MULT: New height references and their efficiency in multi-ethnic populations

Area of Science:

• Pediatric Endocrinology
• Human Growth and Development
• Public Health Nutrition

Background:

• Existing height references may not accurately represent diverse multi-ethnic populations.
• Accurate growth monitoring is crucial for identifying potential health and nutritional issues in children.

Purpose of the Study:

• To develop novel multi-ethnic height references (MULT).
• To compare the new MULT references against established Dutch, CDC, and WHO height references.
• To evaluate the applicability of MULT references for assessing the nutritional status of multi-ethnic children.

Main Methods:

• Development of MULT height references using the LMS method and GAMLSS on longitudinal data from multi-ethnic cohorts.
• Comparison of growth trajectories using M and S curves.
• Statistical analysis of agreement between MULT, WHO, and CDC references using Lin's concordance correlation coefficient (CCC) and Cohen's kappa (K).

Main Results:

• MULT references indicate taller stature in boys and girls during specific age periods compared to CDC and WHO references.
• An almost perfect agreement (CCC > 0.99) was observed between MULT and WHO height references for children aged 2-5 years.
• Population comparative analysis included over 91,000 observations from 17,641 subjects.

Conclusions:

• The developed MULT height references represent a taller population compared to existing international standards.
• High agreement with WHO growth charts, especially for children under 5 years, suggests the utility of MULT references.
• MULT references offer a valuable tool for assessing the nutritional status of diverse, multi-ethnic pediatric populations.