[WHO child growth standards for children 0-5 years. Percentile charts of length/height, weight, body mass index and head circumference]. / Standardy who rozwoju fizycznego dzieci w wieku 0-5 lat. Siatki centylowe dlugosci/wysokosci masy ciala wskaznika masy BMI I obwodu glowy.

The aim of this paper was to present the growth standards for children aged 0-5 years - which is a new tool for the assessment of health, growth and nutritional status recommended by WHO for use all over the world. These standards were elaborated in 2006 on the basis of the results of the WHO Multicentre Growth Reference Study (a longitudinal and cross-sectional survey) carried out between 1997-2003 in Brazil, Ghana, India, Norway, Oman and the USA. An innovative approach to developing growth reference was applied. Healthy children living under conditions allowing them to achieve their full genetic potential were the sample of children under study. The results showed that the growth pattern of children in their early childhood in different countries, ethnic groups and of different socioeconomic status was the same when their health and care needs were met. The new standards indicate how children should grow in all countries, rather than merely describing how they grew at a particular place and time. The WHO Child Growth Standards for Children 0-5 years were adapted and used in over 100 countries. Activities designed to adapt WHO standards in Poland were undertaken in 2009. The comparison between the growth reference for Warsaw children and WHO standards showed no differences, or very small ones. Following discussion with the participation of many experts, in 2011 recommendations concerning the implementation of these standards were signed by the Committee of Human Development and the Committee of Anthropology of the Polish Academy of Science, the Main Board of the Polish Anthropological Society, the Institute of Mother and Child, and the Institute of Food and Nutrition. The percentile charts were adapted to the set of percentiles hitherto used in Poland.

Polish 2010 growth references for school-aged children and adolescents.

Growth references are useful in monitoring a child's growth, which is an essential part of child care. The aim of this paper was to provide updated growth references for Polish school-aged children and adolescents and show the prevalence of overweight and obesity among them. Growth references for height, weight, and body mass index (BMI) were constructed with the lambda, mu, sigma (LMS) method using data from a recent, large, population-representative sample of school-aged children and adolescents in Poland (n = 17,573). The prevalence of overweight and obesity according to the International Obesity Taskforce definition was determined with the use of LMSGrowth software. Updated growth references for Polish school-aged children and adolescents were compared with Polish growth references from the 1980s, the Warsaw 1996-1999 reference, German, and 2000 CDC references. A positive secular trend in height was observed in children and adolescents from 7 to 15 years of age. A significant shift of the upper tail of the BMI distribution occurred, especially in Polish boys at younger ages. The prevalence of overweight or obesity was 18.7% and 14.1% in school-aged boys and girls, respectively. The presented height, weight, and BMI references are based on a current, nationally representative sample of Polish children and adolescents without known disorders affecting growth. Changes in the body size of children and adolescents over the last three decades suggest an influence of the changing economical situation on anthropometric indices.

[Physical development and puberty of Polish 13 year old adolescents in the first decade of 21st century. Current status and secular trend of growth and maturation in the last 30 years]. / Rozwój fizyczny i dojrzewanie polskich 13-latków w pierwszej dekadzie XXI wieku. Stan obecny oraz trend sekularny wzrastania i dojrzewania w ostatnim trzydziestoleciu.

THE AIM OF THE STUDY: 1. Current physical status and selected pubertal features were assessed in Polish 13-year old adolescents, in urban and rural areas. 2. Dynamics and secular trends of body height, mass and body mass index in 1980-2008 were analyzed. MATERIAL AND METHODS: The study was conducted in 2008 in prospective cohort of 605 children (305 girls and 300 boys), who had been observed in the neonatal period, later at age of 3 years and now at age of 13 years. 49% adolescents were from urban and 51% from rural area. For secular trend analyses comparisons of the age and sex-specific means of body height, mass and BMI from 2008 with previous data from 1980, 1999 and 2005 in 13-year old were carried out. Similar comparison was made concerning average age at menarche by using previous probit analysis to determine average age at menarche during the last 3 decades. RESULTS: Mean values of anthropometric features in adolescents were a little higher in 13-yrs old living in urban than rural area, but were statistically insignificant. Two thirds of examined 13-year-old girls already had their first period (menarche), statistically more often urban living girls (p = 0,017). The median age at menarche for entire group of 13-year-old girls estimated by means of Kaplan-Meier analysis was 12.77 years. The girls from urban areas had their first menses earlier than their rural living peers (12.65 and 12.88 years, p = 0.01). There were no statistically significant differences in urban and rural boys concerning age of appearance of facial hair. There are increases of mean height and weight values during the period of 30 years in 13-year-olds (2.51 cm and 2.2 kg for girls and 5.51 cm and 5.08 kg for boys) and BMI 0.21 kg/m3 and 0.75 kg/m2 for girls and boys. The average age of menarche was almost the same as in Warsaw girls in 1986 and 1996. CONCLUSIONS: 1. The study confirmed a reduction of differences in somatic development between 13-years olds in rural and urban areas. 2. Difference in mean age at menarche is still observed, they show earlier maturation in urban girls (about 2 months earlier than in rural girls). 3. Positive secular trend in height in Polish 13-year-olds is observed during the last 3 decades. 4. The mean age at menarche in Polish girls stabilized at 12.77 years in the last decade.

