P1.01: Differences in measurements of recumbent length and standing height in young children affect magnitude of BMI and its interpretation
✍ Scribed by Anette E. Buyken; Sebastian Hahn; Anja Kroke
- Publisher
- John Wiley and Sons
- Year
- 2004
- Tongue
- English
- Weight
- 71 KB
- Volume
- 46
- Category
- Article
- ISSN
- 0323-3847
No coin nor oath required. For personal study only.
✦ Synopsis
In the first 2 years children's height measurements should base on recumbent length and thereafter on standing height (stature). However, since individual height assessment in 2-and 3-year old children may differ from this standard, information on the difference between these two measurements is needed. This study compared length and stature of 2-and 3-year old children included in the Dortmund Nutritional and Anthropometrical Longitudinally Designed (DONALD) Study. Measurements to the nearest 0.1 cm were carried out using an infantometer and a digital stadiometer. At age 2 years, average length of girls (n=224) and boys (n=203) was 88.3 (3.1) and 89.9 (3.2) cm, mean differences (stature minus length) were -0.47 (0.65) and -0.45 (0.64) cm, respectively, corresponding BMI values were 16.18 (1.3) and 16.46 (1.2) kg/m2, with mean differences of +0.17 (0.24) and +0.16 (0.23). According to stature measurements 9.4% of the girls and 10.8% of the boys were overweight (BMI > 90th percentile), while length measurements classified only 7.1% and 9.4%, respectively, as overweight. Mean differences of a similar magnitude were observed at age 3 years: -0.53 (0.62) cm and +0.17 (0.20) kg/m2 in girls (n=248) and -0.47 (0.65) cm and +0.14 (0.20) kg/m2 in boys (n=277), with 7.6% and 7.3% being classified as overweight according to stature measurements as opposed to 5.4% and 4.8% using length measurements. Proportions of children classified into the same quartile by both measurements ranged from 80-88%. Bland-Altman plots indicated no systematic variations of mean differences over the range of measurements for all age-and sexstrata. In conclusion, changing measurements from length to stature results in a notable upward shift in BMI, which is not reflected in the current German percentiles. This shift may thus result in misinterpretation of individual BMI levels or may introduce bias in trend observations. Hence, standards to account for these differences may need to be developed.