Anthropometric changes in children and adolescents from 1965 to 2005 in Korea

The aim of this study was to assess the secular growth changes in Korean children and adolescents during the last four decades. In 2005, 68,790 boys and 62,557 girls were recruited for this study across the nation in 2005. Anthropometric data (weight, height, etc.) were measured. We compared the results of previous nationwide growth studies with this study. The results of this survey indicate that the growth and developmental status of Korean children and adolescents has been changed substantially compared with those in 1965, 1975, 1984, and 1997. The data presented in this study show a distinct secular increase in growth in body height and weight of Korean children and adolescents spanning this period. A nationwide survey every 5 years would be beneficial to establish a reference standard for the growth of children and adolescents according to the socioeconomic, environmental, and nutritional changes.     

Construction of a New Growth References for China Based on Urban Chinese Children: Comparison with the WHO Growth Standards

Introduction

Growth references for Chinese children should be updated due to the positive secular growth trends and the progress of the smoothing techniques. Human growth differs among the various ethnic groups, so comparison of the China references with the WHO standards helps to understand such differences.

Methods

The China references, including weight, length/height, head circumference, weight-for-length/height and body mass index (BMI) aged 0–18 years, were constructed based on 69,760 urban infants and preschool children under 7 years and 24,542 urban school children aged 6–20 years derived from two cross-sectional national surveys. The Cole’s LMS method is employed for smoothing the growth curves.

Results

The merged data sets resulted in a smooth transition at age 6–7 years and continuity of curves from 0 to 18 years. Varying differences were found on the empirical standard deviation (SD) curves in each indicator at nearly all ages between China and WHO. The most noticeable differences occurred in genders, final height and boundary centiles curves. Chinese boys’ weight is strikingly heavier than that of the WHO at age 6–10 years. The height is taller than that of the WHO for boys below 15 years and for girls below 13, but is significantly lower when boys over 15 years and girls over 13. BMI is generally higher than that of the WHO for boys at age 6–16 years but appreciably lower for girls at 3–18 years.

Conclusions

The differences between China and WHO are mainly caused by the reference populations of different ethnic backgrounds. For practitioners, the choices of the standards/references depend on the population to be assessed and the purpose of the study. The new China references could be applied to facilitate the standardization assessment of growth and nutrition for Chinese children and adolescents in clinical pediatric and public health.     

Secular Trends in Growth and Nutritional Status of Mozambican School-Aged Children and Adolescents

Objectives

The purpose of this study was to examine secular changes in growth and nutritional status of Mozambican children and adolescents between 1992, 1999 and 2012.

Methods

3374 subjects (1600 boys, 1774 girls), distributed across the three time points (523 subjects in 1992; 1565 in 1999; and 1286 in 2012), were studied. Height and weight were measured, BMI was computed, and WHO cut-points were used to define nutritional status. ANCOVA models were used to compare height, weight and BMI across study years; chi-square was used to determine differences in the nutritional status prevalence across the years.

Results

Significant differences for boys were found for height and weight (p<0.05) across the three time points, where those from 2012 were the heaviest, but those in 1999 were the tallest, and for BMI the highest value was observed in 2012 (1992<2012, 1999<2012). Among girls, those from 1999 were the tallest (1992<1999, 1999>2012), and those from 2012 had the highest BMI (1999<2012). In general, similar patterns were observed when mean values were analyzed by age. A positive trend was observed for overweight and obesity prevalences, whereas a negative trend emerged for wasting, stunting-wasting (in boys), and normal-weight (in girls); no clear trend was evident for stunting.

Conclusion

Significant positive changes in growth and nutritional status were observed among Mozambican youth from 1992 to 2012, which are associated with economic, social and cultural transitional processes, expressing a dual burden in this population, with reduction in malnourished youth in association with an increase in the prevalence of overweight and obesity.     

