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Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

The height-, weight-, and BMI-for-age of Polish school-aged children and adolescents relative to international and local growth references

Authors: Zbigniew Kulaga, Mieczysław Litwin, Marcin Tkaczyk, Agnieszka Różdżyńska, Katarzyna Barwicka, Aneta Grajda, Anna Świąder, Beata Gurzkowska, Ewelina Napieralska, Huiqi Pan

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

The growth of children is an indicator of health and society's wellbeing. Growth references are useful in monitoring a child's growth, which is a very important part of child care. Poland's growth references are not updated regularly. Although several growth reference ranges have been developed in Poland over recent years, sampling was restricted to urban populations of major cities. The aim of this study was to assess how well Polish children match with, or diverge from, regional charts and to compare them with international growth references.

Methods

Four Polish and two international (WHO 2007 and USCDC2000) growth references were used to calculate the height, weight and BMI z-scores in a recent, large, population-representative sample of school-aged children and adolescents in Poland. The distributions of z-scores were analysed with descriptive and inferential statistical methods.

Results

Mean height z-scores calculated with the use of the WHO 2007 and USCDC2000 references were positive and significantly different from zero over the entire age range. The mean height z-score was closest to zero in the Poznan reference for boys (0.05) and Warszawa reference for girls (0.01). Median weight z-scores were positive under all weight references over the entire age range with only the exception of 18-year-old girls' weight z-score calculated relative to USCDC2000. Median BMI z-scores were positive in males in early childhood, decreasing with age. In the case of girls, the median BMI z-score calculated using WHO 2007 and USCDC2000 was close to zero in early childhood, decreased in adolescents and reached minimum values at age 18 years. Median BMI z-scores calculated with the use of the Lodz reference fluctuated between 0.05 and 0.2 over the studied age range.

