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Updated: Jul 6, 2025

Assessment of Child Anthropometry in a Large Epidemiologic Study
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Limitations of BMI z scores for assessing weight change: A clinical tool versus individual risk

Shana Adise1, Kyung E Rhee2, Jennifer Laurent3

  • 1Department of Pediatrics, Division of Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, California, USA.

Obesity (Silver Spring, Md.)
|January 9, 2024
PubMed

Insights

Pediatric growth curves can be misleading for tracking individual weight changes over time. This paper discusses appropriate methods for analyzing pediatric weight gain in research to ensure accurate cardiometabolic assessments.

Area of Science:

  • Pediatric Endocrinology
  • Growth Monitoring
  • Obesity Research

Background:

  • Pediatric growth curves are clinically useful but can be misleading for within-person longitudinal analysis.
  • Accurate metrics are crucial for understanding cardiometabolic consequences of pediatric weight gain.
  • Reference pediatric Body Mass Index (BMI) z-scores are widely, yet inappropriately, used as the standard for longitudinal research.

Purpose of the Study:

  • To critically evaluate the methodology behind creating reference growth curves.
  • To delineate appropriate uses of pediatric BMI growth curves in cross-sectional and longitudinal research.
  • To guide the selection of metrics for evaluating pediatric weight gain and associated risks.

Main Methods:

  • Review of methodologies for constructing reference growth curves.
  • Analysis of the application of pediatric BMI growth curves in research settings.
  • Discussion on metric selection for longitudinal pediatric obesity research.

Main Results:

  • Reference growth curves have specific methodologies impacting their interpretation.
  • Misapplication of growth curves in longitudinal studies can lead to inaccurate conclusions.
  • Standardized reference scores are essential for accurate assessment of obesity-related risks over time.

Conclusions:

  • Standardized reference scores are essential for accurate assessment of obesity-related risks over time.
  • Careful metric selection is vital for precise analysis of pediatric weight gain and cardiometabolic health.
  • This paper provides guidance for appropriate use of growth curves in pediatric research.

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