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Comparison of the effects of different growth standards on infants in Urban Shanghai: a cluster-randomized controlled

Jun-Li Wang1,2, Jing-Qiu Ma1,2, Ming-Yu Xu1,2

  • 1Department of Child and Adolescent Healthcare, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.

Chinese Medical Journal
|January 11, 2019
PubMed

Insights

Adopting World Health Organization (WHO) 2006 growth standards, instead of Shanghai growth standards, significantly reduced infant overweight risk up to one year of age in Shanghai. This finding is crucial for preventing childhood obesity.

Area of Science:

  • Pediatrics
  • Public Health
  • Growth Monitoring

Background:

  • Shanghai growth standards are higher than WHO standards, potentially increasing infant overweight risk.
  • Caregiver feeding practices may be influenced by differing growth standards, impacting infant weight.
  • Childhood obesity is a growing concern in urban populations, necessitating effective growth monitoring strategies.

Purpose of the Study:

  • To compare the impact of Shanghai and WHO 2006 growth standards on infant overweight risk.
  • To evaluate differences in infant growth parameters (z-scores) based on growth standards used.
  • To inform public health policies regarding optimal growth monitoring for early childhood obesity prevention.

Main Methods:

  • Cluster-randomized controlled trial in Shanghai involving 19 community health centers (November 2013 - December 2015).
  • Infants monitored using either Shanghai (S-group) or WHO 2006 (W-group) growth standards.
  • Weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and weight-for-length z-score (WLZ) assessed, with overweight prevalence compared.

Main Results:

  • Overweight ratios were significantly higher in the S-group at 9 months (4.3% vs 3.4%) and 12 months (3.8% vs 2.2%) compared to the W-group.
  • Infants in the S-group showed significantly greater increases in WAZ and WLZ, and a decrease in LAZ, relative to the W-group.
  • Statistically significant differences were observed in overweight prevalence and z-score changes between the two groups.

Conclusions:

  • Adoption of WHO 2006 growth standards is recommended to reduce infant overweight risk in Shanghai.
  • Implementing WHO growth standards can mitigate the risk of developing childhood obesity up to one year of age.
  • Standardizing growth monitoring with WHO criteria may improve early detection and prevention of infant overweight.
Abstract

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