title: Application of the 2006 WHO growth standard from birth to 4 years to Pacific Island children.
abstract: BACKGROUND
  Pacific adults and children have very high rates of obesity.
  
  
  OBJECTIVE
  Body size at birth, 2- and 4 years for the whole cohort, compliant (not smoking and breastfed) and non-compliant children was compared to the 2006 World Health Organization (WHO) growth standard using z-scores.
  
  
  METHODS
  Longitudinal data (n=659) from the 2000 Pacific Island family birth cohort study of weight at birth and weight and height at 2- and 4 years was analysed.
  
  
  RESULTS
  At birth the average child was 3.673+/-0.501 kg; z-score 0.605 units higher (P<0.000001) than the WHO standard. At 2- and 4 years, average z-scores for weight and body mass index (BMI) were significantly different from 0 (mean z-scores for weight +1.062 and +1.688, for BMI +1.701 and +1.969 respectively, P<0.000001). Mean height was significantly lower (P<0.000001) z-score=-0.232 at 2 years but higher (P<0.000001) at 4 years, z-score=+0.626. Over 4 years, the daily weight gain was 11.2 g day(-1) compared with 8.9 g day(-1) for the WHO child. Compliant (n=287) compared to non-compliant (n=372) weighed less and were slightly shorter at 2- and 4 years measurement points. Non-compliant children categorized as non-smoking (n=229) weighed more than smoking mothers' (n=143) children at birth, 2- and 4 years.
  
  
  CONCLUSIONS
  Pacific children are born heavy, over 4 years increase in weight is faster and between 2- and 4 years increase in height is faster than the reference breastfed child, independent of pre- and postnatal factors. Smoking decreases the rate of weight gain and children who are not breastfed gain weight faster. Interventions to limit weight gain need to start with the family before conception.
authors.affiliation: Centre for Physical Activity and Nutrition Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand. erush@aut.ac.nz
authors.forename: E C
authors.initials: EC
authors.lastname: Rush
authors.forename: J
authors.initials: J
authors.lastname: Paterson
authors.forename: V V
authors.initials: VV
authors.lastname: Obolonkin
authors.forename: K
authors.initials: K
authors.lastname: Puniani
mesh_terms: D000367:Age Factors; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009765:Obesity / Q000209:etiology*; D010139:Pacific Islands; D012015:Reference Standards; D014944:World Health Organization