Table
of Contents
Previous
Article
Next Article
Nutrition
& Obesity Publications
WIN
NIDDK
|
Winter 1999
Revised Pediatric Growth Charts for the U.S. to Include
New BMI Chart
By Robert J. Kuczmarski, Dr. P.H.,
NCHS/CDC
The National Center for Health Statistics (NCHS) growth charts for infants,
children, and adolescents are undergoing major revisions for the first
time since their development in 1977. The revision project, led by the
NCHS of the Centers for Disease Control and Prevention (CDC), is designed
to provide improved instruments for screening and evaluating the attained
size and growth patterns of children in the United States.
The availability of advanced statistical procedures and additional national
survey data, especially from the Third National Health and Nutrition Examination
Survey (NHANES III, 1988-94) beginning at 2 months of age, provided the
opportunity to address issues and concerns that arose with widespread
national and international applications of the charts.
The revised charts will have smoothed percentile curves for measures
included in the 1977 charts, with one particularly notable change. Gender-specific
body mass index-for-age charts for ages 2 through 19 years will replace
the weight-for-stature charts for children and adolescents, which were
limited to the evaluation of prepubescent children.
Basing the growth charts on body mass index (BMI; kg/m2) has the following
advantages:
- BMI tracks over time, and the tracking increases with increasing
age in the pediatric years. BMI-for-age growth charts can be used clinically
beginning at 2 years of age, when an accurate stature can be obtained.
An additional advantage is that BMI charts can now be used for children
ages 2 years or older who were too short to plot on the 1977 weight-for-stature
charts.
- BMI is predictive of body fatness. It can also be used throughout
the range of values to rank individuals with their peers, and to characterize
underweight or at risk of underweight, although no expert guidelines
currently exist for the classification of underweight based on BMI.
There is clearly a need for further research in this area.
- The BMI percentile charts, when properly applied, can be used to screen
individuals in clinical settings. Primary care providers and public
health programs will be able to assess and monitor overweight in youths.
The charts can also be used in surveillance of populations and for the
early identification of persons who might benefit either from secondary
prevention or from various interventions targeted toward controlling
body weight.
Further information on the revised growth charts can be obtained at
the NCHS/CDC Internet website (www.cdc.gov/nchswww).
|