Stature, weight, and body mass among young US children born at term with appropriate birth weights

OBJECTIVE: To describe weight, stature, and body mass index (BMI) changes occurring before the age of 7 years, which may influence the prevalence of overweight in adolescence and adulthood. METHODS: Regression models predicting height and weight at ages 2 months to 6. 75 years were based on the third National Health and Nutrition Examination Survey. Birth certificate data were used to adjust ethnic-specific models for birth weight for gestational age. RESULTS: Attained height is higher for non-Hispanic black children than for either non-Hispanic white or Mexican American children (P 85th percentile than either non-Hispanic white or black children (boys = 25.6%, SE = 2.7 compared with 14.1%, SE = 1.7 and 16.5%, SE = 1.7, respectively; girls = 21.9%, SE = 3.6 compared with 13.0%, SE = 1.7 and 13.7%, SE = 2.2, respectively). For non-Hispanic whites and Mexican Americans and for non-Hispanic black boys, BMI decreased slightly between ages 2 and 6.75 years; BMI for non-Hispanic black girls did not. CONCLUSION: Size differences before the age of 7 years may influence later ethnic-specific overweight prevalence, independent of prenatal influences.     

Genetic and environmental determinants of growth in Mexican-Americans

Height and weight data from the Mexican-American portion of the Hispanic Health and Nutrition Examination Survey (HHANES) are shown for children of ages 2 to 17 years and compared with data for non-Hispanic white children from the second National Health and Nutrition Examination Survey and with the National Center for Health Statistics (NCHS) reference curves. Differences in stature between the Hispanic Health and Nutrition Examination Survey and the reference populations were minor prior to adolescence and could be entirely attributed to the greater poverty of Mexican-Americans. However, differences increased during adolescence (ie, median stature was less than the 25th percentile of the NCHS reference population at 17 years of age) and, in contrast with earlier ages, were independent of poverty. Similar growth patterns were observed in samples of upper-class subjects from Mexico and Guatemala. Nonetheless, the extent to which the short stature of Mexican-American adolescents is genetic is unclear because there is an apparent time trend toward greater stature in the Mexican-American population. In conclusion, the NCHS reference curves are appropriate growth standards for preadolescent Mexican-American children. Whether they are valid for Mexican-American adolescents remains unclear.     

Self-reported weight status and dieting in a cross-sectional sample of young adolescents: National Health and Nutrition Examination Survey III.

OBJECTIVE: To explore the relationship of self-reported weight status and dieting to actual weight and height in a cross-sectional nationally representative sample of young adolescents. METHODS: Weights and heights were obtained on 1932 adolescents aged 12 to 16 years enrolled in the National Health and Nutrition Examination Survey III. Information on adolescents' perception of weight status, desired weight, and weight loss attempts was obtained by questionnaire. RESULTS: Adolescents' reports of whether they considered themselves overweight or normal weight correlated poorly with medical definitions of overweight: 52% of girls who considered themselves overweight were, in fact, normal weight (body mass index < or = 85th percentile), while only 25% of boys who considered themselves overweight were normal weight (P<.001). Adolescent white girls were significantly more likely to consider themselves overweight, even when their weight status was normal, than black girls (P<.001), black boys (P<.001), and white boys (P<.001). Adolescent white girls were also more likely to diet than black girls (P<.001), black boys (P<.001), and white boys (P<.001). Dieting behavior was associated with whether adolescents viewed themselves as overweight independent of whether they actually were overweight. Racial differences between dieting and self-perceived weight status were limited to girls. There were no significant differences in self-perceived weight status (P = .28), dieting behaviors (P = .99), and desire to weigh less (P = .95) among black and white boys. CONCLUSIONS: Significant sex and racial differences existed in weight perception, desired weight, and dieting. A high proportion of normal-weight white girls consider themselves overweight and have attempted to lose weight.     

