Principles of growth assessment.

1. Leila Beker, PhD, RD 1. United States Food and Drug Administration Washington, DC 1. Centers for Disease Control and Prevention Growth Charts: United States . Centers for Disease Control and Prevention. 2000. Available at: http://www.cdc.gov/growthcharts/ 2. Pediatric Nutrition Handbook . Committee on Nutrition. