WHO 2006 Child Growth Standards overestimate short stature and underestimate overweight in Japanese children

2018 ◽  
Vol 31 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Mikako Inokuchi ◽  
Nobutake Matsuo ◽  
John I. Takayama ◽  
Tomonobu Hasegawa
Keyword(s):  
Short Stature ◽  
Care Center ◽  
Standard Deviation Score ◽  
Child Growth ◽  
World Health ◽  
Japanese Children ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Growth Standards ◽  
Who Standards

AbstractBackground:It is unclear whether the World Health Organization (WHO) 2006 Child Growth Standards are applicable to East Asian populations. We investigated the applicability of the WHO standards of length/height and weight to a cohort representing middle-class children in Japan.Methods:A cohort of children aged 0–5 years (3430 boys, 3025 girls) in the Tokyo Child Care Center Survey consecutively recruited from 2007 to 2013 were studied. Age- and sex-specific z-scores of length/height, weight and weight for length/height were calculated relative to either the WHO standards or the Japanese 2000 Growth References (nationally representative cross sectional survey data).Results:Compared with the WHO standards, Japanese children at birth, 1, 3, 5 years were shorter (length/height standard deviation score [SDS] −0.26, −0.82, −0.81, −0.63 for boys, and −0.15, −0.67, −0.84, −0.62 for girls, respectively) and lighter (weight SDS −0.62, −0.36, −0.34, −0.42 for boys and −0.60, −0.17, −0.29, −0.43 for girls, respectively). Weight for length/height showed smaller differences at various length/height points (SDS −0.05 to 0.15 for boys, 0.01 to 0.29 for girls, respectively).Conclusions:Adoption of the WHO standards would substantially alter the prevalence of short stature, underweight and overweight in Japanese children 0–5 years of age. These findings advocate the use of the national references in Japan.

scholarly journals Stunting and ‘overweight’ in the WHO Child Growth Standards – malnutrition among children in a poor area of China

2009 ◽  
Vol 12 (11) ◽  
pp. 1991-1998 ◽  
Author(s):  
Xiaoli Wang ◽  
Bengt Höjer ◽  
Sufang Guo ◽  
Shusheng Luo ◽  
Wenyuan Zhou ◽  
...  
Keyword(s):  
Child Growth ◽  
High Rate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Growth Standards ◽  
International Growth ◽  
Who Standards ◽  
Poor Area ◽  
Nutritional Status Of Children ◽  
Height For Age

AbstractObjectiveThe aims of the present paper were to assess the nutritional status of children under 5 years old using the 2006 WHO Child Growth Standards (‘the WHO standards’) and to compare the results with those obtained using the National Center for Health Statistics/WHO international growth reference (‘the NCHS reference’).DesignThis was a community-based cross-sectional survey. The WHO standards were used to calculate Z-scores of height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ) and BMI-for-age (BMIZ).SettingFifty counties of thirteen mid-western provinces, China.SubjectsA total 8041 children aged <5 years were measured during a 2-month period from August to October 2006.ResultsThe prevalence of stunting, underweight and wasting were 30·2 %, 10·2 % and 2·9 %, respectively. The prevalence of overweight and the possible risk of overweight were as high as 4·1 % and 16·8 %. Further analysis among the children with possible risk of overweight found that the percentage of stunting (HAZ < −2) was 57·6 %, the percentage with −2 ≤ HAZ ≤ 2 was 41·0 % and the percentage with HAZ > 2 was only 1·4 %. The prevalence of stunting was 21·9 % and of underweight was 12·7 % by the NCHS reference.ConclusionsStunting was the most serious problem that was impeding child growth and development. The high rate of ‘overweight’ was a false impression, the truth being ‘stunting overweight’, and the way to solve it should be to increase protein and other nutrients in the diet at an early age.

scholarly journals Cross-sectional study of child and adolescent growth in Ecuador

2019 ◽  
Vol 21 (2) ◽  
pp. 006
Author(s):  
Wilmer Alexander Tarupi ◽  
Yvan Lepage ◽  
Roland Hauspie ◽  
María Luisa Félix ◽  
Claude Monnier ◽  
...  
Keyword(s):  
Growth Curves ◽  
Cross Sectional Study ◽  
Child Growth ◽  
World Health ◽  
Growth Monitoring ◽  
Cross Sectional ◽  
Important Indicator ◽  
Growth Standards ◽  
Who Standards ◽  
Health Organization

Child growth is internationally recognized as an important indicator for monitoring health in populations. There exists a wide controversy regarding the use of international growth standards versus local references. This study seeks to construct reference growth curves for school-age Ecuadorian children and adolescents, and to compare them with World Health Organization (WHO) standards, in order to identify the differences and their public health implications. The study authors enrolled 2891 children (1644 girls and 1247 boys) aged 5 to 18 years, from a variety of climatic zones and ethnic groups. LMS method was used to construct Ecuadorian curves for height, weight and Body Mass Index. Comparisons of Ecuadorian and WHO curves were graphically illustrated. U.S children were taller than Ecuadorian children across all age ranges, with larger differences between the two populations in children over 13 years. Consequently, estimates of low height and extremely low height, as well as overweight, obese and undernourished, were significantly different between WHO standards and the Ecuadorian references. Population-specific growth curves may be more adequate for growth monitoring of Ecuadorian children than WHO growth curves. We advocate for the construction of an Ecuadorian growth reference for clinical use based on national population, from conception to maturity, as an accurate instrument for monitoring growth.

Implications of the WHO Child Growth Standards in rural Honduras

2012 ◽  
Vol 15 (6) ◽  
pp. 1015-1022 ◽  
Author(s):  
Erin K Nichols ◽  
Joseph S Nichols ◽  
Beatrice J Selwyn ◽  
Carol Coello-Gomez ◽  
George R Parkerson ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Child Growth ◽  
Policy Implications ◽  
Kappa Statistics ◽  
Reference Standard ◽  
Cross Sectional ◽  
Growth Standards ◽  
Growth Reference ◽  
Who Standards ◽  
The Impact

AbstractObjectiveThe present study analysed the impact of using the 2006 WHO Child Growth Standards (‘the WHO standards’) compared with the 1977 National Center for Health Statistics (NCHS) international growth reference (‘the NCHS reference’) on the calculated prevalence of chronic malnutrition in children aged 6·0–59·9 months.DesignAnthropometric data were collected as part of a cross-sectional study exploring the association between household environments and nutritional status of children. Z-scores were computed for height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ) using each reference/standard. Results were compared using Bland–Altman plots, percentage agreement, kappa statistics, line graphs and proportion of children in Z-score categories.SettingThe study was conducted in thirteen rural villages within Honduras's department of Intibucá.SubjectsChildren aged 6·0–59·9 months were the focus of the analysis, and households with children in this age range served as the sampling unit for the study.ResultsThe WHO standards yielded lower means for HAZ and higher means for WAZ and WHZ compared with the NCHS reference. The WHO standards and NCHS reference showed good agreement between Z-score categories, except for HAZ among males aged 24·0–35·9 months and WHZ among males aged >24·0 months. Using the WHO standards resulted in higher proportions of stunting (low HAZ) and overweight (high WHZ) and lower proportions of underweight (low WAZ). The degree of difference among these measures varied by age and gender.ConclusionsThe choice of growth reference/standard employed in nutritional surveys may have important methodological and policy implications. While ostensibly comparable, data on nutritional indicators derived with different growth references/standards must be interpreted cautiously.

scholarly journals Comparison of the World Health Organization (WHO) Child Growth Standards and the National Center for Health Statistics/WHO international growth reference: implications for child health programmes

