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Title: A comparison of the National Center for Health Statistics and new World Health Organization growth references for school-age children and adolescents with the use of data from 11 low-income countries
Authors: Rousham, Emily K.
Roschnik, Natalie
Baylon, Melba A.B.
Bobrow, Emily A.
Burkhanova, Mavzuna
Campion, M. Gerda
Adle-Chua, Teresita
Degefie, Tedbabe
Hilari, Caroline
Kalengamaliro, Humphreys
Kassa, Tamiru
Maiga, Fadima
Mahumane, Bonifacio J.
Mukaka, Mary
Ouattara, Fatimata
Parawan, Amado R.
Sacko, Moussa
Patterson, David W.
Sobgo, Gaston
Khandaker, Ikhtiar U.
Hall, Andrew
Keywords: Dietetics
Developing countries
Nutrition
Children
Adolescents
Statistics
Issue Date: 2011
Publisher: © American Society of Clinical Nutrition
Citation: ROUSHAM, E.K. ... et al., 2011. A comparison of the National Center for Health Statistics and new World Health Organization growth references for school-age children and adolescents with the use of data from 11 low-income countries. American Journal of Clinical Nutrition, 94 (2), pp. 571-577.
Abstract: BACKGROUND: In 2007 new WHO growth references for children aged 5-19 years were introduced to replace the NCHS references. OBJECTIVE: The study aimed to compare the prevalence of stunting, wasting and thinness estimated by the NCHS and WHO growth references. DESIGN: NCHS and WHO height-for-age z-scores were calculated using cross-sectional data from 20,605 schoolchildren aged 5-17 years in 11 low income countries. The differences in the percentage of stunted children were estimated for each year of age and sex. Z-scores of BMI-for-age and weight-for-height were calculated using the WHO and NCHS references respectively to compare differences in the prevalence of thinness and wasting. RESULTS: No systematic differences in mean z-scores of height-for-age were observed between the WHO and NCHS growth references. However, z-scores of height-for-age varied by sex and age, particularly during early adolescence. Among children for whom weight-for-height could be calculated, the estimated prevalence of thinness (WHO reference) was consistently higher than the prevalence of wasting (NCHS reference) by as much as 9% in girls and 18% in boys. CONCLUSION: In undernourished populations, the application of the WHO (2007) references may result in differences in the prevalence of stunting for each sex compared with using the NCHS references, as well as a higher estimated prevalence of thinness compared with wasting. An awareness of these differences is important for comparative studies or when evaluating programs. For school-age children and adolescents across all ranges of anthropometric status, the same growth references should be applied when undertaking such studies.
Description: The published version of this article is available at: http://dx.doi.org/10.3945/​ajcn.110.008300.
Version: Accepted for publication
DOI: 10.3945/ajcn.110.008300
URI: https://dspace.lboro.ac.uk/2134/15219
Publisher Link: http://dx.doi.org/10.3945/ajcn.110.008300
ISSN: 0002-9165
Appears in Collections:Closed Access (Sport, Exercise and Health Sciences)

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