Comparison of the China growth charts with the WHO growth standards in assessing malnutrition of children

Yang, Zhenyu; Duan, Yifan; Ma, Guansheng; Yang, Xiaoguang; Yin, Shan

doi:10.1136/bmjopen-2014-006107

Cited by 33 publications

(31 citation statements)

References 22 publications

(35 reference statements)

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“…Most studies to date have not systematically compared both undernutrition and overnutrition classification using the 3 international references examined here. Some have compared older references previously recommended by the WHO and IOTF, 33 , 34 , 35 many have assessed the WHO growth standards in children aged 0-5 years, including measures such as weight-for-height, 20 , 36 , 37 , 38 , 39 , 40 , 41 , 42 and yet others have also explored the comparability of locally constructed BMI references. 19 , 21 , 23 , 34 , 35 , 43 , 44 Much of this evidence is based on European and American populations, 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 43 , 45 , 46 and research on the current references in Asian populations of wide age ranges has been limited.…”

Section: Discussionmentioning

confidence: 99%

The Use of Different International References to Assess Child Anthropometric Status in a Malaysian Population

Partap

Young

Allotey

et al. 2017

The Journal of Pediatrics

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ObjectiveTo assess the prevalence of child underweight, overweight, and obesity in a Malaysian population according to 3 international references because classification of anthropometric status may differ according to the reference used to express body mass index (BMI).Study designWe assessed data from 6414 children aged 6-18 years, collected by the South East Asia Community Observatory. Child underweight, overweight, and obesity were expressed according to 3 internationally used BMI references: World Health Organization 2007, International Obesity Task Force 2012, and Centers for Disease Control and Prevention 2000. We assessed agreement in classification of anthropometric status among the references using Cohen's kappa statistic and estimated underweight, overweight, and obesity prevalence according to each reference using mixed effects Poisson regression.ResultsThere was poor to moderate agreement between references when classifying underweight, but generally good agreement when classifying overweight and obesity. Underweight, overweight, and obesity prevalence estimates generated using the 3 references were notably inconsistent. Overweight and obesity prevalence estimates were higher using the World Health Organization reference vs the other 2, and underweight prevalence was up to 8.5% higher and obesity prevalence was about 4% lower when using the International Obesity Task Force reference.ConclusionsThe choice of reference to express BMI may influence conclusions about child anthropometric status and malnutrition prevalence. This has implications regarding strategies for clinical management and public health interventions.

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Section: Discussionmentioning

confidence: 99%

The Use of Different International References to Assess Child Anthropometric Status in a Malaysian Population

Partap

Young

Allotey

et al. 2017

The Journal of Pediatrics

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“…The limitation of this study was that the sample size was not very large; because of this, the numbers of stunting and obesity were low. The prevalence of stunting assessed using the WHO's standards and China's standards in other studies had a significant difference [31]. Whether the prevalence of stunting and obesity has a significant difference when assessed using the WHO's growth standards and China's standard should be researched with a larger sample size.…”

Section: Discussionmentioning

confidence: 88%

“…We did not find that the WHO's standards were able to reduce the detection rate of stunting and increase the detection rate of obesity significantly. Yang et al [31] also found that the prevalence of obesity assessed using the WHO's and China's standards had no significant difference. The Czech Republic compares the growth indicators of breastfed children with the national and WHO standard.…”

Section: Discussionmentioning

confidence: 98%

Differences between WHO Growth Standards and China Growth Standards in Assessing the Nutritional Status of Children Aged 0–36 Months Old

Tian

Gao

Sha

et al. 2019

IJERPH

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Background: At present, whether to use the World Health Organization’s (WHO) growth standards or native growth standards to assess the nutritional status in a given population is unclear. This study aimed to compare the differences between the WHO’s growth standards and China’s growth standards in assessing the nutritional status of children aged 0~36 months. Methods: We used z-scores to evaluate the nutritional status of children. The weight-for-age z-scores (WAZs), length/height-for-age z-scores (LAZ/HAZs), and weight-for-length/height z-scores (WLZ/WHZs) were calculated using the WHO’s growth standards and China’s growth standards. MeNemar’s test was used to compare the nutritional status of children. Results: The results in this study showed that there were differences between the WHO’s standards and China’s standards in assessing children’s nutritional status except for stunting and obesity. The prevalence of underweight assessed using China’s standards was higher than when using the WHO’s standards (except when 3 and 36 months old). The prevalence of wasting was significantly higher when assessed using China’s standards than when using the WHO’s standards from 12 to 36 months. The prevalence of overweight was higher when assessed using the WHO’s standards from 3 to 8 months. Conclusions: Both the WHO’s and China’s growth standards are useful measures in assessing children’s nutritional status but with key significant differences. Therefore, caution should be taken in selecting appropriate measures in a given population.

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“…Different previous studies in different countries found that growth charts differed from the WHO growth standards with regard to the height of children. For example, the results from WHO sample children were taller than the CDC and Japanese child population, and it is expected to obtain higher prevalence stunting (< − 2 SD) of if WHO references are used; however, in the population of China, Poland, and Germany, the cutoff value for depicting stunting were higher than those reported values by WHO, resulting in the underestimate of stunting prevalence in these nations when WHO references are applied [21][22][23][24]. According to the observed difference between our study results in terms of heightfor-age and the higher centiles of our study than corresponding WHO, it is expected to have underestimates of stunting for our local population by applying WHO references.…”

Section: Discussionmentioning

confidence: 99%

Local growth charts for an Iranian child population aged 2–5 years in comparison with the World Health Organization Child Growth Standards

Heidari

Feizi

Rezaei

et al. 2020

Egypt Pediatric Association Gaz

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Background: There are no national reference charts in Iran for children aged under five. This study aimed to develop representative growth reference charts of height, weight, and BMI for children aged 2-5 years in Isfahan, Iran, and to compare them with the WHO reference curves. Results: This population-based study has a combination of longitudinal and cross-sectional design. It included 1325 and 761 healthy children, who were born between 2002 and 2015 in Isfahan, central Iran, in longitudinal and crosssectional phases. Expert health care providers measured the height and weight of children in health centers. The lambda-mu-sigma method was used to construct the age-and sex-specific growth charts of anthropometric measures. The study sample comprised 1029 boys and 1057 girls. The centiles of height, weight, and BMI of boys were higher than that of girls in all age groups. The weight patterns of studied children were close to those of the WHO references in the lower percentiles. However, our study children, especially girls, were lighter compared with WHO standards based on the middle and upper percentiles of the weight distribution. Compared with WHO standards, boys of our study were taller especially at older ages. The percentiles of the BMI for our study samples were considerably lower than WHO standards. Conclusion: There are differences between our local growth charts for weight, height, and BMI with WHO standards. The local growth standards could be more precise for assessing growth problems in local and national settings. Due to notable differences between our results with WHO standards, future studies are warranted for constructing nationwide growth charts.

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Comparison of the China growth charts with the WHO growth standards in assessing malnutrition of children

Cited by 33 publications

References 22 publications

The Use of Different International References to Assess Child Anthropometric Status in a Malaysian Population

The Use of Different International References to Assess Child Anthropometric Status in a Malaysian Population

Differences between WHO Growth Standards and China Growth Standards in Assessing the Nutritional Status of Children Aged 0–36 Months Old

Local growth charts for an Iranian child population aged 2–5 years in comparison with the World Health Organization Child Growth Standards

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