Physical growth of five to ten year old Xavante indian children in Mato Grosso

OBJECTIVE: To investigate the physical growth of Xavante children aged 5-10 years and living at the Sangradouro and s?o Marcos reservations, state of Mato Grosso, central Brazil. METHODS: A cross-sectional survey was carried out in February 1997 in two native Brazilian Indian schools. Our sample included 233 children. The following data were collected: birth date, sex, weight, height, arm-muscle circumference, and triceps skinfold thickness. Data on height and weight were compared to National Center for Health Statistics (NCHS) growth charts following the recommendation of the World Health Organization. RESULTS: Our results show that 9% of our population sample had height-for-age Z scores <-2. For boys, statistically significant differences (P<0.05) in height-for-age and weight-for-age Z scores were observed between the two communities. Similar differences were not observed for girls. Xavante children are, in average, shorter in height than North-American children. However, for some age groups, the average values of height overlap with those of the Brazilian children investigated by the National Research on Health and Nutrition (PNSN). CONCLUSIONS: The physical growth profile of Xavante children presented important differences when compared to that of a number of other South American native Indian populations. Based on the information collected, we argue that North-American curves can be used to evaluate the nutritional status of Xavante children.     

Indications of early obesity in low-income Hmong children.

OBJECTIVE--To determine if there is evidence of obesity in low-income Hmong children. DESIGN--Cross-sectional survey. SETTING--Women, Infants, and Children clinics in Minneapolis, Minn. PARTICIPANTS--271 US-born Hmong children, ages 1.00 through 4.99 years. SELECTION PROCEDURES--Consecutive sample of all Hmong children seen in two clinics between September and December 1989. INTERVENTIONS--None. MEASUREMENTS/MAIN RESULTS--Heights and weights were measured and converted to National Center for Health Statistics z scores of weight for age, height for age, and weight for height. Relative to National Center for Health Statistics reference data, mean height-for-age z scores decline progressively after age 2 years to--1.2 z at age 4.5 years. Mean weight-for-height z scores exceeded the National Center for Health Statistics reference significantly at ages 3 and 4 years, and there was more than a fourfold excess of Hmong children beyond the 95th percentile in weight for height at these ages. CONCLUSIONS--There is evidence of early obesity in Hmong children, an ethnic group heretofore considered to be a low risk for obesity.     

Growth performance of Bangladeshi affluent school children (5–14 years)

A cross sectional anthropometric survey of 2045 healthy children (5–14 years) of affluent society of Dhaka City was done with the aim to compare their growth with the National Centre for Health Statistics (NCHS) standard. It was found that both weight and height of boys and girls of the studied children fall between 25th to 50th percentile of NCHS standard. In case of boys, body weight deviates below 25th percentile after 12 years whereas mean height is nearly parallel to 50th percentile upto 14 years. In case of girls, the pattern of growth is same except the fall below 25th percentile at the age of 8 and 9 years and the height remains above 25th percentile upto 12 years. It can be concluded that mean growth of affluent Bangladeshi school children is comparable to NCHS standard with minor variations.     

Prevalence of undernutrition in Santal children of Puruliya district, West Bengal

This study was carried out to determine the prevalence of undernutrition among the Santal children of Puruliya district of West Bengal. 442 Santal children (216 boys and 226 girls) aged 5-12 years were taken from randomly selected schools of Balarampur and Baghmundi areas of Puruliya. Nutritional status was analyzed by Z-score values according to the height for age, weight for age and weight for height reference data of National Center for Health Statistics (NCHS). The prevalence of undernutrition among Santal children was as follows: stunting (17.9%), underweight (33.7%) and wasting (29.4%). Severe (below -3 Z-score) stunting, underweight and wasting were found in 4.98%, 7.92% and 9.51% of Santal children, respectively. In girls, prevalence of stunting (21.7%) and wasting (35.8%) was higher in comparison to boys (13.8% stunting and 22.7% wasting).     

Evaluation of the nutritional status of 1st-year school children in Campinas, Brazil.

We present findings from a study of nutritional status amongst 1st year primary school children in Brazil. The study was based on a 10% stratified random sample of children in Campinas, Sao Paulo State. The primary schools in the city were grouped into four socio-economic strata (high, medium, low and very low) based on the type of school maintenance (private or maintained by the local or by the State government) and the socio-economic characteristics of the school's catchment area. The nutritional status of 1942 children was assessed by looking at the distributions of z-scores of weight-for-age, height-for-age and weight-for-height in relation to growth charts of the National Center for Health Statistics reference population. In the overall population, 22% of the children were found to be stunted (z-score of height-for-age less than -1.0), 15% wasted (z-score of weight-for-height less than -1.0), 22% underweight (z-score of weight-for-age less than -1.0) and 5% overweight (z-score of weight-for-height greater than 2.0). These figures represent an excess of 6% of stunted children and also 6% of underweight children in comparison with the expected values in the NCHS reference population, and an excess of 2% overweight. The data were analysed by age, sex, ethnic group and socio-economic level. Both stunting and low weight-for-age were observed in 32% of children from the very low socio-economic level, with the highest percentages amongst the oldest children. A total of 11.6% of children from the high socio-economic stratum were obese. These results emphasize the need for different programmes to deal with nutritional problems in different groups of the population.     

