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Implications of adopting the WHO 2006 Child Growth Standard in the UK: two prospective cohort studies.

Wright C, Lakshman R, Emmett P, Ong KK - Arch. Dis. Child. (2007)

Bottom Line: To assess the potential effect of its use on weight and growth monitoring of UK children.Adoption of the WHO 2006 Growth Charts would set a markedly lower standard of weight gain beyond the age of 4 months for UK infants and could support efforts to avoid future childhood obesity.However, the WHO standard is not representative of size at birth in the UK.

View Article: PubMed Central - PubMed

Affiliation: Division of Developmental Medicine, University of Glasgow, Glasgow, UK.

ABSTRACT

Background: The WHO 2006 Child Growth Standard is based on data from international optimally nourished breastfed infants from birth to age 5 years.

Objective: To assess the potential effect of its use on weight and growth monitoring of UK children.

Participants: Full-term members of two population-based UK birth cohorts: the Children in Focus sub-cohort of the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 1335) and the Gateshead Millennium Baby Study (GMS; n = 923).

Design: Growth data from birth to 5 years were converted into z-scores relative to the WHO 2006 standard.

Results: Compared with the WHO standard, both UK cohorts had higher birth weights (mean z-scores: GMS, 0.17; ALSPAC, 0.34) and ALSPAC had higher birth lengths. After birth, length showed a good fit at all ages. By 2-4 months, both cohorts were similar in weight to the WHO median (mean WHO weight z-score at 4 months: GMS, 0.01; ALSPAC, -0.07), but thereafter the UK cohorts were heavier (mean WHO weight z-score at 12 months: GMS, 0.57; ALSPAC, 0.65). At age 12 months, the risk of being classified as underweight (weight <2nd centile) was considerably lower according to the WHO standard than by the UK 1990 Growth Reference (RR = 0.15, 95% CI = 0.07 to 0.32), and the risk of being classified as obese at 4-5 years (body mass index >98th centile) was slightly increased (RR = 1.35, 95% CI = 1.02 to 1.78).

Conclusions: Adoption of the WHO 2006 Growth Charts would set a markedly lower standard of weight gain beyond the age of 4 months for UK infants and could support efforts to avoid future childhood obesity. However, the WHO standard is not representative of size at birth in the UK.

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Related in: MedlinePlus

Mean z-scores for weight from birth to 24 months and at 4–5 years, according to WHO 2006 Growth Standard (WHO 2006) or the British 1990 Growth Reference (UK 1990) for the Gateshead Millennium Baby Study (GMS) and the Children in Focus sub-cohort of the Avon Longitudinal Study of Parents and Children (ALSPAC). Dotted lines in each panel indicate the time periods with less density of measurements.
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adc-93-07-0566-f01: Mean z-scores for weight from birth to 24 months and at 4–5 years, according to WHO 2006 Growth Standard (WHO 2006) or the British 1990 Growth Reference (UK 1990) for the Gateshead Millennium Baby Study (GMS) and the Children in Focus sub-cohort of the Avon Longitudinal Study of Parents and Children (ALSPAC). Dotted lines in each panel indicate the time periods with less density of measurements.

Mentions: Both cohorts showed a reasonably good fit with the UK 1990 reference during the first year of life, as indicated by mean weight and length z-scores close to zero (table 1 and fig 1). The only exception was a transient decline in weight z-score in GMS at age 12 days, which may be expected, as the UK 1990 reference makes no allowance for the physiological neonatal weight loss. By age 4–5 years, weight and BMI z-scores in both cohorts were higher than the UK 1990 average.


Implications of adopting the WHO 2006 Child Growth Standard in the UK: two prospective cohort studies.

Wright C, Lakshman R, Emmett P, Ong KK - Arch. Dis. Child. (2007)

Mean z-scores for weight from birth to 24 months and at 4–5 years, according to WHO 2006 Growth Standard (WHO 2006) or the British 1990 Growth Reference (UK 1990) for the Gateshead Millennium Baby Study (GMS) and the Children in Focus sub-cohort of the Avon Longitudinal Study of Parents and Children (ALSPAC). Dotted lines in each panel indicate the time periods with less density of measurements.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2532956&req=5

adc-93-07-0566-f01: Mean z-scores for weight from birth to 24 months and at 4–5 years, according to WHO 2006 Growth Standard (WHO 2006) or the British 1990 Growth Reference (UK 1990) for the Gateshead Millennium Baby Study (GMS) and the Children in Focus sub-cohort of the Avon Longitudinal Study of Parents and Children (ALSPAC). Dotted lines in each panel indicate the time periods with less density of measurements.
Mentions: Both cohorts showed a reasonably good fit with the UK 1990 reference during the first year of life, as indicated by mean weight and length z-scores close to zero (table 1 and fig 1). The only exception was a transient decline in weight z-score in GMS at age 12 days, which may be expected, as the UK 1990 reference makes no allowance for the physiological neonatal weight loss. By age 4–5 years, weight and BMI z-scores in both cohorts were higher than the UK 1990 average.

Bottom Line: To assess the potential effect of its use on weight and growth monitoring of UK children.Adoption of the WHO 2006 Growth Charts would set a markedly lower standard of weight gain beyond the age of 4 months for UK infants and could support efforts to avoid future childhood obesity.However, the WHO standard is not representative of size at birth in the UK.

View Article: PubMed Central - PubMed

Affiliation: Division of Developmental Medicine, University of Glasgow, Glasgow, UK.

ABSTRACT

Background: The WHO 2006 Child Growth Standard is based on data from international optimally nourished breastfed infants from birth to age 5 years.

Objective: To assess the potential effect of its use on weight and growth monitoring of UK children.

Participants: Full-term members of two population-based UK birth cohorts: the Children in Focus sub-cohort of the Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 1335) and the Gateshead Millennium Baby Study (GMS; n = 923).

Design: Growth data from birth to 5 years were converted into z-scores relative to the WHO 2006 standard.

Results: Compared with the WHO standard, both UK cohorts had higher birth weights (mean z-scores: GMS, 0.17; ALSPAC, 0.34) and ALSPAC had higher birth lengths. After birth, length showed a good fit at all ages. By 2-4 months, both cohorts were similar in weight to the WHO median (mean WHO weight z-score at 4 months: GMS, 0.01; ALSPAC, -0.07), but thereafter the UK cohorts were heavier (mean WHO weight z-score at 12 months: GMS, 0.57; ALSPAC, 0.65). At age 12 months, the risk of being classified as underweight (weight <2nd centile) was considerably lower according to the WHO standard than by the UK 1990 Growth Reference (RR = 0.15, 95% CI = 0.07 to 0.32), and the risk of being classified as obese at 4-5 years (body mass index >98th centile) was slightly increased (RR = 1.35, 95% CI = 1.02 to 1.78).

Conclusions: Adoption of the WHO 2006 Growth Charts would set a markedly lower standard of weight gain beyond the age of 4 months for UK infants and could support efforts to avoid future childhood obesity. However, the WHO standard is not representative of size at birth in the UK.

Show MeSH
Related in: MedlinePlus