Conclusions

In this contemporary sample of Polish school-aged children, distributions of height, weight and BMI differed from those of children from the international growth references. These differences should be considered when using the references. There exist certain limitations to the analysis of height, weight, and BMI z-scores when Polish regional references are used.
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Literature
1.
go back to reference Report of a WHO Expert Committee: Physical status: the use and interpretation of anthropometry. Geneva. 1995 Report of a WHO Expert Committee: Physical status: the use and interpretation of anthropometry. Geneva. 1995
2.
go back to reference Gelander L: Children's growth: a health indicator and a diagnostic tool. Acta Paediatr. 2006, 95: 517-518. 10.1080/08035250600644747.CrossRefPubMed Gelander L: Children's growth: a health indicator and a diagnostic tool. Acta Paediatr. 2006, 95: 517-518. 10.1080/08035250600644747.CrossRefPubMed
3.
go back to reference Tanner JM: Growth as a mirror of the condition of society: secular trend and class distinction. Acta Paediatr Jpn. 1987, 29: 96-102.CrossRefPubMed Tanner JM: Growth as a mirror of the condition of society: secular trend and class distinction. Acta Paediatr Jpn. 1987, 29: 96-102.CrossRefPubMed
4.
go back to reference Komlos J: Preface. Stature, Living Standards, and Economic Development. Essays in Anthropometric History. Edited by: Komlos J. 1994, Chicago: The University of Chicago Press, 9-11. Komlos J: Preface. Stature, Living Standards, and Economic Development. Essays in Anthropometric History. Edited by: Komlos J. 1994, Chicago: The University of Chicago Press, 9-11.
5.
go back to reference Cole TJ: Growth references and standards. Human Growth and Development. Edited by: Cameron N. 2006, San Diego: Academic Press, 386- Cole TJ: Growth references and standards. Human Growth and Development. Edited by: Cameron N. 2006, San Diego: Academic Press, 386-
6.
go back to reference de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J: Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007, 85: 660-667. 10.2471/BLT.07.043497.CrossRefPubMedPubMedCentral de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J: Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007, 85: 660-667. 10.2471/BLT.07.043497.CrossRefPubMedPubMedCentral
7.
go back to reference Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL: 2000 CDC growth charts for the United States: methods and development. Vital Health Stat. 2002, 11: 1-190. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL: 2000 CDC growth charts for the United States: methods and development. Vital Health Stat. 2002, 11: 1-190.
8.
go back to reference Palczewska I, Niedzwiedzka Z: Somatic development indices in children and youth of Warsaw. Med Wieku Rozwoj. 2001, 5 (Suppl 1): 18-118.PubMed Palczewska I, Niedzwiedzka Z: Somatic development indices in children and youth of Warsaw. Med Wieku Rozwoj. 2001, 5 (Suppl 1): 18-118.PubMed
9.
go back to reference Krawczyński M, Krzyżaniak A, Walkowiak J: Developmental standards of body height and weight in children and adolescents between 3-18 years of age in the city of Poznań. Pediatria Praktyczna. 2000, 8: 341-353. Krawczyński M, Krzyżaniak A, Walkowiak J: Developmental standards of body height and weight in children and adolescents between 3-18 years of age in the city of Poznań. Pediatria Praktyczna. 2000, 8: 341-353.
10.
go back to reference Gołąb S, Chrzanowska M: The child of Cracow 2000. The level of the biological development in Cracow children and youth. 2002, Kraków: Academy of Physical Education in Cracow Gołąb S, Chrzanowska M: The child of Cracow 2000. The level of the biological development in Cracow children and youth. 2002, Kraków: Academy of Physical Education in Cracow
11.
go back to reference Rosset I, Roślak M, Grabowska J, Borowska-Strugińska B, Lorkiewicz W, Sitek A, Stolarczyk H, Śmiszkiewicz-Skwarska A, Żądzińska E: The state of physical development of children in Łódź. Dziecko łódzkie 2004. Normy rozwoju biologicznego. Edited by: Żądzińska E. 2009, Łódź: Medical University in Łódź, 65-100. Rosset I, Roślak M, Grabowska J, Borowska-Strugińska B, Lorkiewicz W, Sitek A, Stolarczyk H, Śmiszkiewicz-Skwarska A, Żądzińska E: The state of physical development of children in Łódź. Dziecko łódzkie 2004. Normy rozwoju biologicznego. Edited by: Żądzińska E. 2009, Łódź: Medical University in Łódź, 65-100.
12.
go back to reference Cole TJ, Green PJ: Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med. 1992, 11: 1305-1319. 10.1002/sim.4780111005.CrossRefPubMed Cole TJ, Green PJ: Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med. 1992, 11: 1305-1319. 10.1002/sim.4780111005.CrossRefPubMed
13.
go back to reference Fayter D, Nixon J, Hartley S, Rithalia A, Butler G, Rudolf M, Glasziou P, Bland M, Stirk L, Westwood M: Effectiveness and cost-effectiveness of height-screening programmes during the primary school years: a systematic review. Arch Dis Child. 2008, 93: 278-284. 10.1136/adc.2006.109843.CrossRefPubMed Fayter D, Nixon J, Hartley S, Rithalia A, Butler G, Rudolf M, Glasziou P, Bland M, Stirk L, Westwood M: Effectiveness and cost-effectiveness of height-screening programmes during the primary school years: a systematic review. Arch Dis Child. 2008, 93: 278-284. 10.1136/adc.2006.109843.CrossRefPubMed
15.
