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Comparison of National Growth Standards for Turkish Infants and Children with World Health Organization Growth

Rüveyde Bundak1, Zehra Yavaş Abalı2, Andrzej Furman3

  • 1University of Kyrenia, Faculty of Medicine, Department of Pediatric Endocrinology, Kyrenia, North Cyprus

Journal of Clinical Research in Pediatric Endocrinology
|February 9, 2022
PubMed

Insights

World Health Organization (WHO) growth standards do not accurately reflect Turkish children's growth. National growth charts are more appropriate for assessing pediatric health and nutritional status in Turkey.

Area of Science:

  • Pediatric endocrinology and growth studies.
  • Public health and international growth standards.
  • Childhood anthropometry and nutritional assessment.

Background:

  • The use of World Health Organization (WHO) growth standards in pediatric practice is debated globally.
  • National growth charts are proposed to better represent a population's unique genetic and ethnic characteristics.
  • This study addresses the controversy by comparing Turkish children's growth data with WHO international standards.

Purpose of the Study:

  • To compare length/height, body weight, and body mass index (BMI) of healthy Turkish children (0-18 years) against WHO growth standards.
  • To evaluate the suitability of WHO standards for the Turkish pediatric population.
  • To determine if national growth charts are more appropriate for Turkish children.

Main Methods:

  • Collected anthropometric data (length/height, weight, BMI) from 2391 boys and 2102 girls aged 0-5 years, and 1100 boys and 1020 girls aged 6-18 years in Turkey.
  • Plotted the 3rd, 50th, and 97th percentile curves for Turkish children and compared them with WHO data.
  • Analyzed Z-score values and percentile distributions across different age groups.

Main Results:

  • Turkish children were taller than WHO standards after age 10, with notable differences in pubertal years.
  • From 6 months onward, Turkish children exhibited higher weight-for-age values across the 3rd, 50th, and 97th percentiles.
  • Z-scores and percentile values (50th, 15th, 85th, 95th) were generally higher in Turkish children, especially between 6 months-3 years and 6-18 years.

Conclusions:

  • WHO growth standards do not accurately represent the growth patterns of Turkish children.
  • Using WHO standards may lead to misclassification of short stature and underweight prevalence in Turkish children, particularly those aged 0-5 years.
  • National growth standards are recommended as more appropriate for assessing the growth and nutritional status of Turkish children.
Abstract

Keywords:
Growth chartsTurkish childrenWHO standards

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