Use of the World Health Organization (WHO) growth standards to evaluate prevalence and predictors of overweight in preschool children enrolled in the WIC program

Abstract

With the current childhood obesity epidemic, tools for accurate diagnosis of childhood obesity are needed. The World Health Organization (WHO) issued new growth standards for children under five that differ considerably from the 2000 Centers for Disease Control and Prevention (CDC) growth charts. We used records of 143,792 children aged 2‐5 years who participated in the Massachusetts Special Supplemental Nutrition Program for Women, Infants and Children from 2001‐06 to compare the prevalence and predictors of childhood overweight using the WHO vs. the CDC cut‐offs. The prevalence of overweight (>95th percentile) was 17.0% using the CDC cut‐offs vs. 23.6% using the WHO cut‐offs; the difference was largest in children 24‐27 mo of age (12.7% vs. 25.4%, respectively). In a logistic regression model controlling for birth weight and child age, factors significantly related to child overweight, assessed using the WHO cut‐offs, were maternal pre‐pregnancy weight (obese vs. normal OR=1.81 (1.72‐1.91)), Hispanic ethnicity (OR=1.50 (1.43‐1.56, ref=non‐Hispanic), maternal education (some college vs. less than high school graduate (HS), OR=0.80, 0.75‐0.85, HS vs less than HS OR=0.90, 0.86‐0.94) and child sex (OR=0.89, 0.85‐0.93, ref=male). Using the WHO charts will result in a higher estimated prevalence of childhood overweight and allow for earlier diagnosis, thus making earlier intervention possible.Supported by a grant from the United States Department of Agriculture Economic Research Service Research Innovation and Development Grants in EconomicsGrant Funding SourceUnited States Department of Agriculture Economic Research Service Research Innovation and Development Grants in Economics