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Human size changes over time with worldwide secular trends in height, weight, and body mass index (BMI). There is general agreement to relate the state of nutrition to height and weight, and to ratios of weight-to-height. The BMI is a ratio. It is commonly used to classify underweight, overweight and obesity in adults. Yet, the BMI is inappropriate to provide any immediate information on body composition.
It is accepted that the BMI is “a simple index to classify underweight, overweight and obesity in adults”. It is stated that “policies, programmes and investments need to be “nutrition-sensitive”, which means they must have positive impacts on nutrition”. It is also stated that “a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions“. But these statements are neither warranted by arithmetic considerations, nor by historic evidence.
Measuring the BMI is an appropriate screening tool for detecting an unusual weight-to-height ratio, but the BMI is an inappropriate tool for estimating body composition, or suggesting medical and health policy decisions.
Changes in body height throughout extended historic periods are very complex and dynamic processes. Thispilot study aimed to investigate the pattern of longitudinal height z-scores changes in children before and after entering kindergarten. In summer 2016, we measured height and weight of 32 children from 4 groups of two kindergartens aged 3–6 years. All ages were centered according to the age of entry into the kindergarten. For each child we determined mean z-scores for height before and after entering the kindergarten, and assessed the variances for each kindergarten group. Twenty-two children targeted in height z-scores towards average height of their respective kindergarten group, 10 children did not. Due to the small numbers, the convergence in height variance however, remained insignificant (chi-squared independence test, p = 0.127). Additional studies with larger sample sizes are needed to confirm this pilot study.
Background: It has been shown that modern life style with reduced physical activity can lead to lower bone accumulation. Also a decline trend in external skeletal robustness in children and young adolescents, measured by the Frame Index (FI), seems to have a parallel trend with the increase in overweight and obesity. Based on these findings we estimate that likely, the FI should be changed after a decade in the Argentinean population as well as in others population of the world. Thereby, the aim of the present study was to describe, using the FI, the pattern of external skeletal robustness in school children aged 6-14 years from two cohorts of Argentina (Puerto Madryn, Chubut) and to compare them with the European reference (Czech Republic, Germany, Poland and Russia). Methods: Elbow breadth and height of Puerto Madryn school children were collected in two cross-sectional studies conducted between 2001-2006 (cohort 1 = C1) and 2014-2016 (cohort 2 = C2). Percentiles (P) values, for males and females, from C1 and C2 were calculated combining the LMSmethod and its extension. A t-test has been used to compare, by age and sex, the FI values between the Argentinean cohorts and the European reference (ER). Then, in order to know the percentage of the variation of the percentiles values between cohorts, as well as with ER, percent differences between means (PDM%) were employed. Results: FI from Argentinean cohorts differed significantly from ER. Even more, C2 was not only smaller than ER, but also than C1. In males, C1-C2 showed significant differences at 6-8, 11 and 12 years and in females at all ages. Then, respect to ER each Argentinean cohort showed significant differences in males of C1 at 6, 12-14 years and in females at 6 and 11-14 years; and of C2, in both sexes, from 6 to 14 years. The PDM% values for elbow breadth of male were negative in ER-C1 in all percentiles analyzed; in ER-C2 positive (P3 and P50) and negative (P97) and C1-C2 recorded positive values. In females, elbow breadth showed negative values for ER-C1 (P50 and P97), and positive for the remaining values. Finally, height registered, in both sexes, negative values in ER-C1 (except P97 in females), ER-C2 and C1-C2. Conclusions: After ten years of the first study carried on in Puerto Madryn, school children show a negative trend in the external skeletal robustness. Additionally, the children of both Argentinean cohorts have lower values compared to the European reference, and mainly the actual cohort. This situation would be explained, in part, by the progressive increase over time of overweight and obesity as consequence, among others, of the change in the quantity and/or quality of the food that children have access to and with the physical activity they do at school and outside.
