A comparison of growth standards: similarities between NCHS Harvard Denver and privileged African children and differences with Kenyan rural children.

Abstract

This mongraph has 3 objectives: to report the physical growth of rural Kenyan children living in 2 fertile coffee growing villages in machakos district; to compare the growth of this kenyan population with sets of reference values for growth derived from healthy predominantly Caucausian or East African Bantu populations and also with 2 studies of growth in rural Kenyan children; to compare different commonly available sets of growth references with each other to determine the degree to which they differ and to discuss the implications of these differences for the use of various growth charts. The anthropometric measurements include weight height mid upper arm circumference and triceps skinfold thickness. The study sample consisted of preschool and primary school children 1-18 years of age who lived in 2 villages in Machakos between December 1975 and January 1980. The degree of growth stunting is remarkable and consistent for all age groups. The achieval growth of the rural Kenyan children was compared to reference values from the New National Child Services (NCHS) growth charts with the Denver increments and with 3 studies on well-to-do East African Bantu children. Of more general importance to international nutrition is the comparison of various available growth references with each other. These include the Harvard Standards the NCHS and the WHO growth charts. The data strongly support the view that ethnic differences are very much less important than other factors as causes of growth failure in children. Poverty poor food intake infectious and parasitic diseases and other environmental factors are some examples. The analysis shows that the WHO published references are not identical to the NCHS percentiles but the differences may only be of some importance for research. The comparisons of the Harvard and NCHS references show relatively small differences and the differences in mean and median weights and heights of the Harvard NCHS and WHO references are small. The Denver references provide growth increments whereas the Harvard and NCHS do not. All 3 studies show that priviledged children have weights and heights which are remarkably similar to the NCHS references at ages 3-13 years. In contrast Bantu children from underpriviledged families show marked growth defects from 2 to 17 years of age. As far as East Africa is concerned growth deficits in children appear to be a feature of deprivation and poverty rather than of ethnicity.