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United States Department of Agriculture

Agricultural Research Service

Title: Evaluation of the feasibility of international growth standards for school-aged children and adolescents

Authors
item Butte, Nancy
item Garza, Cuthberto - BOSTON COLLEGE
item DE Onis, Mercedes - WHO GENEVA

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: November 14, 2006
Publication Date: January 23, 2007
Citation: Butte, N.F., Garza, C., De Onis, M. 2007. Evaluation of the feasibility of international growth standards for school-aged children and adolescents. Journal of Nutrition. 137(1):153-157.

Interpretive Summary: New international growth standards are needed to monitor the growth and development of school-aged children and adolescents, and to monitor the prevalence of underweight and overweight in populations around the world. The global increase in childhood obesity and the release of a new international growth standard for infants and preschool children by the World Health Organization (WHO) has raised the question of the need for international growth standards for school-aged children and adolescents. The growth patterns of healthy children reared under conditions that support optimal growth and development were taken. A Working Group made recommendations for the development of an international growth standard for children and adolescents. Based on these patterns, growth standards for these age groups should be developed for clinical and public health applications. The impact of this work is that guidelines were recommended for the development of new international growth standards of school-aged children and adolescents.

Technical Abstract: The development of an international growth standard for the screening, surveillance, and monitoring of school-aged children and adolescents has been motivated by 2 contemporaneous events, the global surge in childhood obesity, and the release of a new international growth standard for infants and preschool children by the WHO. If a prescriptive approach analogous to that taken by WHO for younger children is to be adopted for school-aged children and adolescents, several issues need to be addressed regarding the universality of growth potential across populations and the definition of optimal growth in children and adolescents. A working group of experts in growth and development and representatives from international organizations concluded that subpopulations exhibit similar patterns of growth when exposed to similar external conditioners of growth. However, based on available data, we cannot rule out that observed differences in linear growth across ethnic groups reflect true differences in genetic potential rather than environmental influences. Therefore, the sampling frame for the development of an international growth standard for children and adolescents must include multi-ethnic sampling strategies designed to capture the variation in human growth patterns. A single international growth standard for school-aged children and adolescents could be developed with careful consideration of the population and individual selection criteria, study design, sample size, measurements, and statistical modeling of primary growth and secondary ancillary data. The working group agreed that existing growth references for school-aged children and adolescents have shortcomings, particularly for assessing obesity, and that appropriate growth standards for these age groups should be developed for clinical and public health applications.

Last Modified: 10/19/2014
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