National Growth Charts Research Articles

Comparison of Growth and Nutritional Status between Children in North Korean Refugee Families and South Korean Children

Purpose: This study aims to compare the growth and nutritional status of the children in North Korean Refugee (NKR) families and South Korean (SK) children.Methods: This study examined 101 children of NKR families and 294 SK children. Researchers interviewed subjects using a standardized questionnaire and measured their height and weight. The nutritional status of children was estimated using the 2017 Korean National Growth Charts for children and adolescents using their weight.Results: The children of NKR families were significantly shorter than the SK children (140.8±10.1 vs. 146.9±9.3, p<0.001) and weighed less (38.1±9.4 vs. 42.0±9.5, p<0.001). The prevalence of stunting and being underweight among children of NKR families was significantly higher than that of the SK children (stunting: 6.9% vs. 1.4%, p<0.001; underweight: 10.9% vs. 1.0%, p<0.001). However, there was no statistically significant difference in the prevalence of wasting and obesity.Conclusion: Although children of NKR families have been living in SK for 4.4 years, their nutritional problems are more severe than those of SK children.

Assessing fetal growth in Africa: Application of the international WHO and INTERGROWTH-21st standards in a Beninese pregnancy cohort.

Fetal growth restriction is a major complication of pregnancy and is associated with stillbirth, infant death and child morbidity. Ultrasound monitoring of pregnancy is becoming more common in Africa for fetal growth monitoring in clinical care and research, but many countries have no national growth charts. We evaluated the new international fetal growth standards from INTERGROWTH-21st and WHO in a cohort from southern Benin. Repeated ultrasound and clinical data were collected in women from the preconceptional RECIPAL cohort (241 women with singleton pregnancies, 964 ultrasounds). We modelled fetal biometric parameters including abdominal circumference (AC) and estimated fetal weight (EFW) and compared centiles to INTERGROWTH-21st and WHO standards, using the Bland and Altman method to assess agreement. For EFW, we used INTERGROWTH-21st standards based on their EFW formula (IG21st) as well as a recent update using Hadlock's EFW formula (IG21hl). Proportions of fetuses with measurements under the 10th percentile were compared. Maternal malaria and anaemia prevalence was 43% and 69% respectively and 11% of women were primigravid. Overall, the centiles in the RECIPAL cohort were higher than that of INTERGROWTH-21st and closer to that of WHO. Consequently, the proportion of fetuses under 10th percentile thresholds was systematically lower when applying IG21st compared to WHO standards. At 27-31 weeks and 33-38 weeks, respectively, 7.4% and 5.6% of fetuses had EFW <10th percentile using IG21hl standards versus 10.7% and 11.6% using WHO standards. Despite high anemia and malaria prevalence in the cohort, IG21st and WHO standards did not identify higher than expected proportions of fetuses under the 10th percentiles of ultrasound parameters or EFW. The proportions of fetuses under the 10th percentile threshold for IG21st charts were particularly low, raising questions about its use to identify growth-restricted fetuses in Africa.

Management of growth failure and other endocrine aspects in patients with Noonan syndrome across Europe: A sub-analysis of a European clinical practice survey

To date, there is a lack of international guidelines regarding the management of the endocrine features of individuals with Noonan syndrome (NS). The aim was to develop a clinical practice survey to gather information on current treatment and management of these patients across Europe. A group of 10 experts from three clinical specialities involved in the management of NS patients (clinical geneticists, paediatric endocrinologists, and paediatric cardiologists) developed a 60-question clinical practice survey. The questionnaire was implemented in Survey Monkey and sent to physicians from these three specialities via European/national societies. Contingency tables and the Chi-Squared test for independence were used to examine differences between specialities and countries. In total, responses of 364 specialists (paediatric endocrinologists, 40%; geneticists, 30%; paediatric cardiologists, 30%) from 20 European countries were analysed. While endocrinologists mostly referred to national growth charts for the general population, geneticists mostly referred to NS-specific growth charts. Approximately half of the endocrinologists perform growth hormone (GH) stimulation tests in short patients with low IGF1 levels. Two thirds of endocrinologists begin GH treatment for short patients in early childhood (4-6.9 years), and over half of them selected a threshold of -2 standard deviation score (SDS) according to national growth charts. The main concerns about GH treatment appear to be presence of hypertrophic cardiomyopathy (HCM) (59%), increased risk of malignancy (46%), and limited efficacy (31%). When asked if they consider HCM as a contraindication for GH treatment, one third of respondents skipped this question, and among those who replied, two thirds selected 'cannot answer', suggesting a high level of uncertainty. A total of 21 adverse cardiac responses to GH treatment were reported. Although most respondents had not encountered any malignancy during GH treatment, six malignancies were reported. Finally, about half of the endocrinologists expected a typical final height gain of 1-1.5 SDS with GH treatment. This survey describes for the first time the current clinical practice of endocrine aspects of NS across Europe and helps us to identify gaps in the management but also in the knowledge of this genetic disorder.

