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The prevalence of childhood obesity has increased dramatically all over the world in recent years. While obesity in adults can be easily measured using the BMI calculation, determining overweight and obesity in children is more controversial. The aim was to compare the three most used international classification systems (WHO 2007, CDC 2000 and Cole-IOTF) to determine overweight and obesity in infant and adolescent populations. We performed a systematic review in accordance with the PRISMA 2020 guidelines of articles comparing any of the three classification systems. The main findings were that the WHO 2007 criteria show the highest prevalence of overweight and obesity in the child and youth population. The prevalence of childhood overweight and obesity was determined to be higher in boys than in girls in most studies, when analysing the classifications of the WHO 2007, CDC 2000 and Cole-IOTF together. However, there was a higher prevalence of overweight and obesity in girls than in boys when only the CDC 2000 and Cole-IOTF criteria were considered. Both the results of the review and the great heterogeneity found in the meta-analysis show that it is necessary to unify the criteria for the classification of childhood overweight and obesity. International standards are insufficient for working with the current population. A working group should be created to address this issue and agree on the unification of a gold standard, taking into account the geographical region, the ethnic groups and the age groups of the child and youth population and above all, the secular growth.
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Introducción: La forma más fácil y económica para observar el crecimiento es la antropometría, Para medir el crecimiento se utilizan estándares de referencia que evalúan a la normalidad del crecimiento. Las curvas de crecimiento recomendadas por la OMS hasta antes del 2006 eran las del NCHS y CDC, a partir de abril del 2006 la OMS propuso el uso del nuevo patrón de crecimiento. Objetivo: Medir la concordancia entre las tablas de referencias de crecimiento de la OMS 2007 y del NCHS/CDC 2000 utilizando los indicadores talla para la edad (T/E) e índice de masa corporal para la edad (IMC/E). Materiales y Métodos: Estudio analítico de corte trasverso. Se estudiaron 148 niños de entre 5 y 16 años que asistieron a escuelas de tres comunidades rurales. Las variables analizadas fueron T/E e IMC/E diferenciada por sexo. Se estimó el coeficiente kappa para evaluar la concordancia entre las referencias. Se utilizó programas estadísticos WHO Antro Plus V.1.0.4, y con EpiInfo v3.5.1 2008. Resultados: La concordancia más alta se encontró entre las referencias de la OMS 2007 y el CDC 2000 con el indicador T/E en la niñas con κ=0,882 y en los niños κ=0,760; con el indicador IMC/E el coeficiente Kappa más alto se encontró en la población de niños (κ=0,733) y en las niñas (κ=0,452). Conclusiones: Se obtuvo una concordancia buena entre ambas tablas de referencias para el indicador T/E. Existen concordancia moderada con el indicador IMC/E entre las referencias de la OMS 2007 y CDC 2000 para el diagnóstico nutricional.
Introduction: The easiest and most economical way to observe growth is anthropometry. To measure growth, reference standards are used that evaluate the normality of growth. The growth curves recommended by the WHO until before 2006 were those of the NCHS and the CDC. As of April 2006, the WHO proposed the use of new growth pattern charts. Objective: To measure the concordance between the 2007 WHO growth reference tables and those of the 2000 NCHS / CDC using the height-for-age (T / E) and body-mass-index-for-age (BMI / E) indicators. Materials and Methods: This was a cross-sectional analytical study. We studied 148 children between 5 and 16 years of age who attended schools in three rural communities. The variables analyzed were T / E and BMI / E, differentiated by sex. The kappa coefficient was estimated in order to evaluate the concordance between the references. The WHO Antro Plus V.1.0.4 and Epi Info v3.5.1 2008 were used for statistical analysis. Results: The highest concordance was found between the 2007 WHO growth reference tables and the 2000 CDC tables with the T / E indicator in girls with κ = 0.882 and in boys with κ = 0.760; with the IMC / E indicator, the highest Kappa coefficient was found in the population of boys (κ = 0.733) and in girls (κ = 0.452). Conclusions: There is good concordance between both reference tables for the T / E indicator. There is moderate agreement with the IMC / E indicator between the 2007 WHO and 2000 CDC growth references tables for the diagnosis of nutritional status..
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BACKGROUND: Growth references are useful for the screening, assessment and monitoring of individual children as well as for evaluating various growth promoting interventions that could possibly affect a child in early life. AIM: To determine the growth centiles of Malaysian children and to establish contemporary cross-sectional growth reference charts for height and weight from birth to 6 years of age based on a representative sample of children from Malaysia. METHODS: Gender- and age-specific centile curves for height and weight were derived using the Cole's LMS method. Data for this study were retrieved from Malaysian government health clinics using a two-stage stratified random sampling technique. Assessment of nutritional status was done with the SD scores (Z-scores) of WHO 2006 standards. RESULTS: Boys were found to be taller and heavier than girls in this study. The median length of Malaysian children was higher than the WHO 2006 standards and CDC 2000 reference. The overall prevalence of stunting and underweight were 8.3% and 9.3%, respectively. CONCLUSIONS: This study presents the first large-scale initiative for local reference charts. The growth reference would enable the growth assessment of a Malaysian child compared to the average growth of children in the country. It is suggested that the use of WHO 2006 Child Growth Standards should be complemented with local reference charts for a more wholesome growth assessment.
