Secondary analysis of anthropometric data from a South African national food consumption survey, using different growth reference standards.

The National Center for Health Statistics (NCHS) references were used to analyse anthropometric data from the 1999 National Food Consumption Survey (NFCS) of South Africa. Since then, however, The Centers for Disease Control and Prevention (CDC) 2000 reference and the World Health Organization (WHO) 2006 standards were released. It was anticipated that these reference and standards may lead to differences in the previous estimates of stunting, wasting, underweight and obesity in the study population. The aim was to compare the anthropometric status of children using the 1977 NCHS, the 2000 CDC growth references and the 2006 WHO standards. All children 12-60 months of age with a complete set of anthropometric data were included in the analyses. Data for 1,512 children were analysed with SAS 9.1 for Windows. A Z-score was calculated for each child for weight-for-age (W/A), weight-for-length/height (W/H), length/height-for-age (H/A) and body mass index (BMI)-for-age, using each of the three reference or standards for comparison. The prevalence of stunting, obesity and overweight were significantly higher and the prevalence of underweight and wasting were lower when using the WHO standards compared to the NCHS and the CDC references. The higher than previously established prevalence of stunting at 20.1% and combined overweight/obesity at 30% poses a challenge to South African policy makers to implement nutrition programmes to decrease the prevalence of both stunting and overweight. The 2006 WHO growth standard should be the standard used for assessment of growth of infants and children younger than 5 years in developing countries.