Comparing the nutritional status of children and adolescents from North Korean defector families and South Korean families

ObjectiveThis study aimed to investigate the nutritional status of children and adolescents from North Korean defector (NKD) families who are currently living in South Korea (SK) and compared with the...

Characteristics of pregnant women and their newborns of the Korean CHildren’s ENvironmental health Study (Ko-CHENS)

BACKGROUND AND AIM: The Korean CHildren’s ENvironmental health Study (Ko-CHENS) is a nationwide birth cohort study investigating the effects on children’s health and development. As core cohort recruitment was closed in 2020, we disclose the baseline profiles and the characteristics of the participating mothers and children using questionnaires administered during pregnancy and delivery outcomes. METHODS: Thirteen Regional Centers located throughout Korea were responsible for recruiting women in early pregnancy residing in their respective recruitment areas. Self-administered questionnaires and medical records were collected to secure information on demographic factors, socioeconomic status, environmental exposure, lifestyle, and delivery information. In the period up to delivery, we measured indoor environmental exposure and collected bio-specimens, including blood, urine, and umbilical cord blood. RESULTS:The total number of pregnancies was 5,799 and discounting pregnancies by the same woman, the study included 5,581 unique mothers and resulted in 5,452 live births. Response rate of the questionnaires of recruited women was 98.4% and the mean gestational ages (GA) was 14 weeks. The mean age of the subjects was 31.9 years old and the result showed 0.6% of maternal smoking and 1.8% of maternal alcohol drinking during pregnancy rate. Out of 5,581 mothers, we also obtained 5,221 labor and delivery record resulted in 5,213 live births and a sex ratio of births was 49 girls to 51 boys, with 38.6 weeks mean GA at delivery. Preterm delivery rate in singleton pregnancies was 7.8% and showed higher rate with older mothers. The mean weight at birth for total newborn was 3.2kg and the mean birth length at 50.2cm which was comparable to the latest version of Korean National Growth Charts for children and adolescents released in 2017. CONCLUSIONS:Ko-CHENS results can assess various exposure burdens for the highly susceptible population and can strengthen the national pregnant woman and children environmental health management by providing policy guidance. KEYWORDS: National birth cohort, pregnancy outcome, delivery outcome

International versus national growth charts for identifying small and large-for-gestational age newborns: A population-based study in 15 European countries.

BackgroundTo inform the on-going debate about the use of universal prescriptive versus national intrauterine growth charts, we compared perinatal mortality for small and large-for-gestational-age (SGA/LGA) infants according to international and national charts in Europe.MethodsWe classified singleton births from 33 to 42 weeks of gestation in 2010 and 2014 from 15 countries (N = 1,475,457) as SGA (birthweight <10th percentile) and LGA (>90th percentile) using the international Intergrowth-21st newborn standards and national charts based on the customised charts methodology. We computed sex-adjusted odds ratios (aOR) for stillbirth, neonatal and extended perinatal mortality by this classification using multilevel models.FindingsSGA and LGA prevalence using national charts were near 10% in all countries, but varied according to international charts with a north to south gradient (3.0% to 10.1% and 24.9% to 8.0%, respectively). Compared with appropriate for gestational age (AGA) infants by both charts, risk of perinatal mortality was increased for SGA by both charts (aOR[95% confidence interval (CI)]=6.1 [5.6–6.7]) and infants reclassified by international charts from SGA to AGA (2.7 [2.3–3.1]), but decreased for those reclassified from AGA to LGA (0.6 [0.4–0.7]). Results were similar for stillbirth and neonatal death.InterpretationUsing international instead of national charts in Europe could lead to growth restricted infants being reclassified as having normal growth, while infants with low risks of mortality could be reclassified as having excessive growth.FundingInfAct Joint Action, CHAFEA Grant n°801,553 and EU/EFPIA Innovative Medicines Initiative 2 Joint Undertaking ConcePTION grant n°821,520. AH received a PhD grant from EHESP.