Aim Growth is both a matter of amplitude and tempo. We aimed to develop references for body height, body weight and body mass index (BMI) with respect to tempo of maturity. Methods Data obtained from the German KiGGS study (2003-2006) on body height, body weight and presence or absence of the menarche were re-analysed in 3776 girls, aged 10-17years. We developed smoothed centiles for BMI-, body-height- and body-weight-for-age using the LMS method for premenarcheal and postmenarcheal girls. Results Body height, body weight and BMI differed significantly between premenarcheal and postmenarcheal girls. On average, postmenarcheal girls aged 11-17years were 5.3cm taller and 9.7kg heavier, and their BMI was 2.9kg/m2 higher than in premenarcheal girls of the same calendar age. Conclusion Adolescent BMI rises with calendar age and biological age. New reference charts for adolescent girls aged 10-18years were generated to be inserted into the currently used references to avoid misclassifying underweight and overweight pubertal girls.
Development of birthweight and length for gestational age and sex references in Yucatan, Mexico
(2022)
Objective To develop sex- and gestational age specific reference percentiles and curves for birth weight and length for Yucatec neonates using data from birth registers of infants born during 2015-2019. Material and methods Observational, descriptive, epidemiologic study in a 5-year period including every registered birth in the state of Yucatan, Mexico using birth registries. A total of 158 432 live, physically healthy singletons (76 442 females and 81 990 males) between 25 and 42 weeks of gestation were included in the analysis. We used the LMS method to construct smoothed reference centiles (3rd, 10th, 25th, 50th, 75th, 95th, and 97th) and curves for males and females separately. Results Mean maternal age was 26 (SD = 6.22) years. Fifty-two percent of births occurred by vaginal delivery, 37% were firstborn and similar proportions were second (33%) and third or more (30%) born. 5.5% of newborns included in the references corresponds to neonates born before 37 weeks of gestation (5.9% boys and 5.1% girls). In both sexes, the percentage of infants with a birthweight less than 2500 g was 6.7%. The birthweight at the 50th percentile for males and females at 40 weeks of gestation in this cohort was 3256 and 3167 g, respectively, and the corresponding values for birth length were 50.23 and 49.84 cm (mean differences between sexes: 89 g and 0.40 cm, respectively). Conclusion The reference percentile and curves developed in this study are useful for research purposes and can help health practitioners to assess the biological status of infants born in Yucatan.
Background: In our modern world, the way of life in nutritional and activity behaviour has changed. As a consequence, parallel trends of an epidemic of overweight and a decline in external skeletal robusticity are observed in children and adolescents. Aim: We aim to develop reference centiles for external skeletal robusticity of European girls and boys aged 0 to 18 years using the Frame Index as an indicator and identify population specific age-related patterns. Methods: We analysed cross-sectional & longitudinal data on body height and elbow breadth of boys and girls from Europe (0-18 years, n = 41.679), India (7-18 years, n = 3.297) and South Africa (3-18 years, n = 4.346). As an indicator of external skeletal robusticity Frame Index after Frisancho (1990) was used. We developed centiles for boys and girls using the LMS-method and its extension. Results: Boys have greater external skeletal robusticity than girls. Whereas in girls Frame Index decreases continuously during growth, an increase of Frame Index from 12 to 16 years in European boys can be observed. Indian and South African boys are almost similar in Frame Index to European boys. In girls, the pattern is slightly different. Whereas South African girls are similar to European girls, Indian girls show a lesser external skeletal robusticity. Conclusion: Accurate references for external skeletal robusticity are needed to evaluate if skeletal development is adequate per age. They should be used to monitor effects of changes in way of life and physical activity levels in children and adolescents to avoid negative health outcomes like osteoporosis and arthrosis.