Nutritional status of adolescents in the context of the Moroccan nutritional transition: the role of parental education

In Morocco, the beginning of the nutritional transition is closely linked to social and economic transformations and changes in behaviour and traditional lifestyles. The objective of this study is to describe the current pattern of food consumption and the nutritional status of adolescents in the province of Ouarzazate and its association with parents' educational level. The sample comprises 327 high school students from Ouarzazate: 135 (41.3%) boys and 192 (58.7%) girls (age range 15-20 years). For both boys and girls, the results show lower height and BMI z-scores than the WHO reference values. Adolescents whose parents have a low educational level have lower height/age and BMI/age z-scores than those whose fathers have a high educational level. No differences are observed in total daily energy intake depending on fathers' educational level, but the energy provided by lipids is higher in adolescents whose fathers have a high educational background. The quality of fats consumed (MUFA+PUFA/SFA) is better among those boys whose fathers have low education, but no differences are observed for girls. The process of nutritional transition is not uniform in the sample, but depends on the socioeconomic characteristics of population groups, which include, among others, accessibility of certain food, differences in habits and lifestyles related to energy expenditure, and higher prevalence of overweight and obesity in more favoured groups.     

Childhood malnutrition and growth in a rural area of Western Kenya

An anthropometric survey was carried out on 1,383 school students aged 5-17 years in Suba district (a rural area of western Kenya). Body size and proportion were computed from height, weight, sitting height, arm circumference, and skinfolds. The aim of the study was to evaluate patterns of growth and nutritional status of the Luo population by assessment of the prevalence and trends of malnutrition among children and adolescents. Very few age-groups show significant sex differences for height, body weight, and arm muscle area. However, there are several differences in skinfold thicknesses and arm circumference, always with higher mean values in girls. Analysis of the nutritional status (weight-for-age, height-for-age, and BMI-for-age) shows significant differences among the age-groups in both sexes. Boys present lower Z-scores than girls and there are higher percentages of malnourished subjects (stunted and underweight) among the males. The Luo data were compared with those of other African populations. Their body dimensions, nutritional status, and growth are similar to those of the other sub-Saharan samples. In conclusion, the Luo children are generally undernourished at the older ages: adolescents (11-16 years of age) show the most severe undernutrition and the highest percentages of undernourished subjects. In addition to the higher risk of undernutrition in teenagers, an emerging problem of over-nutrition is evident among the younger age-groups, with a higher prevalence in females. These findings are discussed in light of sexual dimorphism in sensitivity to adverse environmental conditions.     

Body composition, weight status, body image and weight control practices among female adolescents from eastern Austria

The prevalence rates of obesity, but also of altered eating behaviour up to clinically manifested eating disorders have increased dramatically during the last years. In the present study the weight status, body composition and eating behaviour as well as weight controlling strategies of 1752 female adolescents ageing between 12 and 18 years (x=14.6) from Eastern Austria were documented. Furthermore, data regarding socioeconomic status and educational level of the probands were collected. It could be shown, that a higher educational level or a higher socioeconomic status was associated with a significantly lower fat percentage and a significantly lower prevalence of overweight and obesity. Underweight and severe underweight was predominantly found among girls ageing between 15 and 18 years of higher educational level. Weight controlling behaviour such as stepping on scale and altered or restricted eating behaviour was widespread among the probands, independent of weight status and socioeconomic parameters. Body weight and shape concerns were also found very frequently independent of educational level. The results of the present study corroborate the findings of former investigations, that disturbed eating behaviour and concerns regarding body weight and shape are found among all socioeconomic groups.     

Menarcheal onset is associated with body composition parameters but not with socioeconomic status

In the present study the menarcheal status (pre-or postmenarcheal), body composition, weight status, and socioeconomic parameters such as type of school and parental educational level as of 1752 female adolescents ageing between 12 and 18 years (x = 14.6) from rural areas of Eastern Austria were documented. Furthermore the association patterns between body composition, socioeconomic parameters and menarcheal status were analyzed. It turned out, that body composition parameters such as BMI, lean body mass and absolute and relative fat mass were significantly associated with menarcheal status. Postmenarcheal girls were taller and exhibited a higher weight status, a higher absolute and relative amount of fat mass and a higher amount of lean body mass than their premenarcheal counterparts of the same age. In contrast to the significant association between body composition and menarcheal status, no significant impact of educational level on menarcheal status, indicating socioeconomic status could be documented.     

