WHO 2006 child growth standards: implications for the prevalence of stunting and underweight-for-age in a birth cohort of Gabonese children in comparison to the Centers for Disease Control and Prevention 2000 growth charts and the National Center for Health Statistics 1978 growth references

Schwarz, Norbert; Grobusch, Martin P.; Decker, Marie-Luise; Poetschke, Marc; Oyakhirome, Sunny; Kombila, Davy; Fortin, Julien; Lell, Bertrand; Issifou, Saadou; Kremsner, Peter G.; Klipstein‐Grobusch, Kerstin

doi:10.1017/s1368980007001449

Cited by 29 publications

(37 citation statements)

References 26 publications

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“…Difference between the WHO and USCDC height-for-age z score means and estimates for stunting by the WHO and USCDC references was not significant. Previous studies reported a lower prevalence of underweight and stunting while a higher prevalence of overweight and obesity using the WHO reference compared to the USCDC reference [39-42]. The USCDC growth charts over-estimate the under-nutrition and under-estimate the over-nutrition.…”

Section: Discussionmentioning

confidence: 97%

Height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children

et al. 2012

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BackgroundChild growth is internationally recognized as an important indicator of nutritional status and health in populations. This study was aimed to compare age- and gender-specific height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children.MethodsA population-based study was conducted with a multistage cluster sample of 1860 children aged five to twelve years in Lahore, Pakistan. Smoothed height, weight and BMI percentile curves were obtained and comparison was made with the World Health Organization 2007 (WHO) and United States' Centers for Disease Control and Prevention 2000 (USCDC) references. Over- and under-nutrition were defined according to the WHO and USCDC references, and the International Obesity Task Force (IOTF) cut-offs. Simple descriptive statistics were used and statistical significance was considered at P < 0.05.ResultsHeight, weight and BMI percentiles increased with age among both boys and girls, and both had approximately the same height and a lower weight and BMI as compared to the WHO and USCDC references. Mean differences from zero for height-, weight- and BMI-for-age z score values relative to the WHO and USCDC references were significant (P < 0.001). Means of height-for-age (present study: 0.00, WHO: -0.19, USCDC: -0.24), weight-for-age (present study: 0.00, WHO: -0.22, USCDC: -0.48) and BMI-for-age (present study: 0.00, WHO: -0.32, USCDC: -0.53) z score values relative to the WHO reference were closer to zero and the present study as compared to the USCDC reference. Mean differences between weight-for-age (0.19, 95% CI 0.10-0.30) and BMI-for-age (0.21, 95% CI 0.11-0.30) z scores relative to the WHO and USCDC references were significant. Over-nutrition estimates were higher (P < 0.001) by the WHO reference as compared to the USCDC reference (17% vs. 15% overweight and 7.5% vs. 4% obesity) while underweight and thinness/wasting were lower (P < 0.001) by the WHO reference as compared to the USCDC reference (7% vs. 12% underweight and 10% vs. 13% thinness). Significantly lower overweight (8%) and obesity (5%) prevalence and higher thinness grade one prevalence (19%) was seen with use of the IOTF cut-offs as compared to the WHO and USCDC references. Mean difference between height-for-age z scores and difference in stunting prevalence relative to the WHO and USCDC references was not significant.ConclusionPakistani school-aged children significantly differed from the WHO and USCDC references. However, z score means relative to the WHO reference were closer to zero and the present study as compared to the USCDC reference. Overweight and obesity were significantly higher while underweight and thinness/wasting were significantly lower relative to the WHO reference as compared to the USCDC reference and the IOTF cut-offs. New growth charts for Pakistani children based on a nationally representative sample should be developed. Nevertheless, shifting to use of the 2007 WHO child growth reference might have importan...

