Referencias de peso, estatura e índice de masa corporal para niñas y niños ecuatorianos de 5 a 19 años de edad / Growth references for weight, height, and body mass index for Ecuadorian children and adolescents aged 5-19 years

Introducción. La evaluación del crecimiento durante la infancia y la adolescencia es un componente fundamental de la atención de salud en todos sus niveles, pues es parte del diagnóstico nutricional y permite la detección oportuna de patologías relacionadas. Ecuador, al no disponer de referencias nacionales de crecimiento, ha adoptado los estándares internacionales de la Organización Mundial de la Salud. El objetivo de este estudio fue construir referencias nacionales de peso, estatura e índice de masa corporal para niños, niñas y adolescentes.Métodos. Se investigaron escolares y adolescentes ecuatorianos entre 5 y 19 años de edad durante 1999 y 2012. Los centilos 3, 10, 25, 50, 75, 90 y 97 de peso, talla e índice de masa corporal fueron estimados por el método LMS para datos transversales, que utiliza la transformación Box-Cox para normalizar la distribución de los datos a cada edad.Resultados. Participaron 5934 sujetos sanos (2788 niños y 3146 niñas). Los niños pesaban más y eran más altos que las niñas. En todos los casos, los valores mostraron un aumento creciente conforme la edad avanzaba. A los 18 años, las diferencias entre sexos promediaron 8 kg y 12,5 cm.Conclusión. Las tablas y curvas producto de este estudio constituyen la primera referencia descriptiva del crecimiento de niños ecuatorianos de 5-19 años. Son un importante instrumento de evaluación nutricional. Su implementación en la atención primaria de salud permitirá complementar el diagnóstico nutricional que, tradicionalmente, se realiza sobre la base de los estándares internacionales de la Organización Mundial de la Salud.

Introduction. The assessment of growth during childhood and adolescence is a critical component of health care at all levels, but it is also part of nutritional status diagnosis and the timely detection of related conditions. Ecuador lacks national growth references, so it has decided to adopt the international standards proposed by the World Health Organization. The objective of this study was to develop national references for weight, height, and body mass index for children and adolescents.Methods. Ecuadorian schoolchildren and adolescents aged 5-19 years were studied between 1999 and 2012. The LMS method for cross-sectional data, which uses the Box-Cox transformation to normalize data distribution at each age, was applied to estimate the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centiles for weight, height, and body mass index.Results. A total of 5934 healthy subjects (2788 boys and 3146 girls) participated. Boys were heavier and taller than girls. In all cases, values increased with age. At 18 years old, the differences between sexes averaged 8 kg and 12.5 cm.Conclusion. The tables and curves obtained with this study are the first descriptive growth references for Ecuadorian children and adolescents aged 5-19 years. They are relevant for nutritional assessment. Their use at the primary level of care will aid in nutritional status diagnosis, which has traditionally been done based on the World Health Organization's international standards.

Growth references for weight, height, and body mass index for Ecuadorian children and adolescents aged 5-19 years. / Referencias de peso, estatura e índice de masa corporal para niñas y niños ecuatorianos de 5 a 19 años de edad.

INTRODUCTION: The assessment of growth during childhood and adolescence is a critical component of health care at all levels, but it is also part of nutritional status diagnosis and the timely detection of related conditions. Ecuador lacks national growth references, so it has decided to adopt the international standards proposed by the World Health Organization. The objective of this study was to develop national references for weight, height, and body mass index for children and adolescents. METHODS: Ecuadorian schoolchildren and adolescents aged 5-19 years were studied between 1999 and 2012. The LMS method for cross-sectional data, which uses the Box-Cox transformation to normalize data distribution at each age, was applied to estimate the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centiles for weight, height, and body mass index. RESULTS: A total of 5934 healthy subjects (2788 boys and 3146 girls) participated. Boys were heavier and taller than girls. In all cases, values increased with age. At 18 years old, the differences between sexes averaged 8 kg and 12.5 cm. CONCLUSION: The tables and curves obtained with this study are the first descriptive growth references for Ecuadorian children and adolescents aged 5-19 years. They are relevant for nutritional assessment. Their use at the primary level of care will aid in nutritional status diagnosis, which has traditionally been done based on the World Health Organization's international standards.