Reference values for height, weight and body mass index of German born Turkish children

Turkish children and adolescents born in Northern Europe grow different from native Northern European children, but reference values for height, weight and BMI for these children do not exist. With this study, we intend to provide growth standards for German born Turkish children. Data were obtained from 797 Turkish children and adolescents born in Germany age 0-25.8 years (males), respectively 0-18.3 years (females). We generated synthetic reference values for height, weight, and BMI. The results show that Turkish children and adolescents are heavier after the age of 6 years, and that they remain short after puberty. Eighteen year old Turkish men, and 15-year-old Turkish women are shorter (males 175.2 cm vs. 180.4 cm, p < 0.05; females 159.3 cm vs. 165.0 cm, p < 0.05), and heavier than Germans. Six out of 53 young Turkish men and 9 out of 100 young Turkish women were obese. Twelve out of 53 young Turkish men (23%) and 18 out of 100 young Turkish women (18%) have fallen below the 3rd centile for height. It can be concluded that growth of Turkish children and adolescents born in Germany significantly differs from native children. Reference LMS values for body height, weight and BMI of German born Turkish boys and girls are presented.     

Growth and development in school-age children from Rostov region,Russia: Comparison between urban and rural settings

The purposes of the current study were: (1) to describe growth and physical development and establish norms for schoolchildren from Rostov region in Russia; (2) to compare major characteristics of development between urban and rural children by sex and age.Nearly 200,000 children (198,712) aged between 7 and 17 years from 232 urban and rural schools of Rostov region (Southern Federal District of Russia) participated in the study. School age is a period of intensive growth and physiological and psychological development. Irregularities of personal development are caused by a multitude of factors, such as sex differences, heredity, socio-economic status of a family, standard of living, particular environmental conditions, and lifestyle.It has been established that children from the Southern Federal District of Russia had body mass index values higher than age-appropriate norms for all Russians (Total Russian, Rudnev et al., 2014) and World Health Organization charts. Children from urban settings were taller and heavier than children from rural settings.Sex is one of the most influential factors which play key role in determining specific characteristics of growth and personal development. According to our results, boys and girls both had similar age-related changes in weight and height, but their respective dynamics differed. Girls’ height and weight values accelerated at the age 10 to 12 years and plateaued after the age fourteen, whereas in boys height and weight steadily increased with age, showing slight acceleration at the age 12 to 13 years, and reached a plateau by the age of seventeen.     

Technical note: comparison of the Maresh reference data with the who international standard for normal growth in healthy children

The Maresh reference data on stature and long bone lengths in a sample of healthy middle-class children from Denver, Colorado [Maresh: Am J Dis Child 66 (1943) 227-257; Maresh: Am J Dis Child 89 (1955) 725-742; Maresh: Human growth and development (1970) p 155-200], have been used extensively by biological anthropologists to estimate juvenile age and body size using skeletal elements and to assess growth in skeletal series from different ethnic populations or archaeological cultural groups. How well these data reflect the potentially diverse growth patterns of healthy human populations from different geographic areas is unknown. Similarly, the efficacy of using the Maresh reference data to estimate stunting prevalence in prehistoric populations is unknown. This report presents the results from a comparison of the Maresh data on supine length and standing height to the World Health Organization (WHO) international child growth standard. The WHO growth standard is meant to depict typical human growth under optimal conditions and can be used to assess children worldwide, regardless of ethnicity and socioeconomic status. The results from this comparison indicate that although the Maresh reference data generally conform to the WHO standard, reflecting a normal human growth pattern, and therefore serve as a suitable reference for comparative studies of growth patterns, these reference data are not suitable for estimating stunting prevalence.     