2006 ◽  
Vol 9 (7) ◽  
pp. 942-947 ◽  
Author(s):  
Mercedes de Onis ◽  
Adelheid W Onyango ◽  
Elaine Borghi ◽  
Cutberto Garza ◽  
Hong Yang ◽  
...  
Keyword(s):  
Child Health ◽  
Child Growth ◽  
Growth Patterns ◽  
World Health ◽  
Growth Standards ◽  
International Growth ◽  
Growth Reference ◽  
Who Standards ◽  
Health Organization ◽  
Health Programmes

AbstractObjectivesTo compare growth patterns and estimates of malnutrition based on the World Health Organization (WHO) Child Growth Standards (‘the WHO standards’) and the National Center for Health Statistics (NCHS)/WHO international growth reference (‘the NCHS reference’), and discuss implications for child health programmes.DesignSecondary analysis of longitudinal data to compare growth patterns (birth to 12 months) and data from two cross-sectional surveys to compare estimates of malnutrition among under-fives.SettingsBangladesh, Dominican Republic and a pooled sample of infants from North America and Northern Europe.SubjectsRespectively 4787, 10 381 and 226 infants and children.ResultsHealthy breast-fed infants tracked along the WHO standard's weight-for-age mean Z-score while appearing to falter on the NCHS reference from 2 months onwards. Underweight rates increased during the first six months and thereafter decreased when based on the WHO standards. For all age groups stunting rates were higher according to the WHO standards. Wasting and severe wasting were substantially higher during the first half of infancy. Thereafter, the prevalence of severe wasting continued to be 1.5 to 2.5 times that of the NCHS reference. The increase in overweight rates based on the WHO standards varied by age group, with an overall relative increase of 34%.ConclusionsThe WHO standards provide a better tool to monitor the rapid and changing rate of growth in early infancy. Their adoption will have important implications for child health with respect to the assessment of lactation performance and the adequacy of infant feeding. Population estimates of malnutrition will vary by age, growth indicator and the nutritional status of index populations.

scholarly journals Adoption of the WHO Child Growth Standards to Classify Indonesian Children under 2 Years of Age According to Nutrition Status: Stronger Indication for Nutritional Intervention

2009 ◽  
Vol 30 (3) ◽  
pp. 254-259 ◽  
Author(s):  
Madarina Julia
Keyword(s):  
Nutritional Status ◽  
Nutritional Intervention ◽  
Child Growth ◽  
World Health ◽  
Nutrition Status ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Growth Standards ◽  
Feeding Program ◽  
Z Scores

Background The National Center for Health Statistics/World Health Organization (NCHS/WHO) reference is considered unsuitable for assessing the nutritional status of breastfed children. It is gradually being replaced by the WHO Child Growth Standards in many countries. Objective To assess the implications of adopting the WHO Child Growth Standards to classify Indonesian children according to nutrition status. Methods Data were obtained from two cross-sectional surveys in two districts in Indonesia in 1998. Children under 2 years of age were randomly selected using a two-stage cluster sampling. Z-scores of weight-for-length (WLZ), length-for-age (LAZ), and weight-for-age (WAZ) were calculated based on both the NCHS/WHO reference and the WHO Child Growth Standards. Wasting, stunting, and underweight were defined as z-scores less than −2.0. Results We included 1,374 children, of whom 693 (50.4%) were male and 681 (49.6%) were female. Almost all of the children had initiated breastfeeding and were still being breastfed when the data were collected. According to the WHO Child Growth Standards, the prevalence of wasting did not change with age, but the prevalence rates of stunting and underweight rose steadily with age. Although the contribution of wasting to the classification of underweight was relatively constant, the contribution of stunting increased as the children grew. Conclusions The WHO Child Growth Standards are a better tool for assessing the nutritional status of Indonesian children than the NCHS/WHO reference. However, low WAZ is not a suitable indicator for commencing an extra feeding program, because it reflects stunting instead of wasting. The high prevalence of stunting indicates the need to perform preventive nutritional intervention beginning earlier in life, i.e., in utero.

scholarly journals Variations in estimates of underweight, stunting, wasting, overweight and obesity in children from Argentina comparing three growth charts