Duration and Content Type of Smartphone Use in Relation to Diet and Adiposity in 53,133 Adolescents

ObjectivesAlthough studies suggested that smartphone addiction increases the risk of obesity, it is unknown whether the duration and content type of smartphone use are independently associated with obesity and obesogenic dietary patterns. MethodsUsing a nationally representative sample of 53,133 Korean adolescents (age 12–18 years) in the Korea Youth Risk Behavior Web-Based Survey, we conducted a cross-sectional analysis examining the associations of duration and content type of smartphone use with dietary factors and prevalence of overweight. Duration and content type of smartphone use, dietary intakes, weight, and height were self-reported via online-based questionnaire. Overweight was defined as BMI-for-age ≥85th percentile based on the 2017 Korean National Growth Charts. Multivariable logistic regression was performed on 8 individual dietary factors (≥5 d/wk skipping breakfast, ≥7 times/wk fruits, ≥3 times/d vegetables, ≥3 times/wk fast-food, ramen, chips, soda, sugar-sweetened beverage) and the prevalence of overweight to estimate odds ratios (ORs) and 95% confidence intervals (Cls). All analyses accounted for complex survey sampling and adjusted for potential confounders. ResultsWith adjustment for content type of smartphone use, longer duration of smartphone use (≥5 vs. <2 h/d) was significantly associated with higher frequency of skipping breakfast (OR [CI]: 1.83 [1.72, 1.94]), higher intakes of fast-food (2.14 [1.98, 2.30]), ramen (2.12[1.98, 2.27]), chips (1.43 [1.34, 1.52]), soda (2.34 [2.19, 2.50]), sugar-sweetened beverage (1.88 [1.78, 1.99]), lower intakes of fruits (0.61 [0.57, 0.65]) and vegetables (0.69 [0.64, 0.75]), and higher prevalence of overweight (1.23 [1.15, 1.31]) (all p-trend < 0.001). Compared with using smartphone for information search/retrieval, using messenger, game, entertainment, and SNS were significantly associated with higher intakes of soda and sugar-sweetened beverage, adjusting for duration of smartphone use (all P < 0.05). Game, entertainment, and comics/fiction (vs. information search/retrieval) were associated with higher prevalence of overweight (all P < 0.001). ConclusionsOur data suggest the duration and content type of smartphone use are independently associated with obesogenic dietary patterns and the prevalence of overweight in a dose-response manner. Funding SourcesNRF Korea.

Growth patterns of normo-nourished Afghan, Haitian and Congolese children aged 6-59 months: A comparative study.

International growth charts have been used in the past decades to identify atypical growth and diagnose the nutritional status of individuals. The aim of this study was to construct and compare growth patterns of normo-nourished children between 6-59 months from Afghanistan, Haiti, and the Democratic Republic of the Congo, to assess if it would be worth developing growth charts at a national level.We used an international sample of 46 466 subjects (53.7% female; 46.3% male) from the aforementioned regions. To create the growth charts, we used different statistical methodologies: the Lambda-Mu-Sigma (LMS), LMSP, and LMST models, and regression models based on fractional polynomials. The LMSP models were the ones that fitted our data best and were therefore the ones used to make comparisons between countries using percentiles (3rd, 50th, and 97th).We found that Haitian children were both, taller and heavier than their Afghan and Congolese equals of the same ages. Moreover, differences were bigger in the highest percentiles (i.e., 97th percentile). These differences might be the result of the influence that genetics and diverse social and environmental contexts have on growth rates.Using the same international reference standards for all populations could result in the overestimation or underestimation of the proportion of malnourished children. In light of our results, we recommend the future development of national and regional growth charts to provide health workers with more precise tools to evaluate the nutritional status in the child population.