Waist circumference percentiles in children and adolescents between 6 and 14 years from Santiago,Chile

ObjectiveTo describe the percentile distribution of waist circumference (WC) by sex and age in a representative sample of children and adolescents of lower-middle and low socioeconomic status in Santiago, Chile.MethodsA cross-section of 3022 primary-school students between the ages of 6 and 14 from middle-low and low-class schools of Santiago. Ten schools from the Primary Education Society (SIP) in Santiago, Chile, were selected at random. WC was measured under standardized procedures as instructed by the WHO (midpoint between lower costal margin and iliac crest). The population was categorized between percentiles 10 and 90 and divided by sex and age.ResultsWC tends to increase with age in both males and females, but no significant differences were found in the percentiles by age for boys and girls at any age range (p > 0.05). In our sample, comparing Chilean children with other populations (British, Australian, European-American, African-American, Mexican – American and Colombian), Chilean children have shown a significantly greater WC (p < 0.05).ConclusionsWe present new WC reference values for Chilean children according to sex and age from a representative sample of Chilean population. These can be considered as a new anthropometric assessment tool for estimating cardiometabolic risk in Chilean children.     

Correlation of parental socioeconomic status indicators with morphological and motor dimensions of preschool children

Measuring instruments for assessment of parental socioeconomic status, anthropometric characteristics and motor abilities were used in a sample of 643 preschool children aged 4-6 years and their parents, recruited from preschool institutions in several towns in Voivodina, Serbia. The aim was to analyze the correlation of parental socioeconomic status indicators with morphological and motor dimensions of preschool children. Study results showed the socioeconomic status of the children's families to be relatively homogeneous, with no statistically significant differences in any of the socioeconomic status indicators between families with male and female children. Male and female children differed significantly in the overall space of anthropometric and motor variables, and to a lesser extent in individual variables. The general morphological factor treated as the children's growth and development, and general motor factor were qualitatively comparable. The correlations of socioeconomic factor with general morphological and motor factors of the children were not statistically significant, with the exception of motor factor in 6-year-old male children, at elementary school enrolment. Study results suggested the differences in biological growth and development and motor development recorded in preschool children from Voivodina, Serbia, to be attributable to hereditary factor rather than socioeconomic and environmental factors. Inclusion of older children and use of more socioeconomic status indicators along with some additional indicators should probably yield more reliable results on the issue.     

哈萨克族学生体质发育状况的10年比较分析

报道新疆阿勒泰地区1995年2589名城镇7—18岁哈萨克族(哈族)中小学生身高、体重、胸围、坐高、肩宽、骨盆宽6项体质发育指标的调查结果。男女生体质发育指标随年龄增加而增长,各项指标的年均增长值皆为男生大于女生。与1985年比较,哈族学生的身高、体重、胸围皆有不同程度增长。哈族男女生的身高突增年龄仍分别为14岁和10岁,但是其身高增长却不伴有相应比例的坐高增长,女生部分年龄组的肩宽和男女生各年龄组的骨盆宽呈现负增长,提示哈族学生的体型与10年前相比已经开始有所改变。     

Brazilian Pediatric Reference Data for Quantitative Ultrasound of Phalanges According to Gender,Age, Height and Weight

Aims

To establish normative data for phalangeal quantitative ultrasound (QUS) measures in Brazilian students.

Methods

The sample was composed of 6870 students (3688 females and 3182 males), aged 6 to 17 years. The bone status parameter, Amplitude Dependent Speed of Sound (AD-SoS) was assessed by QUS of the phalanges using DBM Sonic BP (IGEA, Carpi, Italy) equipment. Skin color was obtained by self-evaluation. The LMS method was used to derive smoothed percentiles reference charts for AD-SoS according to sex, age, height and weight and to generate the L, M, and S parameters.

Results

Girls showed higher AD-SoS values than boys in the age groups 7–16 (p<0.001). There were no differences on AD-SoS Z-scores according to skin color. In both sexes, the obese group showed lower values of AD-SoS Z-scores compared with subjects classified as thin or normal weight. Age (r² = 0.48) and height (r² = 0.35) were independent predictors of AD-SoS in females and males, respectively.

