The complexity of measuring growth

In 2006 the WHO released new growth standards. The Multicentre Growth Reference Study collected data on 8500 children between 0 and 5 years of age. Children from Brazil, Ghana, India, Norway, Oman and the US were included in the study. Producing these growth standards was a difficult task. Did WHO select children from the appropriate countries? Were these children truly healthy? Were they fed exclusively by breast for the first 4–6 months of age? And most importantly, were these children raised under socio-economic conditions that allowed them to reach their full growth potential. This is particularly important because as new immigrants acculturate into a society, the growth patterns of these children change. Finally, because of the obesity epidemic, were too many “overweight” children included in the reference sample, thereby inflating appropriate growth curves. In the past we only had to worry about growth faltering; now obesity is just as important. These are just some of the important issues to consider when using the WHO standard.

In this issue, reports from Hong Kong and the United Kingdom, along with a perspective from van Buuren …