Background: Reference charts are widely used in healthcare as a screening tool. This study aimed to produce reference growth charts for school children from West Malaysia in comparison with the United States Centers for Disease Control and Prevention (CDC) chart.
Methods: A total of 14,360 school children ranging from 7 to 17 years old from six states in West Malaysia were collected. A two-stage stratified random sampling technique was used to recruit the subjects. Curves were adjusted using Cole's LMS method. The LOWESS method was used to smooth the data.
Results: The means and standard deviations for height and weight for both genders are presented. The results showed good agreement with growth patterns in other countries, i.e., males tend to be taller and heavier than females for most age groups. Height and weight of females reached a plateau at 17 years of age; however, males were still growing at this age. The growth charts for West Malaysian school children were compared with the CDC 2000 growth charts for school children in the United States.
Conclusion: The height and weight for males and females at the start of school-going ages were almost similar. The comparison between the growth charts from this study and the CDC 2000 growth charts indicated that the growth patterns ofWestMalaysian school children have improved, although the height and weight of American school children were higher than those for West Malaysian school children.
Keywords: Centile curves, LMS method, LOWESS method, Growth charts, Malaysia.
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Human growth is influenced by both genetic and environmental factors (1). Environmental factors affecting human growth such as infectious disease and dietary intake are of particular importance in developing areas of the world (2). Growth rates vary according to gender and age; however, they tend to follow certain standard patterns. Regular assessment of growth in children is important for monitoring their health. Monitoring growth is an important task for health care providers to identify health or nutrition- related problems (3). In addition, screening for children to identify those who deviate from normal growth in a healthy population is an essential prerequisite prior to clinical investigation. Growth references are the most valuable and commonly-used parameters in evaluating the well-being of an individual. Anthropometric data such as body height and weight, and the associated indicators, such as height-for-age, weight-for-age and height-for-weight, can be used to detect and prevent growth-related diseases.
Reference centile curves are widely used in healthcare as a screening tool. These reference values are useful in providing insight as to whether physiological needs for growth and development are met. The centile curves identify subjects that display values of particular measurements which lie in one or the other spectrum of the reference distribution (4). For example, the individual at the 90th percentile for height is taller than 90% of his or her agematched peers.
The pattern of growth in any age of a population changes with time; therefore, it is recommended that references should be updated regularly (5). For optimal monitoring purposes, recent reference growth data based on representative samples from the population are essential (1). International growth charts allow comparison between countries, but regional or national references are more useful in assessing local changes in nutritional status (6). Earlier studies on weight and height curves for Malaysian school children were published by Chen and Dugdale (7) in 1970. However, their data were collected from a small group of about 1,259 school children from the Kuala Lumpur and Petaling Jaya areas of the state of Selangor and not representative of the whole Malaysian population. Moreover, the study was conducted 40 years ago and secular changes must have occurred in children's growth pattern since then. …