Azerbaijan national growth charts for children and adolescents from birth to 16 years

Azerbaijan national growth charts for children and adolescents from birth to 16 years

Azerbaijan national growth charts for children and adolescents from birth to 16 years

Azerbaijan national growth charts for children and adolescents from birth to 16 years

Growth in Exclusively Breastfed and Non-exclusively Breastfed Children: Comparisons with WHO Child Growth Standards and Korean National Growth Charts.

BackgroundThis study examined the relationship of infant feeding with anthropometric indices of children during their first six years of life relative to the Korean National Growth Charts (KNGC) and the World Health Organization Child Growth Standards (WHO-CGS).MethodsThe study population consisted of 547,669 Korean infants and children who were 6 months-old to 6 years-old (born in 2008–2009) and participated in the National Health Screening Program for Infants and Children. Data on height, weight, and type of feeding during the first 6 months (exclusively breastfed [BF] vs. mixed- or formula-fed [FF]) were analyzed.ResultsBF boys and girls were significantly shorter and lighter than FF counterparts from the age of 6 months to 4 years, but these differences were not significant after the age of 4 years. BF boys and girls only had significantly lower body mass index at the age of 2 years. Under the age of 2 years 6 months, and especially under the age of 1 year, BF boys and girls were significantly taller and heavier than the 50th percentile values of the 50th percentile value of the WHO-CGS.ConclusionIn this study using large-scaled national data, Korean breastfed children are shorter and lighter by 3 years 6 months–4 years 6 months, but afterward, there is no significant difference from those who had mixed- or formula-feeding. Substantial disparities in the anthropometric indices of Korean infants under the age of 1 compared to KNCG and WHO-CGS were found, regardless of their infantile feeding types. Our results emphasize the importance of constructing a nationwide reference chart based on actual measurements of BF Korean infants.

Environmental stimulation on height: The story from Indonesia

Background: Since the 19th century, sexual dimorphism has been known to be sensitive to adverse environmental conditions. Migrants are sensitive to economic and political affluence, and tend to adjust in height towards height of their hosts. We aim to study growth, sexual dimorphism, and height of native and migrant children in three primary schools in Nabire, Papua, Indonesia. Material and Methods 1: Cross-sectional data on height were obtained from 186 children (59 and 56 native Papuan girls and boys, respectively; 38 and 33 trans-migrant girls and boys respectively; who are aged 7.0-7.7 (mean 7.45) years from three primary schools in Nabire, Papua, Indonesia. The Indonesian National Growth Charts were used as references for height. Results 1: With 118.4 cm (SD 6.7) cm, trans-migrant 7-year old boys were almost 3 cm taller compared to their native-age-matched-peers (115.7 cm (5.0 SD) cm, p < 0.05). The case was different among the girls. Trans-migrant girls were not significantly taller than native girls. Material and Method 2: We re-analyzed the height data from over 300,000 infants, children and adolescents, age 0-18 year, from 34 Indonesian provinces. The data were obtained from the latest Indonesian 2013 National Basic Health Survey (NHBS), and have previously been used to construct National Indonesian Growth Charts. St. Nicolas House Analysis was used to translate correlation matrices into network graphs and visualizing chains of associations between parameters that were multiply correlated. Results 2: St. Nicolas House Analysis suggested that the growth of male sex were more sensitive to population crowding, and that crowding contributes to the greater height dimorphism in taller populations. Conclusion: Economic prosperity and increased population density stimulate male adult height to a greater extent than female adult height, and increase the sexual dimorphism in height among the tall populations of densely populated wealthy countries.

Double burden of malnutrition and obesity in children and adolescents from North Korean refugee families.

This study assessed the nutritional status of children and adolescents from North Korean refugee (NKR) families who have settled and are living in South Korea (SK). Among the 547 individuals who participated in the study, 526 were ultimately included after excluding 21 with missing height or weight data. Their nutritional status was estimated using the 2017 Korean National Growth Charts for children and adolescents. Stunting, underweight, wasting, and obesity were defined as a height-for-age z-score < −2.0, weight-for-age z-score < −2.0, weight-for-height z-score < −2.0, and body mass index z-score > 2.0, respectively. The overall prevalence of stunting, underweight, wasting, and obesity was 7.0%, 6.8%, 5.3%, and 9.1%, respectively. Meanwhile, the prevalence of stunting, underweight, wasting, and obesity was 5.4%, 7.0%, 7.6%, and 10.3% for individuals settled in SK for <5 years and 6.1%, 6.1%, 0.0%, and 13.3% for those living in SK for ≥5 years, respectively. Therefore, children and adolescents from NKR families experience the double burden of malnutrition and obesity.

