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Measuring and assessing growth
Published in Judy More, Infant, Child and Adolescent Nutrition, 2021
Growth charts have been constructed by measuring a large number of healthy children at varying ages. Centile lines are then constructed showing the normal distribution of weight/height/head circumference measurements at each age. The 50th centile line is the median of the measurements for that age. Fifty per cent of children will have measurements below that line and the other 50 per cent will be above that line. The other centile lines are constructed using standard deviations from the median. The 25th and 75th centile lines are 2/3 of a standard deviation from the median. Twenty-five per cent of children’s measurements will be below the 25th centile line and 75 per cent of children’s measurements will be above that centile line.
Endocrinology and diabetes
Published in Shibley Rahman, Avinash Sharma, A Complete MRCP(UK) Parts 1 and 2 Written Examination Revision Guide, 2018
Shibley Rahman, Avinash Sharma
A growth chart is used to compare a child’s current height and how fast he or she is growing to other children of the same age and gender (male or female). A measurement called standard deviation (SD) is used. If a child’s height is more than 2 SDs below the average height, the child is thought to have short stature.
Measuring a child’s size and boosting activity
Published in Rachel Pryke, Joe Harvey, Annabel Karmel, Weight Matters for Children, 2018
Rachel Pryke, Joe Harvey, Annabel Karmel
When looking at a growth chart, whether for weight or for height, there will be a series of centile lines ranging from the 0.4th centile up to the 99.6th centile. The lines are taken from a large population of healthy children and show the wide variations in height and weight that are normal. (This information was collected in 1990 and is referred to as the 1990 Reference Chart for Age and Sex.) The 50th centile line represents the national average for white British children, with half of them falling above this line and the other half below. In order to see if the population today is getting heavier, the current average weight must be compared with the average from a previous time, for which the 1990 reference chart is used, or centile charts would be misleading. There are slightly different trends for children of other races, with Asian babies tending to be lighter and shorter and African-Caribbean babies tending to be heavier and longer on average. Examples of centile charts are found in Appendix 1.
From growth charts to growth status: how concepts of optimal growth and tempo influence the interpretation of growth measurements
Published in Annals of Human Biology, 2023
Growth charts describe the growth attained by children of different ages. There are two important caveats here. First, growth charts are used to evaluate attained size rather than the process of growth (apart from growth velocity charts). Second, growth charts describe a statistical distribution of measurements. Cut-points to define “normal” growth are based on statistically defined thresholds, such as the 5th percentile or two standard deviations below the mean, and not necessarily on biological properties. The implicit assumption is that a growth chart defines “optimal” growth, because their application is a means to screen for “suboptimal” growth, growth failure, or growth faltering. However, this implicit assumption is only true of prescriptive charts, as explained below. Moreover, growth is a physiologic process that occurs over time and growth faltering, a disruption in physiologic processes supporting growth, can occur in a child who is large, average, or small for age (Perumal et al. 2018). Nevertheless, thresholds for normal growth are used at the population level for research or public health purposes to define the prevalence of certain growth characteristics (such as prevalence of stunting or obesity), and at the individual level, as a threshold for further testing or intervention in clinical care.
Obstacles Preventing Public Health Nurses from Discussing Children’s Overweight and Obesity with Parents
Published in Comprehensive Child and Adolescent Nursing, 2022
Yael Sela, Keren Grinberg, Dan Nemet
Each family health center includes a staff of registered nurses, graduates of an advanced course in public and community health. Meetings with patients and families are usually conducted individually, according to a predetermined schedule, based on the needs of the child and parents (Israel Ministry of Health, 2007). Children’s growth metrics (height and weight) are monitored at every visit using growth charts, and BMI and percentiles are calculated. The personal bond that develops between the nurses and families enables them to provide tailored support and closely monitor the child’s physical and emotional development (Owen et al., 2018; Somekh et al., 2020). Despite the existence of a complete and consistent structured early child development protocol, overweight and obesity rates are still very high, especially for those under age six. It has been suggested that BMI or BMI percentile in the case of children are not an indication of body composition, and theoretically, someone with high muscle mass could be considered overweight or obese by mistake. Yet, unfortunately, this is not the case with the increased prevalence of high BMI or BMI percentile of children above the 85th BMI percentile. For this reason, BMI index is still considered a valid and reliable screening tool for obesity in children (Adab et al., 2018).
Associations between Trust of Healthcare Provider and Body Mass Index in Adolescents
Published in Comprehensive Child and Adolescent Nursing, 2021
Heather K. Hardin, Shirley M. Moore, Scott E. Moore, Naveen K. Uli
BMI was calculated from weight and height collected during a school screening. Height and weight, which were measured in inches and pounds, respectively, were collected using a standardized protocol (Nihiser et al., 2007) with a calibrated digital scale and a stadiometer. Height was measured to the nearest one-eighth inch, while weight was measured to the nearest 0.2 pound. Height and weight were measured in duplicate and averaged. BMI was calculated from height and weight. BMI percentile categories were determined using age- and sex-adjusted BMI percentiles (Kuczmarski et al., 2002). Using the growth chart system of BMI classification, percentile ranges determined the weight category of adolescents. A BMI ≥95th percentile was considered obese, a BMI from 85th percentile to >95th percentile was considered overweight, a BMI percentile from 5th percentile >85th percentile was considered healthy weight, and a BMI <5th percentile was considered underweight.