CitationEckhardt, Cara L. & Adair, Linda S. (2002). Differences in Stunting Prevalences Calculated from Two Similar Growth References May Be Large and Inconsistent in Undernourished Children. Annals of Human Biology, 29(5), 566-578.
AbstractBackground: In 2000, the US Centers for Disease Control and Prevention (CDC) released a set of growth references that address limitations of the internationally recommended 1977 National Center for Health Statistics (NCHS) references.
Aim: This study compares length-for-age Z-scores (LA Z-scores), height-for-age Z-scores (HA Z-scores), and age-specific stunting prevalences of undernourished children using the 1977 NCHS versus the 2000 CDC references.
Subjects and methods: Data come from > 2000 children from the Cebu Longitudinal Health and Nutrition Study in the Philippines. Anthropometric data were collected bimonthly from birth to 2 years, at 8.5 and 11.5 years, and at 15 years in girls and 16 years in boys. Z-scores and stunting prevalences are compared between references.
Results: LA Z-scores were generally lower using the 1977 references, and stunting prevalences were higher from 0 to 2 years, with some crossover. Differences in HA Z-scores after 8.5 years of age were inconsistent in both direction and magnitude by reference and sex, with additional crossover.
Conclusions: When applied to an undernourished population, the two references in question perform differently, with inconsistencies in direction and magnitude of Z-scores and stunting prevalences. The 2000 CDC growth references are clearly an improved tool. However, there are challenges inherent in switching to a new reference that will require the attention of researchers and field workers.
Reference TypeJournal Article
Journal TitleAnnals of Human Biology
Author(s)Eckhardt, Cara L.
Adair, Linda S.