Revista Panamericana de Salud Pública
Print version ISSN 1020-4989
ALVAREZ, Martha Cecilia; LOPEZ, Amalia and ESTRADA, Alejandro. Nutritional status of children in Antioquia, Colombia, according to two reference systems. Rev Panam Salud Publica [online]. 2009, vol.25, n.3, pp. 196-203. ISSN 1020-4989. http://dx.doi.org/10.1590/S1020-49892009000300002.
OBJECTIVE: To compare the anthropometric and nutritional indicators of a group of children in Antioquia, Colombia, according to the reference standards of the World Health Organization and of the National Health Statistics (NCHS), United States of America. METHODS: A descriptive, cross-sectional study was carried out on a representative, random sample of 2 290 children participating in the supplementary food program MANA in Antioquia, Colombia. A comparison was made of the 50th percentile (P50) for weight and length/height, the nutritional status (weight-for-age, length/height-for-age, and weight-for-length/height), and the mean Z scores according to the reference values established by WHO and by NCHS. Student t and χ2 tests were performed, each using 95% confidence intervals (95%CI). RESULTS: The prevalence of general malnutrition was significantly lower when following WHO standards (5.3%; 95%CI: 4.42-6.30) versus NCHS standards (7.6%; 95%CI: 6.56-8.78; P = 0.0014). Chronic malnutrition was greater with the WHO standards (17.6%; 95%CI: 16.03-19.19) than with NCHS's (12.8%; 95%CI: 11.46-14.25; P < 0.001), and severe malnutrition was similar for both (2.0%; 95%CI: 1.49-2.69 and 2.3%; 95%CI: 1.71-2.99, respectively; P = 0.477). The prevalence of overweight was greater with WHO standards (3.8%; 95%CI: 3.07-4.69) than with NCHS standards (2.3%; 95%CI: 1.75-3.04; P = 0.0035). CONCLUSION: When WHO standards are applied, overweight and chronic malnutrition are more easily detected, than with NCHS'; furthermore, the prevalence rate of general malnutrition decreases beginning at 6 months age, while the overall chronic malnutrition prevalence increases. These new standards constitute an appropriate tool for assessing growth and establishing more objective values for malnutrition prevalence. The Antioquía department should establish policies for health, food, and nutrition that will improve the nutritional status of its children.
Keywords : Reference standards; nutritional status; malnutrition; overweight; obesity; child health; Colombia.