Using the new World Health Organisation growth standards: differences from 3 countries

Area of Science:

• Pediatric Nutrition
• Growth Monitoring
• Public Health Research

Background:

• Child nutritional status assessment relies on growth references.
• Previous references (NCHS/WHO) were based on diverse populations.
• New WHO standards are based on optimally nourished children.

Purpose of the Study:

• Compare child nutritional status using new WHO standards versus NCHS/WHO references.
• Analyze differences in wasting, stunting, and underweight prevalence.
• Utilize empirical data from a longitudinal panel study.

Main Methods:

• Analyzed cross-sectional data from the Young Lives study (India, Peru, Vietnam).
• Included ~2000 children aged 6-17.9 months per country.
• Calculated mean z scores and prevalence of malnutrition indicators using both WHO and NCHS/WHO standards.

Main Results:

• WHO standards yielded higher mean z scores for weight-for-length and weight-for-age, and similar length-for-age z scores.
• WHO standards showed mean weight-for-age z scores closer to zero, indicating better reflection of ponderal growth.
• Prevalence of wasting varied (higher in India/Peru, lower in Vietnam); stunting increased, and underweight decreased across all countries using WHO standards.

Conclusions:

• New WHO growth standards alter assessments of child nutritional status.
• Significant differences observed in mean z scores and prevalence of wasting, stunting, and underweight.
• The magnitude and direction of these changes are inconsistent across populations.