Conclusion

AD-SoS values in Brazilian children and adolescents were influenced by sex, age and weight status, but not by skin color. Our normative data could be used for monitoring AD-SoS in children or adolescents aged 6–17 years.     

Trends in the Prevalence of Overweight and Obesity among Chinese Preschool Children from 2006 to 2014

Objective

To examine the trends in the prevalence of overweight and obesity among preschool children from 2006 to 2014.

Methods

A total of 145,078 children aged 3–6 years from 46 kindergartens finished the annual health examination in Tianjin, China. Height, weight and other information were obtained using standardized methods. Z-scores for weight, height, and BMI were calculated based on the standards for the World Health Organization (WHO) child growth standards.

Results

From 2006 to 2014, mean values of height z-scores significantly increased from 0.34 to 0.54, mean values of weight z-scores kept constant, and mean values of BMI z-scores significantly decreased from 0.40 to 0.23. Mean values of height z-scores, weight z-scores, and BMI z-scores slightly decreased among children from 3 to 4 years old, and then increased among children from 4 to 6 years old. Between 2006 and 2014, there were no significant changes in prevalence of overweight (BMI z-scores >2 SD) and obesity (BMI z-scores >3 SD) among 3–4 years children. However, prevalence of obesity (BMI z-scores >2 SD) increased from 8.8% in 2006 to 10.1% in 2010, and then kept stable until 2014 among 5–6 years children. Boys had higher prevalence of obesity than girls.

Conclusions

Mean values of BMI z-scores decreased from 2006 to 2014 among Chinese children aged 3–6 years old due to the significant increase of height z-scores. Prevalence of obesity increased from 2006 to 2010, and then kept stable until 2014 among children aged 5–6 years. The prevalence of obesity was higher in boys than in girls.     

Standards of arm muscle by stature for the assessment of nutritional status of children

This study is based on a sample of 9,134 children ranging in age from 2 to 17 years from which the excessively lean and fat children by skinfold thickness were excluded. This sample was derived from the combined data sets of the first and second National Health and Nutrition Examination Surveys (NHANES I and II) of 1971-1974 and 1976-1980. Means and percentiles of upper arm muscle area were calculated for 3 cm increments in stature from 84 to 184 cm for boys and from 84 to 176 cm for girls. Based on means, Z-score units, and percentile ranges of upper arm muscle area by stature, five operational categories of nutritional status have been established. It is recommended that these standards and this classification system be used to supplement current standards of weight for age and weight for height in order to obtain a more complete assessment of body composition and nutritional status.     

武陵山区苗族儿童少年体质发育

为了探讨武陵山区苗族儿童少年体质发育特征及其规律。本文采用人体测量学的方法 , 对武陵山区苗族儿童少年17项体质发育指标进行测量, 计算11项体质指数。结果表明: 1)苗族儿童少年生长发育的各项指标均值随年龄的增长而增加; 2)苗族男女性的生长发育曲线呈上升趋势并且有交叉现象; 3)苗族男性的身高突增年龄为12-14岁, 女性则为11-13岁; 4)苗族学生的身高均值低于同龄其他民族学生; 5)苗族学生的体质指数年龄变化规律与其他民族基本相似, 但身体各部分的发育程度不相同; 6)苗族学生的维尔维克指数均值高于同龄马山壮族学生。研究显示苗族儿童少年体质发育符合一般生长发育规律, 并有性别差异, 苗族男女生的体质发育相对落后于汉族等其他民族。     