Overweight and obesity prevalence among upper Egypt primary schools' children using Egyptian and CDC growth charts

BackgroundMonitoring of overweight and obesity among children; by using different growth charts; is fundamental to disease prevention and health promotion. Aim of the studyTo determine overweight and obesity for age among primary school children in Upper Egypt using the Egyptian and CDC growth charts. Subjects and methodsCross-sectional research design was used and conducted at 20 public primary schools in four Upper Egypt governorates. The sample size was 5300 children who selected by multistage sampling technique. Interview questionnaire included personal data and anthropometric measurements (height, Weight and BMI) and Egyptian and CDC growth charts. ResultsThe percentages of children being overweight and obese for age using Egyptian chart were low compared to CDC charts (1.9 vs 4.6%, 8.5% vs. 3.3%, 8.7% vs 3.3% respectively). According to Egyptian chart 5.2% and 5% from total studied boys and girls were overweight and obese respectively, while in CDC growth chart 13.3% and 10.5% from total studied boys and girls respectively. ConclusionIt concluded that there were remarkable differences between CDC and Egyptian growth charts references in the classification of child overweight and obesity. The CDC growth chart evident much higher prevalence among the studied children compared to the Egyptian growth chart. RecommendationPeriodic development and reconstruction of national growth chart to represent the growth pattern of all geographical areas in Egypt. Also, further researches needed to assess the differences of both international and national references.

Impact of Nutritional Status on the Severity of Dengue Infection Among Pediatric Patients in Southern Thailand.

Given the lack of specific antiviral drugs and effective vaccine for dengue infection, factors such as host nutritional status that may alter disease progression require investigation. This study examined the relationship between baseline nutritional status and severity of dengue infection in pediatric patients. Data from dengue patients 1-14 years of age treated at four hospitals in southern Thailand (2017-2018) were reviewed. Dengue infection was classified as dengue fever, dengue hemorrhagic fever and dengue shock syndrome. Children's nutritional status was assessed based on international and national growth charts. Binary logistic regression was used to identify factors associated with dengue severity and malnutrition. Overall, 248, 281 and 43 patients had dengue fever, dengue hemorrhagic fever and dengue shock syndrome, respectively. Overweight was associated with increased risk of dengue severity [odds ratio (OR) = 1.76, 95% confidence interval (CI): 1.13-2.75, P = 0.012; OR = 1.84, 95% CI: 1.09-3.09, P = 0.022, per international and national growth criteria, respectively). Stunting was associated with decreased risk of dengue severity (OR = 0.54, 95% CI: 0.33-0.88, P = 0.013; OR = 0.61, 95% CI: 0.39-0.95, P = 0.030, per international and national growth criteria, respectively). Being overweight was significantly and positively associated with levels of hemoglobin >14 g/dL, hematocrit >42%, hemoconcentration ≥20% and platelet count ≤50,000/mm, whereas being stunted was significantly and negatively associated with levels of hemoglobin >14 g/dL and hematocrit >42%. These findings support a hypothesis that malnutrition might influence the severity of dengue infection through host immune response. Overweight children with dengue infections should be closely observed for early signs of severe dengue infection.

P33 Assessment of Dietary Behaviors and Weight Status Among Adolescents from Multicultural Families and Non-Multicultural Families in Korea

