Child growth standards

Field-testing the WHO Child Growth Standards in four countries

Onyango AW, de Onis M, Caroli M, Shah U, Sguassero Y, Redondo N, Carroli B.

Journal of Nutrition 2007;137;149-52.


In April 2006 the WHO released a set of growth standards for children from birth to the age of 5 y. Prior to their release, the standards were field-tested in 4 countries. The main objective was to compare children’s length/height-for-age and weight-for- length/height based on the new standards with clinician assessments of the same children.

The study sampled children <5-y–old attending="" well-child="" clinics="" in="" 2="" affluent="" populations="" (argentina="" and="" italy)="" and="" 2="" less-affluent="" ones="" (maldives="" and="" pakistan).="" length/height="" and="" weight="" were="" measured="" by="" doctors="" and="" epidemiologists="" who="" also="" recorded="" a="" clinical="" assessment="" of="" each="" child’s="" length/height="" in="" relation="" to="" age="" and="" weight="" relative="" to="" length/height.="" anthropometric="" indicators="" of="" nutritional="" status="" were="" generated="" based="" on="" the="" who="">

As expected, Pakistan and the Maldives had higher rates of stunting, wasting, and underweight than Italy and Argentina, and the reverse was true for overweight and obesity. Where stunting was prevalent, the children classified as short were a mean <-2 sd="" for="" height-for-age.="" in="" all="" sites,="" the="" children="" classified="" as="" thin="" were="" indeed="" wasted=""><-2 sd="" for="" weight-for-height)="" and="" a="" positive="" association="" in="" trend="" was="" evident="" between="" weight-for-height="" and="" the="" line-up="" of="" groups="" from="" thin="" to="">

The overall concordance between clinical assessments and the WHO standards-based indicators attested to the clinical soundness of the standards.