2.8 International standard of Children Growth
2.8.1 WHO Child Growth References and Standards
From the early 70s era to till now World Health Organization (WHO) has been publishing lots of editions of reports, journals and country profiles regarding of children's growth and nutritional status and WHO references and recommended for worldwide apply to assess in children's growth and nutritional status (Wang, et al., 2006). In the year 2005, the World Health Organization developed new Growth Reference Standards (GRS) for children. These growth standards have been used worldwide in 8440 children's representative from six different countries and evaluated and promoted healthy growth, breast feeding, better diets, prevention and control of
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These standards are very effective than the WHO previous standards although some countries still use their own growth standards. The WHO 2006 growth standards include anthropometric indicators such as length/height for-age, weight-for-age, weight-for-length/height, BMI-for-age etc. The WHO provides growth charts and tables of percentiles and Z -scores, separately for girls and boys (See Annex-----). The WHO 2006 growth standards suggested about children's growth. According to the WHO, one of the major point of the new standards is that it presumed breastfeeding as a "biological norm" and the new standards can detecting, measuring, monitoring and evaluate both under-nutrition and obesity which is very related to public health in both developed and developing countries (WHO, 2006 ).
Table xx: Key anthropometric measures and indicators provided in recent WHO and US CDC growth references/ standards This table indicates the anthropometric measurement included in the three sets of recent growth standards and the first two are commonly used by people in different countries and “v” indicates available measures
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It is a matter of issue that a number of studies have attempted to address this subject. Here Table 2.5 revealed that the estimated unhealthy and poor growth status can differ when several kinds of growth standards are used. One recent study showed that the Bangladeshi children aged 0–12 months had higher prevalence of wasting than stunting by reference of CDC (2000) growth charts but on the other hand wasting less than stunting reference by WHO (2006) growth charts (Table xx). For that reason, the summarization (See Annex xx) of the main references and classifications are using to define overweight and obesity in children and adolescents. These findings are indicate significant differences in the prevalence of overweight and obesity based on different references. But need more research in these areas in present and future to help the understand and guidelines for correct applications in different populations and for different purposes (Wang, Y., 2004