The use of anthropometry in the prevention of childhood overweight and obesity

OBJECTIVE: To review concepts and propose measures related to the use of anthropometry for early identification of excessive weight gain in children. METHODS: Review of results from national and international studies focusing on the assessment of childhood growth, and evaluation of the weight-for-height z-scores of individual children using the 1977 National Center for Health Statistics and the 2000 Centers for Disease Control and Prevention growth charts. RESULTS: At present, few countries (23%) use indicators based on weight and height measurements to classify child body weight status. Less than one-third of growth monitoring programmes assess the growth of children beyond 6 y of age. Growth charts based on descriptive samples of populations undergoing increasing trends of childhood overweight and obesity result in substantial underestimation of true rates of these conditions. CONCLUSION: Early recognition of excessive weight gain relative to linear growth should become standard clinical practice by the following: (a) the routine collection of height measurements to enable monitoring weight-for-height and body mass index (BMI); (b) the expansion of existing monitoring programmes to include the assessment of all children up to 18 y at least once a year; (c) the interpretation of weight-for-height and BMI indices based on prescriptive reference data; and (d) the early intervention after an increase in weight-for-height or BMI percentiles has been observed.