Abstract
Background: Weight for height in children is often assessed by comparing the child's weight-for-age centile with their height-for-age centile. However, this assessment has not been validated statistically, and it differs from the body mass index (BMI) centile.
Objective: To study indices of weight-for-height based on weight centile-for-age adjusted for height centile-for-age, and to see how they relate to the BMI centile-for-age.
Design: Cross-sectional survey of data for 40 536 boys and girls aged 0–18 y from the 1980 Nationwide Dutch Growth Survey, using the British 1990 and US CDC 2000 growth references.
Outcome measures: Two measures of weight for height: (a) the difference between weight centile and height centile, and (b) BMI centile, with the centiles analysed as SD scores (SDS).
Results: BMI centile is correlated strongly with weight centile (r=0.77) but weakly with height centile (r=0.1). By contrast the difference between weight centile and height centile is correlated only weakly with weight centile (r=0.3) and strongly negatively with height centile (r=−0.5). BMI centile is predicted to high accuracy by the multiple regression on weight centile and height centile (93–97% of variance explained, s.e.e. 0.2 units).
Conclusions: A child's BMI centile can be calculated to high accuracy from their weight and height centiles as read off the weight and height charts. This avoids the need to calculate BMI or to plot it on the BMI chart. A chart is provided to simplify this calculation, which works throughout the spectrum of nutritional status. It can also be used to monitor individuals' weight, height and BMI centiles simultaneously as they change over time. However the simpler procedure of comparing weight and height centiles (eg a difference of two or three channel widths) is a poor measure of weight-for-height and should not be used.
Sponsorship: Medical Research Council programme grant no. G9827821.
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References
Cole TJ . 1991 Weight-stature indices to measure underweight, overweight and obesity In: Anthropometric Assessment of Nutritional Status ed. JH Himes, pp 83–111 New York: Alan R. Liss
Cole TJ . 1994 A new index of child weight-for-height based on weight and height Z scores. (Abstract.) Ann. Hum. Biol. 21: 96
Cole TJ, Green PJ . 1992 Smoothing reference centile curves: the LMS method and penalized likelihood Stat. Med. 11: 1305–1319
Cole TJ, Freeman JV, Preece MA . 1995 Body mass index reference curves for the UK, 1990 Arch. Dis. Child. 73: 25–29
Cole TJ, Freeman JV, Preece MA . 1998 British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalized likelihood Stat. Med. 17: 407–429
Dietz WH, Robinson TN . 1998 Use of the body mass index (BMI) as a measure of overweight in children and adolescents J. Pediatr. 132: 191–193
Freeman JV, Cole TJ, Chinn S, Jones PRM, White EM, Preece MA . 1995 Cross-sectional stature and weight reference curves for the UK, 1990 Arch. Dis. Child. 73: 17–24
Hulse JA, Schilg S . 1996 Monitoring children's growth. (Letter.) Br. Med. J. 312: 122
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL . 2000 CDC growth charts: United States Hyattsville, MD: National Center for Health Statistics
Mulligan J, Voss LD . 1999 Identifying very fat and very thin children: test of criterion standards for screening test Br Med. J. 319: 1103–1104
Poustie VJ, Watling RM, Ashby D, Smyth RL . 2000 Reliability of percentage ideal weight for height Arch. Dis. Child. 83: 183–184
Ramsey BW, Farrell PM, Pencharz P . 1992 Nutritional assessment and management in cystic fibrosis: a consensus report Am. J. Clin. Nutr. 55: 108–116
Roede MJ, Van Wieringen JC . 1985 Growth diagrams 1980. Netherlands third nation-wide survey Tijdschrift voor Sociale Gezondheidszorg 63: (Suppl): 1–34
Sempé M, Pédron G, Roy-Pernot M . 1979 Auxologie: méthode et séquences Paris: Theraplix
Walker SP, Golden MHN . 1988 Growth in length of children recovering from severe malnutrition Eur. J. Clin. Nutr. 42: 395–404
Waterlow JC . 1972 Classification and definition of protein-calorie malnutrition Br. Med. J. 3: 566–569
Acknowledgements
I am grateful to Mike Preece, Angie Wade and Jonathan Wells for their comments on the paper, and to Machteld Roede for providing the Third Nationwide Dutch Growth Survey data.
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Cole, T. A chart to link child centiles of body mass index, weight and height. Eur J Clin Nutr 56, 1194–1199 (2002). https://doi.org/10.1038/sj.ejcn.1601473
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DOI: https://doi.org/10.1038/sj.ejcn.1601473
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