Nutrition Guidance for Healthy Children

NGHC: Childhood Nutrition and Growth (2013)

• Assessment
  How is typical growth appropriately documented for children ages two to 11 years ?

  • Conclusion

    Five studies (two meta-analysis/systematic reviews, three consensus statements) met inclusion criteria for the question.

    Five studies were in substantial agreement that the Centers for Disease Control (CDC) and World Health Organization (WHO) growth charts are based on the growth of healthy, well-nourished children and are appropriate to evaluate growth and nutrition of children from birth to 19 years of age. (Grummer, Kuczmarkski, Looney, Dietitians of Canada, MGRS) There are two sets of CDC growth charts available: one for ages zero to 36 months, and one for ages two to 19 years. The WHO growth charts are available for ages birth to 60 months. The CDC growth charts are recommended to evaluate the growth of children two to 11 years.

    One study concluded that health care providers do not routinely follow recommendations for assessment of the growth of children, with the most common barrier to implementation  being the belief that weight status in children can be identified visually by health care providers. (Looney)  Two studies concluded that interventions are needed to train health care providers in appropriate methods for assessing growth of children. (Looney, Dietitians of Canada)

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: How is typical growth appropriately documented for children ages 2-11 years ?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Grummer-Strawn LM, Reinold C, Krebs NF; Centers for Disease Control and Prevention (CDC). Use of World Health Organization and CDC growth charts for children aged 0-59 months in the United States. MMWR Recomm Rep. 2010; 59 (RR-9): 1-15. Erratum in MMWR Recomm Rep. 2010; 59 (36): 1,184.
      • Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL. 2000 CDC Growth Charts for the United States: Methods and development. Vital Health Stat 11. 2002; (246): 1-190.
      • Looney SM, Spence ML, Raynor HA. Use of body mass index and body mass index growth charts for assessment of childhood weight status in the United States: a systematic review. Clin Pediatr (Phila). 2011; 50 (2): 91-99.
      • Use of growth charts for assessing and monitoring growth in Canadian infants and children: Executive summary. Paediatr Child Health. 2004; 9 (3): 171-184.
      • WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl 2006;450:76-85.
  • Search Plan and Results: NGHC: Optimal Nutrition for Childhood Growth 2011