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Updated: Aug 29, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
[Nutritional status of young children: a comparison among three anthropometric classifications]
1Faculdade de Medicina da Universidade de São Paulo, Area de Pediatria do Centro de Saúde Escola Prof Samuel B Pessoa da FMUSP.
Insights
The Gomez method offers the best accuracy for classifying childhood malnutrition among the tested methods. However, it is not recommended for isolated use, especially in infants under one year old, due to potential misdiagnosis risks.
Area of Science:
- Pediatric Nutrition
- Growth Monitoring
- Nutritional Assessment
Context:
- Accurate nutritional status classification is crucial for early intervention in children under two.
- Existing methods like Waterlow and WHO have limitations in precision.
- Evaluating diagnostic tools is essential for effective public health strategies.
Purpose:
- To compare the diagnostic accuracy of Gomez, Waterlow, and WHO methods for classifying nutritional status in children under two years.
- To assess the predictive values (positive and negative) and agreement coefficients of each method against a gold standard.
- To determine the most reliable method for identifying malnutrition in early childhood.
Summary:
- A study involving 436 infants compared three nutritional status classification methods at 6, 12, 18, and 24 months.
- The Gomez method demonstrated superior positive predictive value (PV+) and negative predictive value (PV-), along with a higher agreement coefficient (K), compared to Waterlow and WHO.
- While Gomez showed better performance, its risk of misdiagnosis, particularly in the first year, precludes its use as a sole diagnostic criterion.
Impact:
- Findings suggest the Gomez method is preferable but requires careful application, especially in infants.
- Highlights the need for refined nutritional assessment tools to minimize misdiagnosis in young children.
- Informs clinical practice and public health policy regarding the most effective methods for early childhood malnutrition screening.
Objective:
to compare the usefulness of the methods proposed by Gomez, Waterlow and W.H.O., to classify the nutritional status of children under 2 years of age.
Method:
the nutritional diagnosis of 436 infants was defined at 6, 12, 18 and 24 months of age, using the three proposed methods. Predictive values, positive (PV+) and negative (PV-), and agreement coefficient (K) were calculated, comparing the nutritional classification of the children on each method with a gold standard of nutritional diagnosis, based on individual growth performance since their birth.
Results:
the three methods showed a good PV-, nearby 0.9, at all tested ages whereas the PV+ and K exhibited lower values. Among the three methods of classification of nutritional status, the method proposed by Gomez achieved the best levels of PV+, PV- and K, at all considered ages, mainly at 18 and 24 months of age.
Conclusions:
the Gomez' method, as an unique criterion, is better than the others, because it has a lower risk of misdiagnosing a case of malnutrition. Nevertheless, this risk is big enough to not recommend its isolated use, mainly during the first year of life,when the risk of a false positive diagnosis of malnutrition is still higher.
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