Are the Growth Standards of the World Health Organization Valid for Spanish Children? The SONEV Study

Abstract

Background: The use of different growth tables to assess the population's nutritional status has given rise to a series of limitations arising from the lack of consensus and uniform methodological criteria. This leads to a disparity of results that prevent an accurate and reliable diagnosis of whether a child is overweight or obese.Objective: The purpose of this study was to develop growth references for weight, height, and body mass index for Eastern-Spanish children from 6 to 16 years of age.Methods: The final sample used to fit the growth curves was made up of 1,102 observations. The 2007 WHO curves are currently used for Child Health Service Cards. Therefore, to make the comparison of the internal values obtained as realistic as possible, the same construction method has been used for the internal curves, modeling age as a continuous variable and simultaneously adjusting the curves, smoothing them using cubic splines and further smoothing the edge effects by means of data extending above or below the upper and lower age limits.Results: Growth curves for percentiles were constructed for both sexes and higher values were noticeably found to set as growth-standard compared to WHO-standards.Conclusion: Our analysis shows that the WHO 2007 standard references are not suitable for Eastern-Spanish children. The standards shown in this study are much more realistic and current, and we believe that their use will help healthcare professionals more effectively combat the current epidemic of overweight and obesity.

Differences in Classification Standards For the Prevalence of Overweight and Obesity in Children. A Systematic Review and Meta-Analysis

“…Finally, in the study carried out by Pérez-Bermejo et al 57 in Spain, significant differences were found in BMI values according to age between the two sexes at some ages, for this reason, the authors argued that, if the WHO reference were used, the rate of overweight and obesity would be double that of national references.…”

“… Note : Being several authors of this work the same, the article 57 has not been valued. Abbreviations : Y, Yes; N, No; U, Unclear.…”

“… de Heer et al (2013) 56 Mexico 653 participants 9.3 years WHO 2007 Normal: 44.6%; Overweight: 17.8%; Obesity: 36.3% CDC 2000 Normal: 49.8%; Overweight: 21.6%; Obesity: 26.6% IOTF 2012 Normal: 47.0%; Overweight: 27.1%; Obesity: 22.8% Fitness Gram 2010 Standards Normal: 45.5%; Overweight: 13.8%; Obesity: 39.2% Of the most frequently used classifications today, WHO 2007 standards are more closely related to the benchmark standards that associate weight status with more adverse health outcomes. Pérez-Bermejo et al (2021) 57 Spain 1183 participants (630 males, 553 females) 6–16 years WHO 2007 Boys (Overweight: 27.5%; Obesity: 5.4%). Girls (Overweight: 36.4%; Obesity: 36.4%).…”

Mediterranean Diet and Genetic Determinants of Obesity and Metabolic Syndrome in European Children and Adolescents

“…Defining international cut-offs provides numerous advantages and it allows researchers to make comparisons with other BMI references [ 43 ]. However, the lack of uniformity in the methodological criteria to develop growth references for childhood BMI could sometimes lead to disparity in the results [ 44 ]. For instance, the World Health Organization’s (WHO) BMI references values might not me suitable for all European children [ 44 ].…”

“…However, the lack of uniformity in the methodological criteria to develop growth references for childhood BMI could sometimes lead to disparity in the results [ 44 ]. For instance, the World Health Organization’s (WHO) BMI references values might not me suitable for all European children [ 44 ]. Other BMI thresholds have been proposed by the U.S. Centers for Disease Control and Prevention (CDC), although the differences in the predictive capacity between the CDC reference and the World Obesity Federation’s reference are minimal [ 45 ].…”