Construction of a New Growth References for China Based on Urban Chinese Children: Comparison with the WHO Growth Standards

Abstract

IntroductionGrowth references for Chinese children should be updated due to the positive secular growth trends and the progress of the smoothing techniques. Human growth differs among the various ethnic groups, so comparison of the China references with the WHO standards helps to understand such differences.MethodsThe China references, including weight, length/height, head circumference, weight-for-length/height and body mass index (BMI) aged 0–18 years, were constructed based on 69,760 urban infants and preschool children under 7 years and 24,542 urban school children aged 6–20 years derived from two cross-sectional national surveys. The Cole’s LMS method is employed for smoothing the growth curves.ResultsThe merged data sets resulted in a smooth transition at age 6–7 years and continuity of curves from 0 to 18 years. Varying differences were found on the empirical standard deviation (SD) curves in each indicator at nearly all ages between China and WHO. The most noticeable differences occurred in genders, final height and boundary centiles curves. Chinese boys’ weight is strikingly heavier than that of the WHO at age 6–10 years. The height is taller than that of the WHO for boys below 15 years and for girls below 13, but is significantly lower when boys over 15 years and girls over 13. BMI is generally higher than that of the WHO for boys at age 6–16 years but appreciably lower for girls at 3–18 years.ConclusionsThe differences between China and WHO are mainly caused by the reference populations of different ethnic backgrounds. For practitioners, the choices of the standards/references depend on the population to be assessed and the purpose of the study. The new China references could be applied to facilitate the standardization assessment of growth and nutrition for Chinese children and adolescents in clinical pediatric and public health.

Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children

“…Comparing the final height and weight data with recent international studies from China, Saudi Arabia, WHO and CDC, it is clear that Indian children are growing almost at par with Chinese and Saudi Arabian children but are still shorter and lighter than their Caucasian counterparts [7,27,28,29] (Table VII and Web Table I). Further, Indian children's stature seems to be comparable to Caucasian children until the onset of pubertal years, however, the growth spurt after puberty is attenuated in Indian children in both sexes, the effect being more pronounced in girls.…”

Reference charts of sitting height, leg length and body proportions for Chinese children aged 0–18 years

“…These results were consistent with other papers: Fredriks et al (2005) reported the correlation coefficients were À0.15 $À0.24 from birth to 21 years in Dutch subjects and Tanaka et al (2004) reported values of À0.09 $À0.32 from 5.5 to 17.5 years in Japan. Zong and Li (2013) reported recently that the height references of Chinese children were significantly different compared with the World Health Organization's (WHO) growth standards. However, it is unclear which body segments of height contribute more to this difference between Chinese and other populations.…”

“…Standing height and sitting height (SH) were measured to the nearest 0.1 cm in standing position for children over 3 years old by using standardized techniques and equipment. The details of measurement of length and height had been reported previously (Zong & Li, 2013). Briefly, crownrump length was measured by an observer standing to the right of the examining table who with their left hand lifted the legs and with their right hand pushed the footboard to the sacrum, prior to recording the measured value.…”

High‐angular resolution diffusion imaging tractography of cerebellar pathways from newborns to young adults

“…Recent tractography studies have shown significant sex‐specific differences in white matter microstructure (Hsu et al., 2008; Kanaan et al., 2012). Future studies, aimed at establishing a normal reference standard, should consider such gender differences, as is common practice in pediatric growth curves (Barbier et al., 2013; Zong & Li, 2013). Fourth, this study's laterality analysis does not include information concerning each patient's left and right handedness which is impossible to establish for the youngest subjects.…”