Introducción. La evaluación del crecimiento durante la infancia y la adolescencia es un componente fundamental de la atención de salud en todos sus niveles, pues es parte del diagnóstico nutricional y permite la detección oportuna de patologías relacionadas. Ecuador, al no disponer de referencias nacionales de crecimiento, ha adoptado los estándares internacionales de la Organización Mundial de la Salud. El objetivo de este estudio fue construir referencias nacionales de peso, estatura e índice de masa corporal para niños, niñas y adolescentes. Métodos. Se investigaron escolares y adolescentes ecuatorianos entre 5 y 19 años de edad durante 1999 y 2012. Los centilos 3, 10, 25, 50, 75, 90 y 97 de peso, talla e índice de masa corporal fueron estimados por el método LMS para datos transversales, que utiliza la transformación Box- Cox para normalizar la distribución de los datos a cada edad. Resultados. Participaron 5934 sujetos sanos (2788 niños y 3146 niñas). Los niños pesaban más y eran más altos que las niñas. En todos los casos, los valores mostraron un aumento creciente conforme la edad avanzaba. A los 18 años, las diferencias entre sexos promediaron 8 kg y 12,5 cm. Conclusión. Las tablas y curvas producto de este estudio constituyen la primera referencia descriptiva del crecimiento de niños ecuatorianos de 5-19 años. Son un importante instrumento de evaluación nutricional. Su implementación en la atención primaria de salud permitirá complementar el diagnóstico nutricional que, tradicionalmente, se realiza sobre la base de los estándares internacionales de la Organización Mundial de la Salud.

Growth references for 0-19 year-old Norwegian children for length/height, weight, body mass index and head circumference.

BACKGROUND: Previous growth references for Norwegian children were based on measurements from the 1970s and 1980s. New reference data, collected through the Bergen Growth Study and the Medical Birth Registry of Norway, are presented as LMS values. MATERIALS AND METHODS: A cross-sectional sample of children aged 0-19 years in stratified randomized design measured in 2003-2006 as a part of the Bergen Growth Study (n = 7291) and birth data of children born in 1999-2003 from the Medical Birth Registry of Norway (n = 12 576) was used to estimate the new references by the means of the LMS method. Measurement reliability was assessed by test-rest studies. RESULTS: New references were constructed for length/height, weight, body mass index (BMI) and head circumference. Length/height and weight for children aged 0-4 years were similar to previous Norwegian references, but mean height increased up to a maximum of 3.4 cm in boys and 2.5 cm in girls during the pubertal years. Mean height was similar to (or slightly higher) in comparison with other recent European references. Reliability of the measurements compared well with published estimates. CONCLUSION: Because of the observed secular trends in growth, it is advised to use the new references, which have been endorsed by the Norwegian Department of Health.

Overweight and obesity in Norwegian children: prevalence and socio-demographic risk factors.

AIM: The aim of this study was to estimate the prevalence of childhood overweight and obesity and to identify socio-demographic risk factors in Norwegian children. METHODS: The body mass index of 6386 children aged 2-19 years was compared with the International Obesity Task Force (IOTF) cut-off values to estimate the prevalence of overweight including obesity (OWOB) and obesity (OB). The effect of socio-demographic factors on this prevalence was analysed using multiple ordinal logistic regression analysis in a subsample of 3793 children. RESULTS: The overall prevalence of OWOB was 13.8% (13.2% in boys and 14.5% in girls, p = 0.146), but the prevalence was higher in primary school children aged 6-11 years (17%, p < 0.001). The risk of being OWOB or OB increased in children with fever siblings (p = 0.003) and with lower parental educational level (p = 0.001). There was no association with parental employment status, single-parent families or origin. CONCLUSION: The prevalence of OWOB and OB in Norwegian primary school children is of concern. Socio-demographic factors have pronounced effects on the current prevalence of overweight and obesity in a cohort of Norwegian children. This knowledge could help to work out strategies to reduce the burden of overweight and obesity in children.

Breastfeeding, growth and growth standards: Performance of the WHO growth standards for monitoring growth of Belgian children.

