Stunting and ‘overweight’ in the WHO Child Growth Standards – malnutrition among children in a poor area of China

Abstract

OBJECTIVE: The aims of the present paper were to assess the nutritional status of children under 5 years old using the 2006 WHO Child Growth Standards ('the WHO standards') and to compare the results with those obtained using the National Center for Health Statistics/WHO international growth reference ('the NCHS reference'). DESIGN: This was a community-based cross-sectional survey. The WHO standards were used to calculate Z-scores of height-for-age (HAZ), weight-for-age (WAZ), weight-for-height (WHZ) and BMI-for-age (BMIZ). SETTING: Fifty counties of thirteen mid-western provinces, China. SUBJECTS: A total 8041 children aged <5 years were measured during a 2-month period from August to October 2006. RESULTS: The prevalence of stunting, underweight and wasting were 30.2 %, 10.2 % and 2.9 %, respectively. The prevalence of overweight and the possible risk of overweight were as high as 4.1 % and 16.8 %. Further analysis among the children with possible risk of overweight found that the percentage of stunting (HAZ < or-2) was 57.6 %, the percentage with -2 <or= HAZ <or= 2 was 41.0 % and the percentage with HAZ > 2 was only 1.4 %. The prevalence of stunting was 21.9 % and of underweight was 12.7 % by the NCHS reference. CONCLUSIONS: Stunting was the most serious problem that was impeding child growth and development. The high rate of 'overweight' was a false impression, the truth being 'stunting overweight', and the way to solve it should be to increase protein and other nutrients in the diet at an early age.