Accuracy of international growth charts to assess nutritional status in children and adolescents: a systematic review

Abstract

Objective: To verify, through a systematic review, the accuracy of nutritional assessment in children and adolescents using the length/height-for-age and BMI-for-age growth charts of the Centers for Disease Control and Prevention (CDC) (2000), the World Health Organization (WHO) (2006/2007) and the International Obesity Task Force (IOTF) (2012). Data source: We selected articles from the databases Medical Literature Analysis and Retrieval System Online (MEDLINE), through PubMed, National Library of Medicine and The National Institutes of Health (NIH), Scientific Electronic Library Online (SciELO) and Virtual Health Library (VHL). The following descriptors were used for the search: “Child”, “Adolescent”, “Nutritional Assessment”, “Growth Chart”, “Ethnic Groups”, “Stature by age”, “Body Mass Index”, “Comparison”, “CDC”, “WHO”, and “IOTF”. The selected articles were assessed for quality through the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the NIH. Data synthesis: Thirty-three studies published between 2007 and 2020 were selected and, of these, 20 presented good quality, 12 presented fair quality and one presented poor quality. For children under five years old, the WHO length/height-for-age growth charts were shown appropriate for children from Argentina, South Africa, Brazil, Gabon, Qatar, Pakistan and the United States. For those five years old and older, the WHO BMI-for-age growth charts were accurate for the Brazilian and Canadian populations, while the IOTF growth charts were accurate for the European populations. Conclusions: There are difficulties in obtaining international growth charts for children from 5 years old and older that go along with a long period of growth, and which include genetic, cultural and socioeconomic differences of multiethnic populations who have already overcome the secular trend in height.

Childhood Obesity and the Cryptic Language of the Microbiota: Metabolomics’ Upgrading

“…However, in children, absolute BMI is not used as a risk marker because its constituent measures vary as a function of normal growth and maturation, necessitating standardization by age and gender [ 37 ]. Therefore, in order to identify the health risks related to excess weight in children and adolescents, age- and gender-specific BMI percentiles, or z-scores, are used, based on reference growth curves, created on the basis of longitudinal and/or cross-sectional studies with samples of children and adolescents considered as standard [ 38 ]. The most used are the Centers for Disease Control and Prevention (CDC) (2000) but above all those of the World Health Organization (WHO) (2006/2007) and of the International Obesity Task Force (IOTF) (2012) growth charts.…”

“…The most used are the Centers for Disease Control and Prevention (CDC) (2000) but above all those of the World Health Organization (WHO) (2006/2007) and of the International Obesity Task Force (IOTF) (2012) growth charts. The two main anthropometric indicators used are length/height by age and BMI by age, as they provide two fundamental parameters, such as the growth trajectory and the identification of underweight or overweight conditions [ 38 ]. CDC growth charts, based on studies conducted in the United States, are expressed in sex- and age-specific percentiles for children and adolescents aged 2 to 19 years, which delineate overweight as a BMI between the 85th and 94th percentiles (included), while obesity is defined by a value ≥ the 95th percentile [ 38 , 39 ].…”

“…The WHO growth diagrams are expressed in percentiles or z-scores and are specific by gender and age group [ 38 ]. Although the WHO recommends the use of its growth tables (2006/2007) for international use, some researchers have highlighted some concerns regarding the choice of BMI percentile cut-offs for these curves [ 29 ].…”

“…According to some authors, together with BCAAs, an alteration of acylcarnitine levels could be used to discriminate between children with or without insulin resistance [ 38 ]. Acylcarnitines, crucial in the transport of fatty acids to the mitochondria for ß-oxidation [ 86 ], may result from incomplete oxidation of fatty acids, and the accumulation of these metabolites, known as lipotoxicity, has been implicated in the development of IR and type 2 diabetes [ 4 ].…”

Fatores associados ao excesso de peso em crianças e adolescentes com Transtorno do Espectro Autista (TEA): uma revisão integrativa

“…Para o diagnóstico de excesso de peso, o principal indicador avaliado é o índice de massa corporal (IMC) para a idade, e os pontos de corte variam de acordo com a curva empregada e a faixa etária (Oliveira et al, 2022) (Granich et al, 2016;Vanwong et al, 2020), sendo que esta última só foi empregada isoladamente em um estudo. Em uma revisão sistemática (Oliveira et al, 2022) foi observado que, de forma geral, as curvas de IMC para a idade do CDC são menos acuradas para o diagnóstico de rastreios nutricionais quando comparadas com as curvas da OMS e do IOTF, mas há que há controvérsias sobre qual delas seria mais apropriada para uso internacional, principalmente quando se trata de crianças maiores de 5 anos e adolescentes (Oliveira et al, 2022).…”