Application of the WHO growth reference (2007) to assess the nutritional status of children in China.

Objective: To assess the nutrition status of children and adolescents in China using the WHO growth reference (2007) in comparison with that defined by the International Obesity Task Force (IOTF) and the Working Group on Obesity in China (WGOC).

Methods: Overweight and obesity were defined by age-, sex-, specific BMI reference developed by WHO (2007), IOTF (2000), and WGOC (2004), respectively. Stunting and thinness were defined as height and BMI less than two standard deviations (SD) of the WHO growth reference (2007), respectively. Data of children and adolescents aged 5 to 19 years (n=54,857, 28,273 boys, 26,584 girls) from the 2002 China National Nutrition and Health Survey (CNNHS) were used in the study.

Results: The prevalence of overweight, obesity, stunting and thinness among Chinese children and adolescents aged 5-19 years was 5.0%, 1.2%, 13.8%, and 7.4%, respectively when the WHO growth reference (2007) was used, whereas the estimated absolute total number affected by these 4 conditions were 14.6, 3.7, 40.6, and 21.8 million, respectively. The prevalence of overweight and obesity was 18.1% in large cities, while the stunting prevalence was 25.1% in rural 4. Obesity prevalence assessed by the WHO growth reference was higher than that as assessed by the IOTF reference, and obesity prevalence assessed by the WGOC reference was lower than that as assessed by the IOTF reference.

Conclusion: The nutritional status of children and adolescents is not equal in different areas of China. Stunting is still the main health problem of the poor, while overweight and obesity are the main health problems in large cities.