Subject(s)
Body Height , Body Weight , Child, Preschool , Cross-Sectional Studies , Growth Charts , Humans , Infant , Infant, Newborn , Malaysia , Reference ValuesABSTRACT
avaliar, nutricionalmente, crianças utilizando os parâmetros do Centro de Controle de Doenças (CDC)-2000 e da Organização Mundial da Saúde (OMS)-2006. MÉTODO: estudo transversal de prevalência das criançasatendidas no Ambulatório de Gastroenterologia Pediátrica da Fundação Santa Casa de Misericórdia do Pará (FSCMPA),entre outubro de 2009 e abril de 2010. RESULTADOS: a maioria (64,7%) das crianças avaliadas eram do sexomasculino; o maior percentual de baixa estatura (BE) foi encontrado pelos critérios do Z-score/OMS-2006 e o menorpelo Percentil/CDC-2000. Com relação ao sobrepeso, foi encontrado 3,9% pelo Percentil e Z-score/OMS-2006 e Z--score/CDC-2000 e 2,6% pelo Percentil/CDC-2000. Obesidade foi encontrada em 2,6%, conforme o Percentil e Z--score/CDC-2000 e Percentil/OMS-2006 e em 1,3% pelo Z-score/OMS-2006. Desnutrição foi mais diagnosticada peloscritérios do Percentil/CDC-2000, seguido pelo Z-score/CDC-2000, Percentil e Z-score da OMS-2006 com 28,9%,22,4%, 17,1% e 11,9% respectivamente; baixo peso (BP) foi encontrado em maior prevalência pelo Percentil/CDC-2000 e em menor prevalência pelo Percentil/OMS-2006. CONCLUSÃO: os resultados são compatíveis com os dadosda literatura, com maior percentual de BE e sobrepeso/obesidade encontrado, respectivamente, pelo Z-score/OMS-2006 e Z-score/Percentil/OMS-2006. Maior prevalência de BP e de desnutrição foram encontrados pelo CDC-2000.
OBJECTIVE: to assesment nutritionally children according to the World Health Organization (WHO) 2006 growthreference and Centers for Disease Control and Prevention (CDC) 2000 growth reference. METHODS: A transversaldescriptive study with children assisted in the ambulatory of Pediatric Gastroenterology of the Santa Casa de Misericórdia do Pará Foundation (FSCMPA), between october of 2006 and april of 2008. RESULTS: there most percentualof short stature was by Z-score/WHO charts and less by percentile/CDC charts. Overweight was 3,9% by Percentile/WHO, Z-score/WHO and z-score/CDC and 2,6% by percentil/CDC. Obesity was in 2,6% according percentile andZ-score/CDC and Percentile/WHO and in 1,3% by Z-score/WHO. Undernutrition was most diagnostic by Percentile/CDC, Z-score/CDC, percentile and Z-score/WHO in 8,9%, 22,4%, 17,1% e 11,9% respectivaly; low weight was accountedin most prevalence by Percentile/CDC and less prevalence by Percentile/WHO. CONCLUSION: the studyshowed similar results to those observed at other studies, whit good agreement between the two curves growth.
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Malnutrition can be associated as one of the factors which affect health status. The term is used to describe imbalance of nutrients either over- or under-nourished, resulting in measurable adverse effects on body composition, function and clinical outcome. The National Health And Morbidity Survey (NHMS) 2011 assessed 4304 individuals aged 10-17 years old through a household survey of Malaysian population. Thinness and obesity are the malnutrition indicators based on Centre for Disease Control (CDC) 2000 classification as recommended by WHO (2007). The findings of the survey showed that the national prevalence of thinness (BMI for age <-2SD), was 9.7% (95% Confidence Interval: 8.4-11.2). The state of Sabah/Labuan had the highest thinness of prevalence, 17.0% (11.1-25.2) and lowest in Penang at 5.3% (2.7-10.0). The prevalence of thinness was higher in urban areas than in rural areas at 10.3% (8.5-12.3). Meanwhile; national prevalence of obesity (BMI for age ≥+2SD) was only 5.7% (4.9-6.7). The state of Perak had the highest obesity prevalence 10.0% (6.2-15.8) and lowest in Sabah/Labuan at 2.4% (1.4-4.1). The obesity prevalence was higher among adolescents in urban areas at 6.3% (5.2-7.6) than in rural areas. Thinness as a form of malnutrition is more prevalent than obesity. Even though the prevalence of obesity is low, the impact affects not only the adolescents, but also the family, the society and the nation in the future. The increasing prevalence of obesity will have significant public health implication related to non-communicable diseases.