<h3>Background</h3> As Korean adolescents in multicultural families (MF) might experience health disparities, assessing their specific nutritional health status is necessary to design effective and tailored nutrition education programs. <h3>Objectives</h3> This study was the first step to develop a nutrition education program for the Korean adolescent in MF. The aim of this study was to identify nutritional health problems of MF' adolescents through comparing dietary and lifestyle behaviors and weight status among Korean adolescents from MF and non-multicultural families (non-MF). <h3>Study Design, Setting, Participants</h3> This study included 111,067 adolescents aged 12–18 years (MF = 1,751, non-MF = 109,316) from the 2017–2018 Korea Youth Risk Behavior Surveys. <h3>Measurable Outcome/Analysis</h3> Data on dietary and lifestyle behaviors were self-reported using a web-based questionnaire and included foods consumption, alcohol drinking, smoking, physical activity, weight control efforts, and perceived health status. Body mass index (BMI) was calculated using the self-reported height and weight (kg/m²). Weight status was determined based on the 2017 Korean National Growth Chart: underweight (weight-for-age <5th percentiles), overweight (85th≤ BMI-for-age <95th percentiles), and obesity (BMI-for-age ≥95th percentiles). <h3>Results</h3> Using a multiple logistic regression after adjustment for sex, school level, residence, and household income, adolescents from MF showed higher odds ratios (ORs) for having underweight (OR = 1.60, 95% CI = 1.29–1.99) and obesity (OR = 1.22, 95% CI = 1.03–1.43) compared to those from non-MF. Adolescents from MF were less likely to intake fruit ≥5 times/week (OR = 0.86, 95% CI = 0.76–0.96) compared to adolescents from non-MF. Boys in MF showed a lower OR for having vegetable ≥5 times/week (OR = 0.74, 95% CI = 0.60–0.92) than boys in non-MF. Compared to non-MF' adolescents, the OR for engaging in physical activity ≥3 days/week was 0.83 (95% CI = 0.74–0.94) in MF' adolescents. <h3>Conclusions</h3> Korean adolescents in MF showed higher risks for having underweight and obesity as well as unhealthy dietary behaviors compared to those in non-MF. Our findings can be used to develop nutrition education programs for adolescents from MF.

Current use and performance of the different fetal growth charts in the Italian population

ObjectivesThe choice of growth charts impacts on screening, diagnosis and clinical management of fetal growth abnormalities. The objectives of the study were to evaluate: 1) the clinical practice at a national level among tertiary referral centers in the use of fetal biometric growth charts; and 2) the impact on fetal growth screening of existing national and international growth charts. Study designA questionnaire was sent to 14 Italian tertiary referral centers to explore biometric reference growth charts used in clinical practice. National and international (Intergrowth-21st and World Health Organization) fetal growth charts were tested on a large national cohort of low risk women with singleton uneventful pregnancy derived from a retrospective cross-sectional multicenter study (21 centers). The percentage of fetuses with biometric measurements below and above the 10th and 90th percentile for each biometric parameter and gestational week were calculated for each growth chart. The percentile curves of the study population were calculated by non-linear quantile regressions. ResultsTwelve Italian centers (86 %) answered to the questionnaire showing a wide discrepancy in the use of growth charts for fetal biometry. The cohort included 7347 pregnant women. By applying Intergrowth-21st growth charts the percentage of fetuses with head circumference, abdominal circumference and femur length below the 10th centile was 3.9 %, 3.6 % and 2.3 %, and above the 90th centile 29.9 %, 32.5 % and 46 %, respectively. The percentages for the World Health Organization growth charts for head and abdominal circumferences and femur length were: below the 10th centile 6.3 %, 7.2 % and 5.3 %, and above 90th centile 22.8 %, 21.3 % and 31.9 %, respectively. ConclusionsThe wide discrepancy in clinical use of fetal growth charts in Italian centers warrants the adoption of an uniform set of charts. Our data suggest that immediate application into clinical practice of international growth charts might result into an under-diagnosis of small for gestational age fetuses and, especially, in an over-diagnosis of large for gestational age fetuses with major consequences for clinical practice. On these grounds, there is an urgent need for a nationwide study for the prospective evaluation of international growth charts and, if needed, the construction and adoption of methodologically robust national growth charts.

