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Updated: Aug 1, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
A chart to link child centiles of body mass index, weight and height
1Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, UK. tim.cole@ich.ucl.ac.uk
Insights
Calculating a child's body mass index (BMI) centile from weight and height centiles is highly accurate. This method bypasses direct BMI calculation, offering a simpler way to monitor nutritional status.
Area of Science:
- Pediatric endocrinology
- Growth assessment
- Nutritional epidemiology
Background:
- Traditional weight-for-height assessment in children lacks statistical validation and differs from body mass index (BMI) centiles.
- Current methods may not accurately reflect a child's nutritional status compared to BMI.
Purpose of the Study:
- To investigate weight-for-height indices derived from weight-for-age and height-for-age centiles.
- To establish the relationship between these indices and BMI centiles in children.
Main Methods:
- Cross-sectional survey of 40,536 children aged 0-18 years from the 1980 Dutch National Growth Survey.
- Utilized British 1990 and US CDC 2000 growth references.
- Analyzed weight and height centiles as standard deviation scores (SDS), comparing direct BMI centiles with the difference between weight and height centiles.
Main Results:
- BMI centile strongly correlates with weight centile (r=0.77) but weakly with height centile (r=0.1).
- The difference between weight and height centiles shows weak correlation with weight centile (r=0.3) and strong negative correlation with height centile (r=-0.5).
- Multiple regression accurately predicts BMI centile from weight and height centiles, explaining 93-97% of the variance.
Conclusions:
- A child's BMI centile can be accurately calculated from readily available weight and height centiles, simplifying nutritional assessment.
- This method eliminates the need for direct BMI computation or plotting, aiding in monitoring nutritional status over time.
- Comparing weight and height centiles directly is an unreliable measure of weight-for-height and should be avoided.
Background:
Weight for height in children is often assessed by comparing the child's weight-for-age centile with their height-for-age centile. However, this assessment has not been validated statistically, and it differs from the body mass index (BMI) centile.
Objective:
To study indices of weight-for-height based on weight centile-for-age adjusted for height centile-for-age, and to see how they relate to the BMI centile-for-age.
Design:
Cross-sectional survey of data for 40 536 boys and girls aged 0-18 y from the 1980 Nationwide Dutch Growth Survey, using the British 1990 and US CDC 2000 growth references.
Outcome Measures:
Two measures of weight for height: (a) the difference between weight centile and height centile, and (b) BMI centile, with the centiles analysed as SD scores (SDS).
Results:
BMI centile is correlated strongly with weight centile (r=0.77) but weakly with height centile (r=0.1). By contrast the difference between weight centile and height centile is correlated only weakly with weight centile (r=0.3) and strongly negatively with height centile (r=-0.5). BMI centile is predicted to high accuracy by the multiple regression on weight centile and height centile (93-97% of variance explained, s.e.e. 0.2 units).
Conclusions:
A child's BMI centile can be calculated to high accuracy from their weight and height centiles as read off the weight and height charts. This avoids the need to calculate BMI or to plot it on the BMI chart. A chart is provided to simplify this calculation, which works throughout the spectrum of nutritional status. It can also be used to monitor individuals' weight, height and BMI centiles simultaneously as they change over time. However the simpler procedure of comparing weight and height centiles (eg a difference of two or three channel widths) is a poor measure of weight-for-height and should not be used.
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