Misclassification of stunting, underweight and wasting in children 0–5 years of South Asian and Dutch descent
Ethnic-specific v . WHO criteria
Bibliographic Data
| ID | 15092455 |
|---|---|
| Authors | J A de Wilde (0000-0002-2491-2376), JA de Wilde (Leiden University Medical Center, corresponding author), M Peters-Koning (Netherlands Youth Institute), BJC Middelkoop (Leiden University Medical Center) |
| Year | 2020 |
| Volume | 23 |
| Issue | 12 |
| Pages | 2078-2087 |
| Publication date | 2020-08-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Public Health Nutrition (JOURNAL) |
| Journal identifiers | ISSN: 1368-9800 • E-ISSN: 1475-2727 |
| Publisher | Cambridge University Press (CUP) (PUBLISHER) |
| DOI | 10.1017/s1368980019004464 |
| PMID | 32476641 |
| OpenAlex | W3030512657 |
| Language | EN |
| Citations received | 3 |
| References cited | 32 |
Objective: Several authors have questioned the suitability of WHO Child Growth Standards (WHO-CGS) for all ethnic groups. The aim of this study was to identify potential misclassification of stunting, underweight and wasting in children of Surinamese Asian Indian, South Asian (Pakistan/India) and Dutch descent. Design: A series of routine cross-sectional measurements, collected 2012–2015. South Asian-specific normative growth references for weight-for-age and weight-for-length/height were constructed using the LMS method based on historic growth data of Surinamese Asian Indians born between 1974 and 1976. WHO-CGS and ethnic-specific references were applied to calculate z-scores and prevalence of stunting, underweight and wasting. Setting: Youth HealthCare, providing periodical preventive health check-ups. Participants: 11 935 children aged 0–5 years. Results: Considerable deviations from WHO-CGS were found, with higher-than-expected stunting rates, especially in the first 6 months of life. Surinamese Asian Indian children showed stunting rates up to 16·0 % and high underweight and wasting over the whole age range (up to 7·2 and 6·7 %, respectively). Dutch children consistently had mean WHO-CGS z-scores 0·3–0·5 sd above the WHO baseline (>6 months). The application of ethnic-specific references showed low rates for all studied indicators, although South Asian children were taller and larger than their Surinamese Asian Indian counterparts. Conclusions: WHO-CGS misclassify a considerable proportion of children from all ethnic groups as stunted in the first 6 months of life. Underweight and wasting are considerably overestimated in Surinamese Asian Indian children. Ethnic-specific growth references are recommended for Surinamese Asian Indian and Dutch children. The considerable differences found between South Asian subpopulations requires further research
Body mass index · Environmental health · Ethnic group · Geography · Overweight · Pathology · Sociology · Underweight · Wasting · Anthropology · Child Nutrition and Water Access · Demography · Food Security and Health in Diverse Populations · Medicine · Obesity, Physical Activity, Diet · Internal Medicine · Pediatrics
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One size does not fit all. How universal standards for normal height can hide deprivation and create false paradoxes
Body mass index and percent body fat
WHO Child Growth Standards based on length/height, weight and age
Asians are different from Caucasians and from each other in their body mass index/body fat per cent relationship
Physical Status
Trends in birth weight and the prevalence of low birth weight and small-for-gestational-age in Surinamese South Asian babies since 1974
Worldwide implementation of the WHO Child Growth Standards
The Asian enigma
Height of South Asian children in the Netherlands aged 0–20 years
BMI-for-age in South Asian children of 0–20 years in the Netherlands
Body size and body composition
| Unique citing works | 3 |
|---|---|
| Citations per year | 0.6 |
| Citation span | 2021 - 2024 (4) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 3 |