go back to reference Cole TJ: A chart to link child centiles of body mass index, weight and height. Eur J Clin Nutr. 2002, 56: 1194-1199. 10.1038/sj.ejcn.1601473.CrossRefPubMed Cole TJ: A chart to link child centiles of body mass index, weight and height. Eur J Clin Nutr. 2002, 56: 1194-1199. 10.1038/sj.ejcn.1601473.CrossRefPubMed
16.
go back to reference Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH, McCrindle B, Mietus-Snyder ML: Progress and challenges in metabolic syndrome in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2009, 119: 628-647. 10.1161/CIRCULATIONAHA.108.191394.CrossRefPubMed Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH, McCrindle B, Mietus-Snyder ML: Progress and challenges in metabolic syndrome in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation. 2009, 119: 628-647. 10.1161/CIRCULATIONAHA.108.191394.CrossRefPubMed
17.
go back to reference Butte NF, Garza C, de Onis M: Evaluation of the feasibility of international growth standards for school-aged children and adolescents. J Nutr. 2007, 137: 153-157.PubMed Butte NF, Garza C, de Onis M: Evaluation of the feasibility of international growth standards for school-aged children and adolescents. J Nutr. 2007, 137: 153-157.PubMed
18.
go back to reference National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents: The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004, 114: 555-576. 10.1542/peds.114.2.S2.555.CrossRef National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents: The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004, 114: 555-576. 10.1542/peds.114.2.S2.555.CrossRef
19.
go back to reference Wang Y, Moreno LA, Caballero B, Cole TJ: Limitations of the current World Health Organization growth references for children and adolescents. Food Nutr Bull. 2006, 27 (Suppl 4): S175-S188.CrossRefPubMed Wang Y, Moreno LA, Caballero B, Cole TJ: Limitations of the current World Health Organization growth references for children and adolescents. Food Nutr Bull. 2006, 27 (Suppl 4): S175-S188.CrossRefPubMed
20.
go back to reference Haas JD, Campirano F: Interpopulation variation in height among children 7 to 18 years of age. Food Nutr Bull. 2006, 27 (Suppl 4): S212-S223.CrossRefPubMed Haas JD, Campirano F: Interpopulation variation in height among children 7 to 18 years of age. Food Nutr Bull. 2006, 27 (Suppl 4): S212-S223.CrossRefPubMed
21.
go back to reference Vignerova J, Lhotska L: A fresh look at growth assessment of infants and young children in the Czech Republic in context of international developments. Cent Eur J Publ Health. 2006, 14: 97-100. Vignerova J, Lhotska L: A fresh look at growth assessment of infants and young children in the Czech Republic in context of international developments. Cent Eur J Publ Health. 2006, 14: 97-100.
22.
go back to reference van Buuren S, van Wouwe JP: WHO Child Growth Standards in action. Arch Dis Child. 2008, 93: 549-551. 10.1136/adc.2007.136010.CrossRefPubMed van Buuren S, van Wouwe JP: WHO Child Growth Standards in action. Arch Dis Child. 2008, 93: 549-551. 10.1136/adc.2007.136010.CrossRefPubMed
23.
go back to reference Hui LL, Schooling CM, Cowling BJ, Leung SS, Lam TH, Leung GM: Are universal standards for optimal infant growth appropriate? Evidence from a Hong Kong Chinese birth cohort. Arch Dis Child. 2008, 93: 561-565. 10.1136/adc.2007.119826.CrossRefPubMed Hui LL, Schooling CM, Cowling BJ, Leung SS, Lam TH, Leung GM: Are universal standards for optimal infant growth appropriate? Evidence from a Hong Kong Chinese birth cohort. Arch Dis Child. 2008, 93: 561-565. 10.1136/adc.2007.119826.CrossRefPubMed
24.
go back to reference Wright C, Lakshman R, Emmett P, Ong KK: Implications of adopting the WHO 2006 Child Growth Standard in the UK: two prospective cohort studies. Arch Dis Child. 2008, 93: 566-569. 10.1136/adc.2007.126854.CrossRefPubMed Wright C, Lakshman R, Emmett P, Ong KK: Implications of adopting the WHO 2006 Child Growth Standard in the UK: two prospective cohort studies. Arch Dis Child. 2008, 93: 566-569. 10.1136/adc.2007.126854.CrossRefPubMed
25.
go back to reference Tate AR, Dezateux C, Cole TJ: Is infant growth changing?. Int J Obes. 2006, 30: 1094-1096. 10.1038/sj.ijo.0803310.CrossRef Tate AR, Dezateux C, Cole TJ: Is infant growth changing?. Int J Obes. 2006, 30: 1094-1096. 10.1038/sj.ijo.0803310.CrossRef
26.
go back to reference Silverwood RJ, Leon DA, De Stavola BL: Long term trends in BMI: are contemporary childhood BMI growth references appropriate when looking at historical datasets?. LLCS. 2009, 1: 27-44. Silverwood RJ, Leon DA, De Stavola BL: Long term trends in BMI: are contemporary childhood BMI growth references appropriate when looking at historical datasets?. LLCS. 2009, 1: 27-44.
27.
go back to reference Pan H, Jiang Y, Jing X, Fu S, Jiang Y, Lin Z, Sheng Z, Cole TJ: Child body mass index in four cities of East China compared to Western references. Ann Hum Biol. 2009, 36: 98-109. 10.1080/03014460802575641.CrossRefPubMed Pan H, Jiang Y, Jing X, Fu S, Jiang Y, Lin Z, Sheng Z, Cole TJ: Child body mass index in four cities of East China compared to Western references. Ann Hum Biol. 2009, 36: 98-109. 10.1080/03014460802575641.CrossRefPubMed
Metadata
Title
The height-, weight-, and BMI-for-age of Polish school-aged children and adolescents relative to international and local growth references
Authors
Zbigniew Kulaga
Mieczysław Litwin
Marcin Tkaczyk
Agnieszka Różdżyńska
Katarzyna Barwicka
Aneta Grajda
Anna Świąder
Beata Gurzkowska
Ewelina Napieralska
Huiqi Pan
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-109

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