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Evaluating C anadian children: WHO , NHANES or what?
Author(s) -
Yasin Abeer,
Filler Guido
Publication year - 2013
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12152
Subject(s) - medicine , national health and nutrition examination survey , demography , cohort , standard score , gerontology , pediatrics , population , statistics , mathematics , environmental health , sociology
Aim The 2006 World Health Organization ( WHO ) growth charts have been widely adopted by C anadian dieticians for growth monitoring of C anadian children rather than the N ational H ealth and N utrition E xamination S urvey ( NHANES III ) reference data. It has been unclear as to which is the most appropriate. Methods We calculated height and weight z‐scores of 3086 consecutive patients (1530 female, 49.6%) aged 0–5 years, attending outpatient clinics at a single tertiary care centre using reference data of the latest NHANES survey and the 2006 WHO growth charts. To address age dependency, data were stratified into age groups. Gender dependency was also investigated. Results Using NHANES III reference intervals, medians of both height z‐score (+0.24) and weight z‐score (+0.32) were significantly non‐zero. The WHO growth charts yielded medians of height z‐score (−0.15) and weight z‐score (+0.36) respectively, also significantly non‐zero. When comparing both reference populations for the entire cohort, C anadian children had significantly different height z‐scores whereas weight z‐scores did not differ. Age classification revealed a significant age dependency with NHANES III charts yielding higher weight z‐scores for up to 8 months and lower z‐scores from 8 to 26 months. No significant differences were observed for older than 26 months. Throughout, height z‐scores were significantly higher with NHANES III charts across all age groups, with a degree of overestimation higher in younger boys than older ones. Conclusion Our results reveal substantial differences between both reference populations and thus interpretation needs to be done with caution, especially when labelling results as abnormal.