ArticlePublic health nutrition2020
Misclassification of stunting, underweight and wasting in children 0-5 years of South Asian and Dutch descent: ethnic-specific
Article in Public health nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Longitudinal assessments of child growth: A six-year follow-up of a cluster-randomized maternal education trial.Clinical nutrition (Edinburgh, Scotland) · 2021Trial
- Use of WHO Growth Standards Rather Than Locally Specific Linear Growth Curves Promotes Equity in Pediatric Growth Research for Children Younger Than 5 Years.Nutrition reviews · 2026Review
- Poor growth in multi-ethnic children with food allergy in Amsterdam.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2025Article
- Age- and height-dependent bias of underweight and overweight assessment standards for children and adolescents.Frontiers in public health · 2024Article
- Avoidant/restrictive food intake disorder, other eating difficulties and compromised growth in 72 children: background and associated factors.Frontiers in child and adolescent psychiatry · 2023Article
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Authors and funding
3 authors.
Funding
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Abstract
objectiveSeveral authors have questioned the suitability of WHO Child Growth Standards (WHO-CGS) for all ethnic groups. The aim of this study was to identify potential misclassification of stunting, underweight and wasting in children of Surinamese Asian Indian, South Asian (Pakistan/India) and Dutch descent.
designA series of routine cross-sectional measurements, collected 2012-2015. South Asian-specific normative growth references for weight-for-age and weight-for-length/height were constructed using the LMS method based on historic growth data of Surinamese Asian Indians born between 1974 and 1976. WHO-CGS and ethnic-specific references were applied to calculate z-scores and prevalence of stunting, underweight and wasting.
settingYouth HealthCare, providing periodical preventive health check-ups.
participants11 935 children aged 0-5 years.
resultsConsiderable deviations from WHO-CGS were found, with higher-than-expected stunting rates, especially in the first 6 months of life. Surinamese Asian Indian children showed stunting rates up to 16·0 % and high underweight and wasting over the whole age range (up to 7·2 and 6·7 %, respectively). Dutch children consistently had mean WHO-CGS z-scores 0·3-0·5 sd above the WHO baseline (>6 months). The application of ethnic-specific references showed low rates for all studied indicators, although South Asian children were taller and larger than their Surinamese Asian Indian counterparts.
conclusionsWHO-CGS misclassify a considerable proportion of children from all ethnic groups as stunted in the first 6 months of life. Underweight and wasting are considerably overestimated in Surinamese Asian Indian children. Ethnic-specific growth references are recommended for Surinamese Asian Indian and Dutch children. The considerable differences found between South Asian subpopulations requires further research.
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