Evaluating Anthropometric References for Use with Developing Country Data

Dawn Neill, University of Washington
Emily Brunson, University of Washington
Donna L. Leonetti, University of Washington
Bettina Shell-Duncan, University of Washington

Anthropometry is a well-known tool used to assess the nutrition and growth of populations. Prior to 2006, two references were used to standardize anthropometrics: 1978 NCHS and 2000 CDC. In 2006, WHO provided another reference for children up to 60 months. Given the availability of multiple references, questions arise regarding their use among non-westernized populations. Studies suggest the 2000 is superior to the 1978, but studies have not addressed potential issues arising from increases in overweight in the 2000 reference population or examined how the references compare. We use cross-sectional data from three developing country populations to compare standardized anthropometric measurements. For WAZ and WHZ, the 2000 produces significantly lower Z-scores compared to the 1978 and 2006, illustrating the effect of increasing weight in the 2000 reference population. For HAZ, the 2006 produced significantly lower Z-scores than the 1978 or 2000, as expected given the construction of this standard.