Growth of normal urban black Southern African children aged 6-19 years

Height-for-age, weight-for-age, weight-for-height, and height gain were studied in two-thousand normal urban black Southern African schoolchildren from Umtata, Republic of Transkei, Southern Africa. The height-for-age data in the present study were less than those of the USA National Centre for Health Statistics (NCHS) data and the overall distribution of height for age was between the 3rd and 75th percentiles of NCHS. In boys, after the age of 13 years, the weight-for-age data in the present study were statistically less than NCHS and the overall distribution of weight-for-age data was between the 10th and 75th percentiles of NCHS. The weight for height in the present study was slightly greater than NCHS and the overall distribution of weight for height data was between 25th and 90th percentiles of NCHS. Adolescent growth spurt occurred in girls at the age of around 11 years, while in boys it occurred around 12 years. The mean duration of the pubertal period was 2 years for boys and girls. Peak height velocity (PHV) was 7.7 and 7.9 cm/year in boys and girls, respectively. The present study may be used a source of reference for urban black schoolchildren in Africa.     

Growth patterns of first-generation Southeast Asian infants

The growth patterns of Southeast Asian infants appear to differ from those of the National Center for Health Statistics standards for US children. This study examines the length, weight, and head circumference curves of 175 healthy, full-term, US-born Laotian and Cambodian infants seen periodically at a pediatric clinic from birth to 18 months of age. The median length, weight, and head circumference values of these infants were significantly lower than those of the National Center for Health Statistics standards for infants older than 6 months. These differences were more striking in girls than boys. A decision to observe rather than to pursue a diagnostic work-up in an otherwise healthy Southeast Asian infant who exhibits a slow growth pattern may be the most appropriate management style.     

First growth reference curves for Tunisian children and adolescents

A growth chart is a powerful graphical tool displaying children's growth patterns. The aim of this study was to develop growth reference curves appropriate for Tunisian children. The collection of data from this cross-sectional study was conducted on 4358 healthy subjects (2182 girls and 2176 boys) in three pediatric centers and 15 schools. Smoothed growth curves were estimated using the LMS method. The smoothed percentile curves for height, weight, sitting height (SH), and leg length (LL) increase rapidly during the 1st years of life and then progress slowly until 18 years. However, the sitting height-to-height ratio (SHTHR) curves decrease sharply before the age of 4 and then stabilize in both sexes. In addition, the comparison between boys and girls indicated that the values are very similar at most ages. Except during puberty, the values in boys increase (P < 0.0001) for the weight, height, SH, and LL parameters and decline (P < 0.0001) in the SHTHR compared to the values in girls. The growth rate curves presented two remarkable velocity peaks: the first appears during the 1st years of life and the second at puberty. Height gains at the last stage of growth (puberty) are around 15.45% of final height for boys and 15.52% for girls. This study showed a number of discrepancies for certain age groups when comparing the median weight and height values with those of the World Health Organization, the National Center for Health Statistics, and Algerian references in both sexes. Conclusion: The smoothed percentile curves for weight and height will be useful to access the general growth of Tunisian children. Furthermore, the SH, LL, and SHTHR curves can be used to monitor body proportions during childhood.     

