Comparison of the 2005 growth charts for Saudi children and adolescents to the 2000 CDC growth charts.
OBJECTIVE
The 2000 CDC growth charts for the United States, a revision of the National Center for Health Statistics/World Health Organization (NCHS/WHO) growth charts, were released in 2002 to replace the NCHS/WHO charts. We evaluated the differences between the CDC growth charts and the Saudi 2005 reference to determine the implications of using the 2000 CDC growth charts in Saudi children and adolescents.


METHODS
The Saudi reference was based on a cross-sectional representative sample of the Saudi population of healthy children and adolescents from birth to 19 years of age. Measurements of the length/stature, weight and head circumference were performed according to expert recommendations. The CDC charts from birth to 20 years were based on a cross-sectional representative national sample from five sources collected between 1963 and 1994. The data from the CDC study including the 3rd, 5th, 50th, 95th, and 97th percentiles were plotted against the corresponding percentiles on the Saudi charts for the weight for age, height for age, weight for height for children from 0 to 36 months and weight for age, stature for age and body mass index for children 2 to 19 years of age.


RESULTS
There were major differences between the two growth charts. The main findings were the upward shift of the lower percentiles of the CDC curves and the overlap or downward shift of the upper percentiles, especially for weight, weight for height, and BMI.


CONCLUSIONS
The use of the 2000 CDC growth charts for Saudi children and adolescents increases the prevalence of undernutrition, stunting, and wasting, potentially leading to unnecessary referrals, investigations and parental anxiety. The increased prevalence of overweight and obesity is alarming and needs further investigation.
El Mouzan
Mohammad I
MI
Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia. drmouzan@gmail.com
Al Herbish
Abdullah S
AS
Al Salloum
Abdullah A
AA
Foster
Peter J
PJ
Al Omar
Ahmad A
AA
Qurachi
Mansour M
MM
Kecojevic
Tatjana
T
D000293:Adolescent; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D012529:Saudi Arabia / Q000453:epidemiology; D014481:United States; D055815:Young Adult
Stat Med. 1992 Jul;11(10):1305-19
1518992
Lancet. 1974 Apr 6;1(7858):611-4
4132271
Saudi Med J. 2007 Oct;28(10):1569-74
17914521
Acta Paediatr Suppl. 2006 Apr;450:56-65
16817679
World Health Organ Tech Rep Ser. 1995;854:1-452
8594834
Saudi Med J. 2003 Jun;24(6):598-602
12847586
J Pediatr Gastroenterol Nutr. 2000;31 Suppl 1:S14-38
10896087
Saudi Med J. 2007 Oct;28(10):1555-68
17914520
Stat Med. 1998 Feb 28;17(4):407-29
9496720
Ann Saudi Med. 1993 Mar;13(2):155-9
17588021
Bull World Health Organ. 1977;55(4):489-98
304391
Bull World Health Organ. 2007 Jun;85(6):441-8
17639241
Int J Obes Relat Metab Disord. 1996 Nov;20(11):1000-5
8923156
Am J Clin Nutr. 1979 Mar;32(3):607-29
420153
Ann Saudi Med. 2004 Mar-Apr;24(2):136-40
15323278
Arch Dis Child. 1995 Jul;73(1):17-24
7639543
Lancet. 1981 Aug 8;2(8241):297-9
6114335
Bull World Health Organ. 1986;64(6):929-41
3493862
Saudi Med J. 2004 May;25(5):580-4
15138524
Vital Health Stat 11. 2002 May;(246):1-190
12043359