The relationship between anthropometric indices derived from the CDC/WHO international reference

Area of Science:

• Pediatric Nutrition
• Anthropometry
• Public Health

Background:

• Standard anthropometric indices like weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ) are crucial for assessing child growth.
• The CDC/WHO reference is widely used but its suitability across different populations and age groups requires scrutiny.

Purpose of the Study:

• To examine the relationship between WAZ, HAZ, and WHZ scores using the CDC/WHO reference.
• To explore the age-related pattern of WHZ and analyze WAZ/WHZ regressions using Ghana Demographic and Health Survey data.
• To evaluate the validity of the WHZ index for identifying malnutrition in young children in developing countries.

Main Methods:

• Analysis of standard deviation scores for WAZ, HAZ, and WHZ based on the CDC/WHO reference.
• Exploration of WHZ patterns with age for reference children.
• Examination of WAZ on HAZ and WHZ regression using Ghanaian survey data (1988).

Main Results:

• Discrepancies in WHZ indices were observed for reference children with heights and weights at the lower end of the population range.
• A discontinuity in WHZ was noted between 23 and 24 months, reflecting the CDC/WHO reference's data source junction.
• Curvature in WHZ values between 3 and 23 months was apparent, especially for children below the reference median.

Conclusions:

• The CDC/WHO WHZ index exhibits peculiarities that may undermine its accuracy for measuring malnutrition in young children in developing nations.
• Age consistency is essential for a reliable weight-for-height index, a criterion not fully met by the current CDC/WHO WHZ.
• Alternative indices for wasting and updated reference figures are recommended for improved malnutrition assessment.