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Section: Discussionmentioning

confidence: 97%

Height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children

et al. 2012

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“…To date, a number of studies have examined the impact of the implications of the WHO growth standards on growth assessment or specific nutrition-related outcomes, such as obesity, in other countries (18)(19)(20)(21)(22)(23)(24). For instance, examinations of growth patterns among British children were conducted by the Expert Group on Growth Standards of the Scientific Advisory Group on Nutrition and Royal College of Paediatrics and Child Health (25,26).…”

Section: Discussionmentioning

confidence: 99%

Growth of Czech Breastfed Infants in Comparison with the World Health Organization Standards

Vignerová¹,

Shriver²,

Paulová³

et al. 2015

Cent Eur J Public Health

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SUMMARYGrowth references are important for paediatric health monitoring. It is critical to understand differences in growth interpretation and potential consequences when using available growth references. This study compares the growth of Czech breastfed children with the current WHO growth standards 2006 and the Czech references 1991, 2001.A total of 960 infant/parent pairs in the Czech Republic were recruited through paediatric practices. Anthropometric data were collected during infants' first 12 months of life and parent questionnaires were gathered during a preventive visit at 18 months.Czech breastfed infants were longer with a greater head circumference at all percentiles compared to the WHO standards and were similar to the national references. The percentile weight-for-age and weight-for-length values of infants (≤ 6 months) were lower, and higher (6-12 months) compared to the WHO standards. The infant growth in the sample differed from both the WHO standards as well as the national references.Our findings indicate that the growth of Czech breastfed children differs from the current national references. These discrepancies were smaller compared to the WHO standards. The results of the study were used for new growth assessment guidelines to optimize feeding recommendations for Czech infants. The adoption of the WHO standards in the Czech Republic is not recommended.

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“…The finding we report here indicated only a slightly higher prevalence of child stunting compared to the previous study, perhaps because of the use of the new WHO reference group. When the new WHO 2006 references are used, rather than the NCHS and CDC charts/references, it leads to a higher proportion of child stunting at all age groups (Schwarz et al, 2008) due to the fact that the WHO standards were developed more recently and with an multi-country, multi-ethnic, breast-fed, healthy cohort across different countries (de Onis et al, 2004; Borghi et al, 2006). …”

Section: Discussionmentioning

confidence: 99%

Socioeconomic disparities and the familial coexistence of child stunting and maternal overweight in guatemala

Lee

Houser

Must

et al. 2012

Economics & Human Biology

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The double burden of malnutrition, defined here as households with a stunted child and an overweight mother (SCOM), is a growing problem in Guatemala. We explored the magnitude of SCOM and the identification of socio-economic factors associated with this malnutrition duality. From the 2000 Living Standards Measurement Study from Guatemala, we obtained a sample of 2492 households with pairs of children 6–60 months and their mothers (18–49 years) and estimated the prevalence of SCOM. Economic characteristics of this sample were assessed with the Concentration Index (CI). Results revealed higher prevalence of child stunting, but a lower prevalence of maternal overweight among the poor compared to the rich households. Economic inequality in child stunting was greater than economic inequality in maternal overweight (CI = −0.22 vs. +0.14). SCOM pairs were more prevalent among the poor and middle SES groups as compared to the rich households. A multivariate logistic regression model showed that SCOM was more likely to occur in households from the middle consumption quintile than in those from the first quintile (odds ratio = 1.7). The findings reported here add new insights into the complex phenomenon observed in households with both extremes of the malnutrition continuum, and support the need for the identification of economic, social and biological interventions aimed at, on the one hand, the prevention of this duality of the malnutrition in those households where it is still non-existent, and on the other hand, to deter or correct the economic, social and biological environments where those mother-child dyads are already affected by such phenomena.

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WHO 2006 child growth standards: implications for the prevalence of stunting and underweight-for-age in a birth cohort of Gabonese children in comparison to the Centers for Disease Control and Prevention 2000 growth charts and the National Center for Health Statistics 1978 growth references

Cited by 29 publications

References 26 publications

Height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children

Height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children

Growth of Czech Breastfed Infants in Comparison with the World Health Organization Standards

Socioeconomic disparities and the familial coexistence of child stunting and maternal overweight in guatemala

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