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  • Original Article
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Application of the 2006 WHO growth standard from birth to 4 years to Pacific Island children

Abstract

Background:

Pacific adults and children have very high rates of obesity.

Objective:

Body size at birth, 2- and 4 years for the whole cohort, compliant (not smoking and breastfed) and non-compliant children was compared to the 2006 World Health Organization (WHO) growth standard using z-scores.

Design:

Longitudinal data (n=659) from the 2000 Pacific Island family birth cohort study of weight at birth and weight and height at 2- and 4 years was analysed.

Results:

At birth the average child was 3.673±0.501 kg; z-score 0.605 units higher (P<0.000001) than the WHO standard. At 2- and 4 years, average z-scores for weight and body mass index (BMI) were significantly different from 0 (mean z-scores for weight +1.062 and +1.688, for BMI +1.701 and +1.969 respectively, P<0.000001). Mean height was significantly lower (P<0.000001) z-score=−0.232 at 2 years but higher (P<0.000001) at 4 years, z-score=+0.626. Over 4 years, the daily weight gain was 11.2 g day–1 compared with 8.9 g day–1 for the WHO child. Compliant (n=287) compared to non-compliant (n=372) weighed less and were slightly shorter at 2- and 4 years measurement points. Non-compliant children categorized as non-smoking (n=229) weighed more than smoking mothers' (n=143) children at birth, 2- and 4 years.

Conclusion:

Pacific children are born heavy, over 4 years increase in weight is faster and between 2- and 4 years increase in height is faster than the reference breastfed child, independent of pre- and postnatal factors. Smoking decreases the rate of weight gain and children who are not breastfed gain weight faster. Interventions to limit weight gain need to start with the family before conception.

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Acknowledgements

We gratefully acknowledge the families who participated in the study as well as other members of the research team. In addition, we wish to express our thanks to the PIF advisory board for their guidance and support. ER and JP were involved in the study design, data collection and data analysis. VO led the data analysis and KN was involved in the study protocols and data interpretation. All authors were involved in writing the manuscript. None of the authors had any conflict of interest.

The Pacific Island Family Study is funded by grants from the Foundation for Research, Science & Technology, the Health Research Council of New Zealand, the Child Health Foundation and the Maurice & Phyllis Paykel Trust.

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Rush, E., Paterson, J., Obolonkin, V. et al. Application of the 2006 WHO growth standard from birth to 4 years to Pacific Island children. Int J Obes 32, 567–572 (2008). https://doi.org/10.1038/sj.ijo.0803751

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  • DOI: https://doi.org/10.1038/sj.ijo.0803751

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