[Assessment of physical development of children and adolescents. Part I. Infants and children up to 5 years--national reference values or WHO standards?]. / Ocena rozwoju fizycznego dzieci i mlodziezy. cz. i. niemowlita i dzieci do 5 lat--normy krajowe czy standardy who?

INTRODUCTION: Growth and development assessment of infants and young children is a very important component of early prophylaxis in paediatric health care. In 2006 the World Health Organization published the new Child Growth Standards for children up to 5 years of age. They describe the optimal pattern of young children development. AIM OF THE STUDY: 1. To compare the cut-off points for selected anthropometric parameters in children up to 5 years between reference values for Polish children and WHO Child Growth Standards. 2. To attempt to answer the question whether the WHO Child Growth Standards can be implemented to assess health and development in children up to 5 years in Poland. METHODS: The differences for mean (50th percentile) and extreme values (3rd and 97th percentile) for length/height for age and weight for age were calculated for boys and girls. The differences in BMI units for overweight (mean + 1 SD) and obesity (mean + 2 SD) were compared using the z-score method. RESULTS: Comparisons of the WHO and Polish length/height and weight for age showed no differences in children aged 1-60 months. Small differences were seen in the 3rd percentile (less than 2%) in children aged 3 and 6 years. BMI values for overweight and obesity were slightly lower for Polish children in the first 6 months of life than in WHO standards. These differences have positive values for boys and girls starting at 9th month and increasing in toddlers. CONCLUSIONS: WHO standards reflect the optimal growth pattern for children from birth up to 5 years. Therefore these instruments should be adopted for Polish children to assessing their growth.

[Assessment of physical development of children and adolescents. Part II. Children and adolescents aged 6-19 years--national references or WHO recommendations?]. / Ocena rozwoju fizycznego dzieci i mtodziezy. cz. ii. dzieci i mtodziez w wieku 6-18 lat- normy krajowe czy rekomendowane przez who?

AIMS: 1. Comparison of cut-off points for selected anthropometric parameters in children and adolescents between reference values for Polish Institute of Mother and Child (IMD) and WHO growth METHODS: The accepted reference system were IMD reference values and the differences for mean (50th) and 3rd and 97th percentile for height and weight were calculated for boys and girls. The differences between BMI units for overweight (85th) and obesity (95th) percentile were compared. Warsaw 1980 reference values were used to estimate secular trend influence on differences between IMD and WHO cut-off points in stunting adolescents. RESULTS: Comparison of height-for-age showed the largest differences with positive values relative to 3rd percentile in the Polish population. Boys aged 16 years attain 4% (6.2 cm) of 3rd percentile height value and girls aged 14 years 2.3% (2.8 cm). Secular trend of the Polish population did not influence the differences between IMD and WHO values in stunting adolescents. The differences for 85th and 95th percentile of BMI were most pronounced in prepubescence and the largest values were for boys and girls aged 10 years. CONCLUSIONS: 1. National height-for-age references should be used for growth assessment in Polish school-aged children and adolescents especially in stunting adolescents identified in puberty. 2. WHO norms for BMI, can be used as a tool for identifying overweight and obesity in epidemiological studies in Poland and for international comparisons. 3. The usefulness of WHO norms for clinical evaluation of overweight and obesity should be discussed among experts.

The influence of trunk inclination on muscle activity during sitting on forward inclined seats.

The aim of the study was to estimate the influence of trunk inclination on muscle activity during sitting on forward inclined seats without backrest. The group consisting of thirteen healthy women was examined. Based on anthropometrical data two types of sitting position were adopted with two different angles between thighs and trunk: 120 and 135 degrees. Bioelectrical activity of five muscles was recorded. There was observed statistical influence of the trunk inclination on erector spinae, gastrocnemius lat. and tibialis anterior (p < 0.05). Especially, the inclination of seat pan influenced tibialis anterior activity (10%), although EMG measured during sitting did not exceed 20% of MVC.

Blood pressure references for Polish children and adolescents.