BACKGROUND: In 2006, the World Health Organization published universal growth standards for all children from birth to 5 years of age, based on a sample of breastfed children. AIMS: The present study documented breastfeeding prevalence in the Flemish Growth Survey 2004, and compared growth of exclusively breastfed children in Flanders with local reference charts and WHO growth standards. SUBJECTS AND METHODS: A subset of 3287 children 0-3 years of age from the Flemish reference population was studied. Prevalence and duration of breastfeeding were estimated with the status quo method. SD scores (SDS) of length/height, weight, BMI, and head circumference were plotted by age. RESULTS: Breastfeeding is initiated for 68.2%of children, and approximately 25%were exclusively breastfed until at least 6 months of age. Breastfed children grow according to a typical pattern that deviates from the local reference curve. The average length of breastfed children is reasonably close to the WHO growth standard, but this does not hold for weight, BMI, or head circumference. In Flanders, breastfed children are more comparable to the local reference than to the WHO growth standards. CONCLUSIONS: Growth of breastfed children is similar to the WHO standards for length, but not for other traits. In Flanders, the use of the recent local growth reference is advised for both breastfed and formula-fed children.

[Growth references for Norwegian children]. / Vekstkurver for norske barn.

BACKGROUND: The growth charts currently used in Norway, are based on measurements from the 1970s and 80s. New data are available from the Bergen Growth Study collected in 2003 - 6. In 2006, WHO published international charts for 0-5 year-old children. MATERIAL AND METHODS: New growth charts based on data from the Bergen Growth Study and the Medical Birth Registry of Norway are presented for children aged 0-19 years. These were compared with existing references and with the WHO curves. RESULTS: Norwegian children aged 0-4 years have length, height and weight measurements that are only marginally different from those in the Norwegian growth charts in current use. In older children there has been an increase in the 50-percentile for height up to 3.4 cm in boys and 2.5 cm in girls. For children older than four years, weight for height has increased, especially for the upper percentiles. The percentile lines in the new Norwegian reference are generally positioned above the WHO standard for weight at birth, and for length/height, weight and head circumference in the age group 6 months to 5 years. INTERPRETATION: The secular trends in growth mirror the need for new charts. The fact that Norwegian children differ from the WHO standards may reflect population differences relating to environment or growth potential between the populations.

Growth of children living in the outskirts of Ankara: impact of low socio-economic status.

BACKGROUND: Most studies of the growth of Turkish schoolchildren are limited to large cities and to subjects from high socio-economic background. Very little is known about growth and development of rural, suburban and low socio-economic children in Turkey. AIM: The purpose of this study is to compare height and weight of school-aged children of low socio-economic background with available growth data from high socio-economic strata, and to verify the possible influences of three socio-demographic parameters on their growth. SUBJECTS AND METHODS: The sample consisted of 1,052 girls and 1,223 boys, aged between 7-17 years, living in the outskirts of Ankara, a suburban area of poor socio-economic background. Centile distributions for height and weight were estimated by the LMS-method. ANOVA and Student's t-test were used to compare mean z-scores for height and weight among the various categories of the socio-demographic parameters. RESULTS: Children living in the outskirts of Ankara have lower mean values for height and weight when compared with growth data of upper socio-economic strata children. The differences were most pronounced during adolescence. Skinfolds were higher in girls than in boys at all ages (largest p = 0.007). There was no clear relationship between growth and the number of siblings, the number of rooms in the house, the mother's and father's education, and the father's professional status (p > 0.05), except for the height of girls (p < 0.05). CONCLUSION: It is suggested that the lower growth status of children living in the outskirts of Ankara is attributable to the poor socio-economic status of this suburban population, which has not changed over the past decades. It is postulated that the growth impairment during adolescence might be due to a reduced tempo of growth in these children.

Total pubertal growth and markers of puberty onset in adolescents with GHD: comparison between mathematical growth analysis and pubertal staging methods.