青藏高原与安第斯高原地区儿童青少年的身高、体重和胸围的对比

通过青藏高原和安第斯山高原地区儿童青少年身高、体重和胸围的比对,探讨高原地区儿童青少年生长发育的规律和特点,找出儿童青少年生长发育的高原地区差异,进一步改善高原地区居民的健康状态,促进儿童青少年生长发育,为高原医学和高原人类学的发展提供理论基础。本文以青藏高原和安第斯山高原地区儿童青少年为研究对象。选择在西藏出生长大、经体检证明身体健康6-21岁藏族男女(父母3代藏族)共2813例有效样本(男,1417例;女,1396例),在知情同意情况下直接测量了身高、体重和胸围。印度、秘鲁、玻利维亚、智利等国家和地区儿童青少年生长发育资料从文献中获取。去除不完整的无法比较及年代过于久远的材料,排除小样本及数据不全和不符合要求的样本,严格控制质量。所有测量数据输入SPSS13.0统计软件包。对数据进行描述性统计分析、独立样本t检验、方差分析等统计学处理。结果显示:1)青藏高原儿童青少年男女身高高于安第斯山男女。2)青藏高原儿童青少年的体重与安第斯山儿童青少年相近。3)青藏高原儿童青少年的胸围明显小于安第斯山儿童青少年。高原地区与非高原地区儿童青少年生长发育相比有相似性又有特殊性(如发育水平低,胸径较大,生长发育指标普遍低于WHO(2007)和本国国内水平)。西藏藏族儿童青少年比安第斯山的发育好,两者具有不同的体质特征,这可能与生态环境、高原缺氧、遗传因素和社会经济文化等多种因素有关。     

Trends in Prevalence of Overweight and Obesity in Danish Infants,Children and Adolescents – Are We Still on a Plateau?

Background

After the worldwide steep increase in child and adolescent overweight and obesity during the last decades, there is now evidence of a levelling off in the prevalence in many countries in the Western world.

Aim

To examine whether there still is a plateau in the prevalence of overweight and obesity in Danish children and adolescents, or whether the prevalence is decreasing or rising again.

Methods

The trends in the prevalence rates were based on three data sets providing comparable repeated estimates: 1) the Danish Health Visitors Child Health Database (DHVCHD) with measurements on infant and childhood height and weight from 2002 to 2011 (n up to 39,984), 2) the Danish National Birth Cohort (DNBC) with maternal reports of measured infant and childhood height and weight from 1998 to 2010 (n up to 56,826) and 3) the Danish part of the Health Behaviour in School-aged Children survey (HBSC) with self-reported information on adolescent height and weight from the years 2002 to 2010 (n = 16,557). Overweight and obesity were categorized according to WHO growth standards. Trends were assessed by repeated point estimates and linear regression analyses providing regression coefficients for changes in per cent per year with 95% confidence intervals (CI).

Results

The prevalence rates of overweight and obesity for infants, children and adolescents showed a mixed pattern of decline, stability and increase (ranging from -1.10 through 0.29 per cent per year with CI’s from -3.10 through 2.37). Overall, there were no consistent statistically significant trends upwards or downwards, although some significant downward trends in childhood and adolescence were observed.

Conclusion

This study, based on data from 1998 through 2011, showed that the prevalence rates of overweight and obesity among Danish infants, children and adolescents were largely still on a plateau with tendencies for a decline among children and adolescents.     

Nutritional status and mortality of highland children in Nepal: Impact of sociocultural factors

This study investigates the nutritional status of native children in the highlands of Nepal (1,700–3,000 m) and explores the relationship between child mortality and surviving children's nutritional status. A random sample of 145 households from 11 villages in the Koshi Hill Zone in east Nepal was surveyed, and the nutritional status of the 438 children <14 years of age living in these households was assessed by means of anthropometry. We found a severe growth retardation in the Nepalese children compared to lowland reference groups as well as to highland children from the Andes. Child mortality and altitude are not significantly different between higher (Brahman and Chetri) and lower (Baisya and Sudra) caste households. A lower caste status and higher altitude of the household is associated with a significantly better nutritional status in offspring. In multiple regression analyses, improved nutritional status in children is significantly associated with lower caste (P = 0.001), higher altitude (P = 0.009), and less crowding (P = 0.001) but not with sibling mortality (P = 0.11). We thus conclude that nutritional status of children in households in the highlands of Nepal is associated with the household's socioeconomic status and altitude but not with mortality among siblings. © 1996 Wiley-Liss, Inc.