What Can Providers Learn From Childhood Body Mass Index Trajectories: A Study of a Large,Safety-Net Clinical Population

ObjectiveTo describe childhood weight gain using body mass index (BMI) z-score trajectories in a low-income urban safety-net population and identify among gender- and race/ethnicity-specific groups any trends for increased risk.MethodsA retrospective cohort study was conducted among 2- to 12-year-old patients (2006–2013) visiting a safety-net provider. BMI z-score trajectories were calculated overall, for gender- and race/ethnicity-specific groups, and for peak BMI percentile subgroups to describe weight gain longitudinally.ResultsFrom 2006 to 2013, a total of 26,234 eligible children were followed for an average of 3.7 years. At baseline (mean age, 4.2 years), 74% of patients were at a normal weight compared to 65% at most recent observation (mean age, 7.8 years). All gender and race/ethnicity subgroups showed increasing average BMI z-scores during childhood. Children consistently under the 50th percentile and those of white race had the most stable BMI z-score trajectories. BMI z-score increased with increasing age in all subgroups. Hispanic boys and black girls had the most significant increase in BMI z-score during this observation period. Children observed in early childhood and whose BMI exceeded the 95th percentile at any time were often already overweight (20%) or obese (36%) by 3 years of age.ConclusionsThe entire population demonstrated an upward trend in BMI z-score trajectory. This trend was most notable among black girls and Hispanic boys. Many obese children were already overweight by age 3, and persistence of obesity after 3 years of age was high, suggesting that intervention before age 3 may be essential to curbing unhealthy weight trajectories.     

Ethnic group differences in overweight and obese children and young people in England: cross sectional survey.

AIMS: To determine the percentage of children and young adults who are obese or overweight within different ethnic and socioeconomic groups. METHODS: Secondary analysis of data on 5689 children and young adults aged 2-20 years from the 1999 Health Survey for England. RESULTS: Twenty three per cent of children (n = 1311) were overweight, of whom 6% (n = 358) were obese. More girls than boys were overweight (24% v 22%). Afro-Caribbean girls were more likely to be overweight (odds ratio 1.73, 95% CI 1.29 to 2.33), and Afro-Caribbean and Pakistani girls were more likely to be obese than girls in the general population (odds ratios 2.74 (95% CI 1.74 to 4.31) and 1.71 (95% CI 1.06 to 2.76), respectively). Indian and Pakistani boys were more likely to be overweight (odds ratios 1.55 (95% CI 1.12 to 2.17) and 1.36 (95% CI 1.01 to 1.83), respectively). There were no significant differences in the prevalence of obese and overweight children from different social classes. CONCLUSION: The percentage of children and young adults who are obese and overweight differs by ethnic group and sex, but not by social class. British Afro-Caribbean and Pakistani girls have an increased risk of being obese and Indian and Pakistani boys have an increased risk of being overweight than the general population. These individuals may be at greater combined cumulative risk of morbidity and mortality from cardiovascular disease and so may be a priority for initiatives to target groups of children at particular risk of obesity.     

Ethnic group differences in overweight and obese children and young people in England: cross sectional survey

Aims: To determine the percentage of children and young adults who are obese or overweight within different ethnic and socioeconomic groups. Methods: Secondary analysis of data on 5689 children and young adults aged 2–20 years from the 1999 Health Survey for England. Results: Twenty three per cent of children (n = 1311) were overweight, of whom 6% (n = 358) were obese. More girls than boys were overweight (24% v 22%). Afro-Caribbean girls were more likely to be overweight (odds ratio 1.73, 95% CI 1.29 to 2.33), and Afro-Caribbean and Pakistani girls were more likely to be obese than girls in the general population (odds ratios 2.74 (95% CI 1.74 to 4.31) and 1.71 (95% CI 1.06 to 2.76), respectively). Indian and Pakistani boys were more likely to be overweight (odds ratios 1.55 (95% CI 1.12 to 2.17) and 1.36 (95% CI 1.01 to 1.83), respectively). There were no significant differences in the prevalence of obese and overweight children from different social classes. Conclusion: The percentage of children and young adults who are obese and overweight differs by ethnic group and sex, but not by social class. British Afro-Caribbean and Pakistani girls have an increased risk of being obese and Indian and Pakistani boys have an increased risk of being overweight than the general population. These individuals may be at greater combined cumulative risk of morbidity and mortality from cardiovascular disease and so may be a priority for initiatives to target groups of children at particular risk of obesity.     

Influence of gender, BMI and Hispanic ethnicity on physical activity in children.

