A secondary analysis of anthropometric data fromthe 1999 National Food Consumption Survey, usingdifferent growth reference standards

[摘要] INTRODUCTION: The best known reference standards used to evaluate thegrowth and development of infants and children are the 1977 National Centre forHealth Statistics (NCHS) - , the 2000 Centres for Disease Control and Prevention(CDC) - and the World Health Organization (WHO) (2006). The NCHS referencestandards were used to analyse anthropometric data from the 1999 NationalFood Consumption Survey (NFCS). It was anticipated that using the 2000 CDCand the 2006 WHO reference standards may lead to differences in the previouslyestimated prevalences of stunting, wasting, underweight, risk of overweight,overweight and obesity in the study population.AIM: To compare the anthropometric status of children aged 12 - 60 monthswhen using the 1977 NCHS -, the 2000 CDC -, and the 2006 WHO referencestandards.METHODS: A secondary analysis of anthropometric data from the 1999 NFCSwas conducted using different reference standards to compare anthropometricstatus in terms of the prevalences of stunting, wasting, underweight, risk ofoverweight, overweight and obesity. Relationships between anthropometricstatus and other variables such as breastfeeding, maternal education level andtype of housing were explored.RESULTS: The prevalences of stunting, obesity and overweight weresignificantly higher and the prevalence of underweight and wasting were lowerwhen using the 2006 WHO compared to the 1977 NCHS and the 2000 CDC reference standards. A significant relationship was found between weight-forheightand breastfeeding when using any one of the reference standards andbetween BMI-for-age and breastfeeding when using the 2006 WHO referencestandard. A significant relationship was shown between maternal education leveland height-for-age and weight-for-age when using any one of the three referencestandards and a significant association was found between weight-for-height andBMI-for-age and the type of housing when using any of the three referencestandards.CONCLUSIONS: The prevalences of stunting and obesity were higher whenusing the 2006 WHO reference standards compared to the 1977 NCHS and2000 CDC reference standards. This may be due to the linear growth and rate ofweight gain of breastfed infants differing from formula fed infants and the 2006WHO reference made use of the exclusively and predominantly breastfed infantliving under normal healthy conditions as the normative model which is aprescription of how children should not grow and .not an indication of howchildren are growing. In conclusion, the 2006 WHO reference standard must bethe only reference standard used nationally and internationally when assessingthe growth and nutritional status of infants and children.

[发布机构] Stellenbosch University