Trends in Anthropometric Measures Among US Children 6 to 23 Months, 1976–2014

BACKGROUND AND OBJECTIVES: The surveillance of children’s growth reflects a population’s nutritional status and risk for adverse outcomes. This study aimed to describe trends in length-for-age, weight-for-age, weight-for-length, and early childhood weight gain among US children aged 6 to 23 months. METHODS: We analyzed NHANES data from 1976–1980, 1988–1994, 1999–2002, 2003–2006, 2007–2010, and 2011–2014. We estimated z scores < –2 (low) and ≥+2 (high) in comparison with World Health Organization growth standards for each indicator. Weight gain (relative to sex-age–specific medians) from birth until survey participation was estimated. Trends were assessed by low birth weight status and race/Hispanic origin. Race/Hispanic origin trends were assessed from 1988–1994 to 2011–2014. RESULTS: In 2011–2014, the prevalence of low and high length-for-age was 3.3% (SE, 0.8) and 3.7% (SE, 0.8); weight-for-age was 0.6% (SE, 0.3) and 7.0% (SE, 1.1); and weight-for-length was 1.0% (SE, 0.4) and 7.7% (SE, 1.2). The only significant trend was a decrease in high length-for-age (5.5% in 1976–1980 vs 3.7% in 2011–2014; P = .04). Relative weight gain between birth and survey participation did not differ over time, although trends differed by race/Hispanic origin. Non-Hispanic black children gained more weight between birth and survey participation in 2011–2014 versus 1988–1994, versus no change among other groups. CONCLUSIONS: Between 1976–1980 and 2011–2014, there were no significant trends in low or high weight-for-age and weight-for-length among 6- to 23-month-old children whereas the percent with high length-for-age decreased. A significant trend in relative weight gain between birth and survey participation was observed among non-Hispanic black children.