The objective of this study was to develop age- and gender-specific reference ranges for blood pressure in a large national database on blood pressure levels throughout childhood and adolescence in young Poles. A prospective cross-sectional study was performed in 2002-2005 in the representative sampling sites, selected randomly from the entire Poland. Altogether, 6,447 school pupils, aged 7-18 years, were involved in the study of which 3,176 were boys and 3,271 were girls. Statistical analysis was performed using STATISTICA for Windows 7.1. The normal range of blood pressure, determined by age and the category of body height percentiles, revealed percentiles values which might serve as reference values to identify cases of high normal blood pressure (the mean blood pressure between 90th and 95th percentiles for age and gender) and hypertension (the mean blood pressure equals or exceeds the 95th percentiles on at least three occasions).

[Value and usefulness of modified screening test for detection of overweight and obesity in school-aged children and adolescents]. / Wartosc i przydatnosc zmodyfikowanego testu przesiewowego do wykrywania nadwagi i otylosci u dzieci i mlodziezy w wieku szkolnym.

UNLABELLED: Overweight and obesity has become an increasing problem in school aged children and adolescents also in Poland. Early detection and treatment of this disorder is crucial. On the basis of height and body mass measurements, the body mass index (BMI) is calculated and is used to assess overweight for maximal correlation with body fat. BMI has been widely used to measure obesity in adults worldwide and it is also used in childhood obesity. The cut-off points of BMI value are the main problem in children and adolescents obesity because BMI varies substantially by age and gender during childhood and adolescence. The aim of the study was a comparison of two methods which were used to assess overweight and obesity in adolescents. A modification of the current screening test for physical development disorders is also proposed. MATERIAL AND METHODS: in comparative analysis of overweight and obesity prevalence we used data from our survey in a representative group of over 8000 adolescents aged 13-15 years, in 2005. Different standards have been used to define overweight and obesity: using 85th BMI percentile or 90th BMI percentile for overweight and 95th BMI percentile or 97th BMI percentile for obesity. RESULTS: the two standards produced consistent estimates of the prevalence of obesity in our sample, but prevalence of overweight produced statistical significant differences. We found underestimation of overweight especially in boys using the standard with 90th BMI percentile references. In case of individual screening test, underestimation of overweight may give a falsely negative result. CONCLUSIONS: 1. Using the Polish standards with 85th percentile references as cut-off point of BMI value instead 90th percentile for overweight increases screening sensitivity. 2. National standards with cut-off points BMI> or =85th percentile for overweight and BMI> or =95th percentile (obesity) are also useful tools for estimation of overweight and obesity prevalence in epidemiological studies and in international comparisons.

[Anthropometric methods in evaluation of somatic development of children with metabolic diseases]. / Metody antropometryczne w ocenie rozwoju somatycznego dzieci z chorobami metabolicznymi.

Somatic development is determined by genetic and environmental factors. Morbidity, especially in chronic metabolic diseases, is considered as one of the environmental factors which significantly influences somatic development. Chronic diseases may affect growth by five mechanisms: nutritional factors, protein loss, chronic inflammation, tissue anoxia with acid-base disturbances and by drugs used in treatment. Somatic development assessment, especially longitudinal observations in chronic diseases, give important informations concerning the growth processes, factors affecting growth and treatment effectiveness. It also allows us to determine the moment of growth delay or catch-up growth. This paper discusses the importance and the interpretation of anthropometric measurements, which should be used in the assessment of somatic development, the dynamics of growth and the nutritional status of children with metabolic diseases.

[Blood pressure of children and adolescents in the Mazowiecki and Wielkopolski provinces]. / Cisnienie tetnicze dzieci i mlodziezy województwa mazowieckiego i wielkopolskiego.

The aim of the study is evaluation of occurrence of elevated blood pressure values in Wielkopolskie and Mazowieckie provinces. The population studied was a representative sample of children & adolescents age 7-18 (1905 in Mazowieckie and 1805 from Wielkopolskie province). The methodology of BP measurement and classification of hypertension followed the guidelines of the III Report of the Task Force on Blood Pressure Control in Children. The occurrence of elevated BP values were significantly higher in Mazowieckie region.

[Somatic development assessment of children with food allergy treated with milk free diet]. / Ocena rozwoju somatycznego dzieci z alergia pokarmowa leczonych diet a eliminacyjna.

The aim of our study was to evaluate the influence of one year elimination diets on the somatic development and the nutritional status of children. 25 patients from the Department of Immunology of the Institute of Mother and Child aged 1-7 years with cow's milk allergy were investigated. The children were divided into two groups: 10 children received hydrolizated casein formula and 15 children received soya protein formula. The somatic development and nutritional status was assessed twice, the first time before the onset of treatment and the second time after one year of treatment. Anthropometric methods were used, body height, body mass, upper arm circumference and subscapular skinfold were measured. The data were compared with the normal Warsaw population data from 1996-99. The results showed that both the diet with hydrolizated casein formula and the soya protein resulted in normal somatic development of children.