| Summary: | Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. === INTRODUCTION: The best known reference standards used to evaluate the
growth and development of infants and children are the 1977 National Centre for
Health Statistics (NCHS) - , the 2000 Centres for Disease Control and Prevention
(CDC) - and the World Health Organization (WHO) (2006). The NCHS reference
standards were used to analyse anthropometric data from the 1999 National
Food Consumption Survey (NFCS). It was anticipated that using the 2000 CDC
and the 2006 WHO reference standards may lead to differences in the previously
estimated prevalences of stunting, wasting, underweight, risk of overweight,
overweight and obesity in the study population.
AIM: To compare the anthropometric status of children aged 12 - 60 months
when using the 1977 NCHS -, the 2000 CDC -, and the 2006 WHO reference
standards.
METHODS: A secondary analysis of anthropometric data from the 1999 NFCS
was conducted using different reference standards to compare anthropometric
status in terms of the prevalences of stunting, wasting, underweight, risk of
overweight, overweight and obesity. Relationships between anthropometric
status and other variables such as breastfeeding, maternal education level and
type of housing were explored.
RESULTS: The prevalences of stunting, obesity and overweight were
significantly higher and the prevalence of underweight and wasting were lower
when using the 2006 WHO compared to the 1977 NCHS and the 2000 CDC reference standards. A significant relationship was found between weight-forheight
and breastfeeding when using any one of the reference standards and
between BMI-for-age and breastfeeding when using the 2006 WHO reference
standard. A significant relationship was shown between maternal education level
and height-for-age and weight-for-age when using any one of the three reference
standards and a significant association was found between weight-for-height and
BMI-for-age and the type of housing when using any of the three reference
standards.
CONCLUSIONS: The prevalences of stunting and obesity were higher when
using the 2006 WHO reference standards compared to the 1977 NCHS and
2000 CDC reference standards. This may be due to the linear growth and rate of
weight gain of breastfed infants differing from formula fed infants and the 2006
WHO reference made use of the exclusively and predominantly breastfed infant
living under normal healthy conditions as the normative model which is a
prescription of how children should not grow and .not an indication of how
children are growing. In conclusion, the 2006 WHO reference standard must be
the only reference standard used nationally and internationally when assessing
the growth and nutritional status of infants and children.
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