OBJECTIVE: The purpose of this study was to examine the association between overweight status and physical activity (PA) among gender and ethnic (Hispanic vs. non-Hispanic) sub-groups in elementary school-age children. METHODS: PA was assessed over five days using the Actigraph accelerometer in 169 fourth grade students (mean age 9.4 years; 50% female; 63% Hispanic; and 43% overweight, defined as body mass index, BMI > or = 85th percentile for age and gender) from four elementary schools in Los Angeles County, California. RESULTS: In the total sample, boys and normal weight students had higher levels of total PA (counts per minute, cpm; p<0.05). Boys spent less time in sedentary PA (p=0.02) and more time in combined moderate to vigorous PA (MVPA, p=0.01). There was a significant gender, ethnicity, and overweight interaction for total PA and MVPA (both p<0.01). MVPA and counts per minute were significantly lower in overweight non-Hispanic girls and Hispanic boys (p<0.05) and marginally lower in overweight non-Hispanic boys (p=0.10) when compared with non-overweight students, while overweight Hispanic girls were more physically active than Hispanic non-overweight girls, though the difference was non-significant (p>0.05). CONCLUSIONS: Data from the present study does not consistently support the prevailing hypothesis that overweight subjects engage in less PA. Results show overweight students engage in less PA than non-overweight students, with the exception that non-overweight Hispanic girls do not engage in more PA than their overweight peers. These results suggest the need for further investigation into the role that ethnicity and overweight status plays in PA levels, particularly among ethnic and gender sub-groups.     

Timing of growth faltering in rural Malawi.

AIM: To determine the timing of growth faltering among under 3 year old children. METHODS: Prospective population based cohort study in Lungwena, rural Malawi, southeast Africa. A total of 767 live born babies were regularly visited from birth until 3 years of age. Weight, height, and mid upper arm circumference were measured at monthly intervals until 18 months and at three month intervals thereafter. Growth charts were constructed using the LMS method and comparisons made to two international databases: the traditional United States National Center for Health Statistics/World Health Organisation (NCHS/WHO) reference and the recently developed 2000 Centers for Disease Control (CDC) growth reference. RESULTS: Compared to the 2000 CDC reference population, newborns in Lungwena were on average 2.5 cm shorter and 510 g lighter. On a population level, height faltering was present at birth and continued throughout the first three years. Weight faltering, on the other hand, occurred mainly between 3 and 12 months of age. At 36 months, the mean weight and height of the study children were 2.3 kg and 10.5 cm lower than those of the reference population, respectively. The results remained essentially similar when the comparisons were made to the NCHS/WHO reference. CONCLUSIONS: The fact that weight and height faltering do not follow identical time patterns suggests that they may have different origin and determinants. Further studies on the aetiology of height faltering and different approaches to preventive interventions are needed.     

Timing of growth faltering in rural Malawi

Aim: To determine the timing of growth faltering among under 3 year old children. Methods: Prospective population based cohort study in Lungwena, rural Malawi, southeast Africa. A total of 767 live born babies were regularly visited from birth until 3 years of age. Weight, height, and mid upper arm circumference were measured at monthly intervals until 18 months and at three month intervals thereafter. Growth charts were constructed using the LMS method and comparisons made to two international databases: the traditional United States National Center for Health Statistics/World Health Organisation (NCHS/WHO) reference and the recently developed 2000 Centers for Disease Control (CDC) growth reference. Results: Compared to the 2000 CDC reference population, newborns in Lungwena were on average 2.5 cm shorter and 510 g lighter. On a population level, height faltering was present at birth and continued throughout the first three years. Weight faltering, on the other hand, occurred mainly between 3 and 12 months of age. At 36 months, the mean weight and height of the study children were 2.3 kg and 10.5 cm lower than those of the reference population, respectively. The results remained essentially similar when the comparisons were made to the NCHS/WHO reference. Conclusions: The fact that weight and height faltering do not follow identical time patterns suggests that they may have different origin and determinants. Further studies on the aetiology of height faltering and different approaches to preventive interventions are needed.     

Body mass index is different in normal Chinese and Caucasian infants.