UNLABELLED: Two methods of determining puberty onset (Preece- Baines model 1 (PB1) and Tanner staging) were used to calculate total pubertal growth (TPG) in adolescents with growth hormone deficiency (GHD). PATIENTS AND METHODS: 34 patients (11 girls) met the following inclusion criteria: isolated GHD, >2 years growth hormone therapy prior to puberty onset, regular weight-adjusted GH dosage, known final height (age >21 years or height velocity <0.5 cm/year), no induction of puberty. PB1 was used to define age and height at onset of the pubertal growth spurt ("take-off"). RESULTS: The results (mean +/- SD) were as follows: in girls, mean age at take-off was 9.8 years; 2.0 +/- 1.1 years before breast stage B2. In boys, mean age at take-off was 11.3 years; 1.4 +/- 0.8 years before testes volume >3 ml. Height at take-off was lower than at Tanner stage 2 by 12.4 +/- 7.6 cm in girls and 7.7 +/- 5.3 cm in boys. TPG was thus markedly greater (p < 0.001) using the PB1 method, as compared with Tanner stage2. Peak height velocity was normal. Final height was -0.5 +/- 0.7 SDS in females and -0.4 +/- 0.9 SDS in males. CONCLUSIONS: The method of measuring TPG from take-off is more objective, and has potentially greater implications for GH therapeutics than the Tanner stage method. In our study, 40% of TPG occurred before "breast stage B2" was attained in GHD girls; whereas 23% of TPG occurred before "testes >3 ml" in GHD boys.

On the independence of adult stature from the timing of the adolescent growth spurt.

Longitudinal studies have shown repeatedly that little or no correlation exists between the timing of the pubertal spurt in stature and adult stature (AS). However, the possibility seems to have been overlooked that such near-zero correlations may, at least theoretically, be an artefact resulting from two opposite tendencies that cancel each other out: a hypothetical "biological" tendency for early maturers to end up as slightly shorter adults and a socially induced tendency, resulting from the existence of social gradients in growth, for accelerated maturation to be accompanied by taller A.S. Data of the Wroclaw Growth Study (355 fitted growth curves) were used to see whether making a sample socially more homogeneous produces any increase in the correlation between age at PHV and AS. No such effects were found. Thus the validity of the view is confirmed that genes controlling the timing of the spurt also affect the shape of the growth curve in such a way that the shorter time available for completion of growth in the early maturers is compensated for by a greater intensity of the spurt itself. © 1994 Wiley-Liss, Inc.

Application of growth models in the analysis of pathological growth data: The case of hypophosphatemic vitamin D-resistant rickets.

Growth in height of 16 patients suffering from hypophosphatemic vitamin D-resistant rickets (HR) was analyzed by means of three nonlinear growth models: the Preece Baines function, the JPPS model, and the triple logistic function. The data were purely longitudinal, covering age ranges from childhood to adulthood, with an average of 3 measurements per year. All three models proved to fit the growth pattern of HR patients with the same degree of accuracy as they do for healthy children, indicating that, despite their small height-for-age and their disproportionately short stature, these patients had a quite normal overall shape of their growth pattern. The JPPS model was particularly appropriate to describe the individual growth pattern of these patients, since the fit of this model was quite robust towards the choice of starting values for the numerical least-squares technique, and the model estimated biological variables in a fairly unbiased way. Analysis of the residuals suggested that in 5 of the 16 patients there was evidence of short-term variations in growth rate (mini-spurts), such as have been described in healthy children. © 1993 Wiley-Liss, Inc.

Longitudinal growth in height, weight, and bone age of Guatemalan Ladino and Indian schoolchildren.

Three longitudinal samples of Guatemalan schoolchildren are compared for amounts and rates of growth in height, weight, and bone age. The samples include children of two ethnic backgrounds: Ladinos, Spanish-speaking people of, generally, Western cultural orientation; and Indians, people of Mayan cultural descent. The Indians are of very low socioeconomic status (SES) and attend a public school in a rural village. The Ladinos come from two SES groups living in Guatemala City, one of high SES attending a private school and the other of low SES attending a public school. Graphical and statistical analyses show that for all samples of boys and girls there are generally, significant differences between samples (high SES>low SES>Indian) for amounts of growth in height, weight, and bone age. Boys show significant differences in rates of growth between samples, with the high SES sample growing more rapidly than the two low SES samples. Girls show significant differences in the rate of growth in height, but not in the rate of growth in weight or bone age. For Both boys and girls, rates of growth in height and weight differ more between samples than does rate of Skeltal development. These results demonstrate that (1) SES-related deficits in growth are cumulative during childhood and early adolescence, that (2) rates of growth for boys are, generally, more sensitive to the influence of SES than are the growth rates of girls, and that (3) childhood growth deficits of low SES children of low SES children are likely to carry over into adulthood.