Twenty-one scientists met for this year’s virtual conference on Auxology held at the University Potsdam, Germany, to discuss child and adolescent growth during times of fear and emotional stress. Growth within the broad range of normal for age and sex is considered a sign of good general health whereas fear and emotional stress can lead to growth faltering. Stunting is a sign of social disadvantage and poor parental education. Adverse childhood experiences affect child development, particularly in families with low parental education and low socioeconomic status. Negative effects were also shown in Indian children exposed prenatally and in early postnatal life to the cyclone Aila in 2009. Distrust, fears and fake news regarding the current Corona pandemic received particular attention though the effects generally appeared weak. Mean birth weight was higher; rates of low, very and extremely low birth weight were lower. Other topics discussed by the participants, were the influences of economic crises on birth weight, the measurement of self-confidence and its impact on growth, the associations between obesity, peer relationship, and behavior among Turkish adolescents, height trends in Indonesia, physiological neonatal weight loss, methods for assessing biological maturation in sportsmen, and a new method for skeletal age determination. The participants also discussed the association between acute myocardial infarction and somatotype in Estonia, rural-urban growth differences in Mongolian children, socio-environmental conditions and sexual dimorphism, biological mortality bias, and new statistical techniques for describing inhomogeneity in the association of bivariate variables, and for detecting and visualizing extensive interactions among variables.
Impact of normal weight obesity on fundamental motor skills in pre-school children aged 3 to 6 years
(2017)
Normal weight obesity is defined as having excessive body fat, but normal BMI. Even though previous research revealed that excessive body fat in children inhibited their physical activity and decreased motor performance, there has been only little evidence about motor performance of normal weight obese children. This study aims to establish whether normal weight obese pre-school children aged 3-6 years will have a significantly worse level of fundamental motor skills compared to normal weight non-obese counterparts. The research sample consisted of 152 pre-schoolers selected from a specific district of Prague, the Czech Republic. According to values from four skinfolds: triceps, subscapula, suprailiaca, calf, and BMI three categories of children aged 3-6 years were determined: A) normal weight obese n = 51; B) normal weight non-obese n = 52; C) overweight and obese n = 49. The Movement Assessment Battery for Children (MABC-2) was used for the assessment of fundamental motor skills. Normal weight obese children had significantly higher amount of adipose tissue p < 0.001 than normal weight non-obese children but the same average BMI. Moreover, normal weight obese children did not have significantly less amount of subcutaneous fat on triceps and calf compared to their overweight and obese peers. In majority of MABC-2 tests, normal weight obese pre-schoolers showed the poorest performance. Moreover, normal weight obese children had significantly worse total standard score = 38.82 compared to normal weight non-obese peers = 52.27; p < 0.05. In addition, normal weight obese children had a more than three times higher frequency OR = 3.69 CI95% (1.10; 12.35) of severe motor deficit performance <= 5th centile of the MABC-2 norm. These findings are strongly alarming since indices like BMI are not able to identify normal weight obese individual. We recommend verifying real portion of normal weight obese children as they are probably in higher risk of health and motor problems than overweight and obese population due to their low lean mass.
‘Nutrition influences height’ has been a common concept for the last decades. Recently, contradictory results occurred when studying the effectiveness of nutritional interventions, questioning the interaction of nutrition and height. Therefore, we hypothesize that, independently of population/country, nutrition does not affect height in children and adolescents. We analyzed data from the study “Young Lives” which was performed in Ethiopia, India, Peru, and Vietnam to describe the health situation of children. We used linear mixed effect models to analyze the influence of nutrition on height. Furthermore, we used Structural Equation Modeling (SEM) to test if the commonly assumed hypothetical interaction of height and nutrition can be supported by data from low and middle-income countries. Estimates for nutrition on height of linear mixed effect models were about zero and randomly significant or non-significant in all analyzed countries. Furthermore, SEM led to the rejection of the ‘nutrition influences height’-hypothesis, as data did not support the models based on this hypothesis. We do not find evidence for a nutritional influence on height in children and adolescents from low and middle-income countries. The widespread assumption that inadequate diet is reflected in short stature, which all modern nutritional interventions are based on, needs to be critically reviewed.