MON-106 Prevalence and Incidence of Obesity in Children and Young Adults in Korea: The Kangwha Study

Childhood obesity is a major global concern, arousing a variety of health problems and high social costs. The prevalence of childhood obesity has increased, but plateaued during the first decade of the 21th century in developed countries. Many previous studies reported cross-sectional data with prevalence of obesity, but researches about incidence of obesity based on longitudinal data is insufficient, especially in Korean population. In this study, we analyzed prevalence and incidence of overweight and obesity in Korean children and young adults from a prospective cohort study. We analyzed data from the Kangwha study, which is a community-based prospective cohort study began in 1986 with 6-year-old, first-grade elementary school students in Kangwha county, South Korea. The Kangwha study is a dynamic cohort, which the number of participants was expanded several times during the follow-up period. The study was started with 482 children, which expanded to total 1,223 participants. The participants were examined annually until 1997, which is 17 years of age. Four adulthood follow-up studies were performed in 1999, 2005, 2010, and 2015. The data includes a 30-year period (1986–2015), with total 16 observations conducted. We used the 2007 Korean National Growth Charts to determine cutoffs for normal weight, overweight, and obesity in children. In adulthood, Asia-Pacific classification of obesity from World Health organization (WHO) recommendation was applied to define overweight and obesity. When the children were in their first-grade of elementary school, prevalence of overweight was 1.04% and obesity was 0.62%. Prevalence of overweight and obesity increased since age 10 (fifth-grade in elementary school) (overweight 4.44%, obesity 1.18%), reaching 7.34% and 3.39% in age 12 (first-grade in middle school), and 9.5% and 5.37% in age 17 (third-grade in high school). Prevalence of overweight and obesity in girls were higher than in boys throughout childhood. Annual incidence of obesity showed small peak at entering middle school (2.1%, age 12), and another peak at third-grade in high school (2.33%, age 17). Also, a positive correlation was found between body mass index (BMI) in younger ages and follow-up BMI. Prevalence of overweight and obesity increased since senior years of elementary school, and more prominent in girls. Detailed study design and larger population would be required for subsequent investigations.

Growth and Nutritional Status of Children in North Korean Refugee Families

Purpose: This study assessed the growth and nutritional status of children in North Korean (NK) refugee families.Methods: This study examined 301 children in NK refugee families. Their growth and nutritional status were estimated using the 2017 Korean National Growth Chart for Children and Adolescents. Stunting, being underweight, and wasting were defined as height-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ) z -scores &lt; –2.0, respectively.Results: The overall prevalences of stunting, being underweight, and wasting were 7.6%, 5.6%, and 5.0%, respectively. In children living in South Korea for &lt;5 years, the prevalences of stunting, being underweight, and wasting were 10.3%, 8.6%, and 3.4%, respectively, compared to 7.9%, 7.9%, and 0.0% for those living in South Korea for ≥5 years. The prevalences of WAZ and WHZ &gt; 2.0 were 5.0% and 11.0%, respectively.Conclusion: Children in NK refugee families still suffer serious malnutrition after settling in South Korea, although being overweight is emerging as a new problem.

Relationship between height and osteosarcoma at the time of diagnosis in the Indian population: A retrospective study

BackgroundIt has been indicated in several instances that tall stature is also an important risk factor in the development of osteosarcoma. This relationship between height and osteosarcoma is substantiated even more by the increasing evidences being put forth in the recent literature on dependence of certain tumors on the growth factors and their receptors, acting through autocrine or paracrine mechanisms. There has been no study on the Indian population that attempts to define such a relationship. PurposeThe primary objective of this study was to define relationship between height of patients and osteosarcoma at the time of diagnosis in the Indian population. Materials/methodsRetrospective data was collected from the old hospital records. Height of patients at the time of diagnosis was compared with expected height of patients of the same age with reference to the standardized growth charts provided by the Indian Academy of Paediatrics. ResultsOut of 98 patients, there were 65 male and 33 female patients with M: F ratio being 1.97:1. The mean age at diagnosis was 17 (SD = 8) years with range of 5–55 years (median = 17 years). Height of the patients at the time of diagnosis was 155.18 (SD = 15.47) cm with range of 115 cm–184 cm (median = 159 cm). Overall, patients with Osteosarcoma were found to be shorter than the expected height deduced from the national growth charts. When patients were divided into two groups of those who were of growing age and those who had completed growth, results were similar. ConclusionThe observation that majority of patients with osteosarcoma in our study were stunted, is an important finding. It could be deduced from this observation that these patients are unable to mount the usual biological response to the overstimulated growth as part of tumorigenesis in osteosarcoma. This could point to a different scenario in the Indian population and more studies need to be carried out with larger number of patients to further elaborate on this observation.