Body composition of Peruvian children with short stature and high weight-for-height. II. Implications for the interpretation for weight-for-height as an indicator of nutritional status.

In some child populations, low height-for-age, suggesting chronic undernutrition, may paradoxically be accompanied by relatively high weight-for-height, suggesting obesity. This growth pattern was investigated with anthropometric assessment and body composition studies using H2(18)O stable isotope dilution in 139 preschool-age Peruvian children. Results suggested low height-for-age (15th percentile National Center for Health Statistics [NCHS]) and high weight-for-height (60th percentile NCHS). Skinfold thicknesses were lower whereas arm muscle areas were more similar to NCHS reference values. Total body water (as percent body weight) was greater than reference values, consistent with lower body fat. Differences in body proportions did not account adequately for the high weight-for-height. The data suggest that the high weight-for-height in these children is not obesity but is associated with lower body fat and greater lean tissue or lean tissue hydration that may reflect dietary, environmental, or genetic influences. Weight-for-height cutoffs for wasting or obesity may require different interpretations for different populations.