Body mass index (BMI) is one of the anthropometric measurements for assessing nutritional status, body composition and adiposity in children. Racial differences in BMI between black and white children and adolescents have been shown in several studies. The aim of this study was to determine whether an ethnic difference in BMI exists between Chinese and Caucasian children in the first two years of life. The BMI of Chinese and Caucasian infants was compared so as to assess the usefulness of the National Center for Health Statistics (NCHS) growth reference data in the assessment of nutritional status of Chinese children. Mean weight, length and BMI were compared between six cohorts of Chinese children and five cohorts of Caucasian children together with the NCHS growth reference data. The changes in the mean BMI curves during the first two years of life in the two ethnic groups were entirely different but the different cohorts in the same ethnic groups displayed a similar pattern of change with age. The difference in change in BMI in the Chinese cohorts was related to the difference in change in their mean weight as compared to the NCHS weight-for-age reference data. In contrast, the change in mean length of the well-nourished Hong Kong Chinese children in the present study followed the mean NCHS height-for-age values. The results of this study suggest that linear growth would be better for the assessment of health and nutrition in infancy and early childhood. If BMI and weight-for-height standards were to be used then an ethnic group-specific and population based reference data set should be used.     

Does disadvantage start at home? Racial and ethnic disparities in health-related early childhood home routines and safety practices

BACKGROUND: Little is known about whether racial/ethnic differences exist in household family activities, safety practices, and educational opportunities known to impact young children's healthy development and school success. OBJECTIVE: To examine whether racial/ethnic disparities exist in early childhood home routines, safety measures, and educational practices/resources. METHODS: The 2000 National Survey of Early Childhood Health is a telephone survey of a nationwide sample of parents of 2608 children aged 4 to 35 months. Differences in family activities, safety measures, and educational practices/resources were examined for white, black, and Hispanic children. RESULTS: Minority children are less likely than white children to have consistent daily mealtimes and bedtimes, and more frequently never eat lunch or dinner with their family. Minority parents are less likely to install stair gates or cabinet safety locks and to turn down hot water settings. Minority parents less often read daily to their child, Hispanic parents more often never read to their child, and minority households average fewer children's books. Black children average more hours watching television daily. Disparities persisting in multivariate analyses included: minority children having increased odds of never eating lunch or dinner with their family, black children not having regular mealtimes (odds ratio, 1.8; 95% confidence interval, 1.2-2.7) and watching 1 more hour of television daily, black parents not installing cabinet locks, minority parents having twice the odds of not installing stair gates and not reading to their child daily, and minority homes having fewer children's books (black homes, -30; and Hispanic homes, -20). Children whose parents completed surveys in Spanish also experienced several disparities. CONCLUSIONS: Young minority children experience multiple disparities in home routines, safety measures, and educational practices/resources that have the potential to impede their healthy development and future school success. Such disparities might be reduced or eliminated through targeted education and intervention by pediatric providers.     

中国0~18岁儿童青少年坐高和下肢长生长参照标准值及生长曲线

背景：坐高和下肢长是线性生长评价中的有用指标,但我国儿童青少年这两个指标的生长参照标准值及标准化生长曲线并未完整公布。 目的：研究和制定中国儿童青少年坐高和下肢长的生长参照标准及曲线,供临床医学及其他相关领域参照使用。 设计：横断面调查。 方法：采用2005年“中国九市7岁以下儿童体格发育调查”和“全国学生体质与健康调研”中九省（市）城区92 494名0~18岁健康儿童青少年的身高和坐高测量数据,以身高减去坐高计算获得下肢长,应用LMS方法制定坐高（顶臀长）和下肢长的生长参照标准值及标准化生长曲线。 主要结局指标：坐高和下肢长的生长参照标准值。 结果：①建立了0~18岁男、女童坐高和下肢长的百分位和标准差单位参照标准值,并绘制了两项指标的标准化生长曲线。②坐高生后第1年增长约14 cm,第2和3年分别增长约6 cm和4 cm,之后每年以2~3 cm幅度稳定增长,男童11~13岁、女童9~11岁坐高增速略提高,之后增速减慢,男童17岁、女童15岁基本停止增长。③下肢长生后第1年增长11~12 cm,第2年增长约6.5 cm,2~5岁以每年4~5 cm幅度增长,之后每年以3~4 cm增长,男、女童分别在15岁和13岁基本停止增长。 结论：建立的坐高和下肢长的生长参照标准值与标准化生长曲线,进一步完善了我国儿童青少年生长发育评价标准的指标体系。