a doctor consultation about their child’s weight problem regularly. **References** Martins, V. J., Florêncio, T. M., Grillo, L. P., Franco, M. D., Martins, P. A., Clemente, A PSawaya, A. L. (2011). Long-lasting effects of undernutrition. > *International Journal of Environmental Research and Public Health*, *8*(12), 1817-1846 Must, A., & Anderson, S. E. (2006). Body mass index in children and adolescents: Considerations for population-based applications. International Journal of Obesity, 30(4), 590-594. Lazzeri, G., Rossi, S., Pammolli, A., Pilato, V., Pozzi, V., & Giacchi, M. V. (2008). Underweight and overweight among children and adolescents in Tuscany (Italy). Prevalence and short-term trends. Research Centre for Health Promotion and Education, 49, 13-21 Dernoncourt, F. (2013). Introduction to Fuzzy Logic. Unpublished master’s thesis, Massachusetts Institute of Technology, Cambridge, England. Spada, L. (2009). Introduction to Fuzzy Sets and Fuzzy Logic. Retrieved September 17, 2009, from University of Salerno, Department of Mathematics and Computer Science Web site: http://logica.dmi.unisa.it/lucaspada/wpcontent/uploads/foligno\_handout.pdf World Health Organization. (2008). Training Course on Child Growth Assessment (Issue Brief No. ISBN 92 4 159507 8). Switzerland: Department of Nutrition for Health and Development. Butte, N. F., Garza, C., & Onis, M. D. (2006). Evaluation of the Feasibility of International Growth Standards for School-Aged Children and Adolescents. Food and Nutrition Bulletin, 27(4). 169-171. Onis, M. D. (2009). Growth curves for school-age children and adolescents. Indian Pediatrics, 46, 463-465 Patel, S. A., Narayan, K. V., & Cunningham, S. A. (2015). Unhealthy weight among children and adults in India: urbanicity and the crossover in underweight and overweight. Annals of Epidemiology, 25(5) Wang, G. H., Tan, T. X., & Cheah, C. S. (2017). Preschool-Age Chinese Children's Weight Status: WHO Classification, Parent Ratings, Child/Family Characteristics. Journal of Pediatric Nursing, 33, 63-69.  Unnithan, A.G. & Syamakumari, S. (2008). Prevalence of Overweight, Obesity andUnderweight among School Going Children in Rural and Urban areas of Thiruvananthapuram Educational District, Kerala State (India). The Internet Journal of Nutrition and Wellness,6(2). Castillo, O., & Melin, P. (2012). Type-2 Fuzzy Logic Systems. Recent Advances in Interval Type-2 Fuzzy Systems SpringerBriefs in Applied Sciences and Technology, 7-12. Nuttall, F. Q. (2015). Body mass index. Nutrition Today, 50(3), 117-128. Khalaf, F. A., Darwish, E. A., & Katab, M. (2012). Prevalence of Underweight, Overweight and Obesity Among Primary School Children in Qatar. Qatar Medical Journa, 2012(1), 24