2012 ◽  
Vol 15 (11) ◽  
pp. 2086-2090 ◽  
Author(s):  
Gisel Padula ◽  
Analía I Seoane ◽  
Susana A Salceda
Keyword(s):  
Cross Sectional Study ◽  
Child Growth ◽  
Overweight And Obesity ◽  
Growth Charts ◽  
Cross Sectional ◽  
Mean Values ◽  
Growth Standards ◽  
Pediatric Society ◽  
Who Standards ◽  
Society Committee

AbstractObjectiveTo compare estimates of underweight, stunting, wasting, overweight and obesity based on three growth charts.DesignCross-sectional study to estimate weight-for-age, length/height-for-age and weight-for-height comparing the 2006 WHO Child Growth Standards (‘the WHO standards’), the 1977 National Center for Health Statistics (NCHS) international growth reference (‘the NCHS reference’) and the 1987 Argentine Pediatric Society Committee of Growth and Development reference (‘the APS reference’). Cut-off points were defined as mean values ±2 sd. Epi-Info software version 6·0 (Centers for Disease Control and Prevention) was used for statistical evaluations (χ2, P ≤ 0·05).SettingGreater La Plata conurbation, Buenos Aires, Argentina.SubjectsA total of 2644 healthy, full-term children from 0 to 5 years of age.ResultsPrevalence of underweight was higher with the WHO standards than with the other references up to the first 6 months. For the rest of the ages, prevalence was lower with the WHO standards. Stunting prevalence was higher with the WHO standards at all ages. Prevalence of wasting was higher with the WHO standards compared with the NCHS reference up to the first 6 months and lower at 2–5 years of age. Overweight and obesity prevalences were higher with the WHO standards at all ages.ConclusionsThe new WHO standards appear to be a solid and reliable tool for diagnosis and treatment of nutritional diseases, also being the only one built with infants fed according to WHO recommendations. Therefore, our results support the decision of the National Ministry of Health about the utilization of the new WHO standards to monitor the nutritional status of Argentinean children aged less than 5 years.

scholarly journals Poor Head Growth Is Associated with Later Mental Delay among Vietnamese Preterm Infants: A Follow-up Study

2020 ◽  
Author(s):  
Chuong Huu Thieu Do ◽  
Malene Landbo Børresen ◽  
Freddy Karup Pedersen ◽  
Tinh Thu Nguyen ◽  
Hung Thanh Nguyen ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Child Growth ◽  
Physical Growth ◽  
World Health ◽  
Growth Data ◽  
Growth Standards ◽  
Head Growth ◽  
Who Standards ◽  
Catch Up

Abstract Background Preterm infants in low- and middle-income countries are at high risk of poor physical growth, but their growth data are still scarce. Objectives To describe the growth of Vietnamese preterm infants in the first 2 years, and to compare with references: World Health Organization (WHO) child growth standards, and healthy Southeast Asian (SEA) infants. Further, to assess the association between growth in the first year and neurodevelopment at 2 years corrected age (CA). Methods We conducted a cohort study to follow up preterm infants discharged from a neonatal intensive care unit for 2 years. Weight, length and head circumference (HC) were measured at 3, 12 and 24 months CA. Neurodevelopment was assessed using Bayley Scales of Infant and Toddler Development—3rd Edition at 24 months CA. Results Over 90% of the cohort showed catch-up weight at 3 months CA. Weight and length were comparable to healthy SEA but were lower than WHO standards. HC was significantly smaller than those of WHO standards with HC Z-scores steadily decreasing from −0.95 at 3 months CA to −1.50 at 24 months CA. Each one decrement of HC Z-score from 3 to 12 months CA was associated with nearly twice an increase in odds of mental delay at 24 months CA (odds ratio 1.89; 95% confidence interval 1.02–3.50). Conclusion Vietnamese preterm infants exhibited early catch-up weight but poor head growth, which was associated with later delays in mental development. Our findings support the importance of HC measures in follow-up for preterm infants.

MORBIDITY PATTERN AMONG ADOLESCENT SCHOOL GIRLS IN RURAL AND URBAN SCHOOL OF JHANSI (U.P.)- A COMPARATIVE CROSS-SECTIONAL SURVEY

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Shubhanshu Gupta ◽  
Sanjeev Kumar ◽  
Piyush D Swami ◽  
Anjana Niranjan
Keyword(s):  
Health Status ◽  
Adolescent Girls ◽  
Low Socioeconomic Status ◽  
Optimal Level ◽  
Cross Sectional Study ◽  
World Health ◽  
World Population ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Rural And Urban

Background: According to World Health Organization, adolescents constitute about one fifth of the world population, and in India they constitute about 21% of the total population. Most of the surveys show that health status of adolescent girls is at sub-optimal level. Objectives: To assess nutritional status and morbidity pattern among the adolescent girls and to suggest measures for improvement of health status of adolescent girls.  Method: A community based cross-sectional study was carried out among 250 adolescent schoolgirls in Rural and urban field practice area of Jhansi school from January 2017 to July 2014. Results: Among the various morbidities eye problem was seen in maximum no of adolescent girls. Eye problem was present in 44.8% of adolescent girls followed by respiratory 14.7% and ear 13.06% disease. Skin disease was present in 3.2% of adolescent girls, which was more in rural girls 6.7% than in urban girls 1.7%, may be due to better hygienic practice in urban schoolgirls. Conclusions: Rural background, low socioeconomic status, illiteracy, birth rate and order, income and number of members in a family have shown to be significant determinants of morbidity pattern in the adolescent girls. Keywords: Adolescent, anemia, morbidity, vaginal discharge.

scholarly journals Hepatitis B Vaccination in Senegalese Children: Coverage, Timeliness, and Sociodemographic Determinants of Non-Adherence to Immunisation Schedules (ANRS 12356 AmBASS Survey)

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 510
Author(s):  
Lauren Périères ◽  
Fabienne Marcellin ◽  
Gora Lo ◽  
Camelia Protopopescu ◽  
El Ba ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Dose Schedule ◽  
World Health Organisation ◽  
Sub Saharan Africa ◽  
World Health ◽  
Hepatitis B Vaccination ◽  
Detailed Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hbv Vaccination

Detailed knowledge about hepatitis B virus (HBV) vaccination coverage and timeliness for sub-Saharan Africa is scarce. We used data from a community-based cross-sectional survey conducted in 2018–2019 in the area of Niakhar, Senegal, to estimate coverage, timeliness, and factors associated with non-adherence to the World Health Organisation-recommended vaccination schedules in children born in 2016 (year of the birth dose (BD) introduction in Senegal) and 2017–2018. Vaccination status was assessed from vaccination cards, surveillance data, and healthcare post vaccination records. Among 241 children with available data, for 2016 and 2017–2018, respectively, 31.0% and 66.8% received the BD within 24 h of birth (BD schedule), and 24.3% and 53.7% received the BD plus at least two pentavalent vaccine doses within the recommended timeframes (three-dose schedule). In logistic regression models, home birth, dry season birth, and birth in 2016 were all associated with non-adherence to the recommended BD and three-dose schedules. Living over three kilometres from the nearest healthcare post, being the firstborn, and living in an agriculturally poorer household were only associated with non-adherence to the three-dose schedule. The substantial proportion of children not vaccinated according to recommended schedules highlights the importance of considering vaccination timeliness when evaluating vaccination programme effectiveness. Outreach vaccination activities and incentives to bring children born at home to healthcare facilities within 24 h of birth, must be strengthened to improve timely HBV vaccination.

scholarly journals Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 133
Author(s):  
Perpetua Modjadji ◽  
Mpinane Pitso
Keyword(s):  
South Africa ◽  
Alcohol Use ◽  
Tobacco Use ◽  
Child Growth ◽  
Growth Patterns ◽  
World Health ◽  
Poor Growth ◽  
Growth Standards ◽  
Validated Questionnaire ◽  
Current Tobacco

Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.

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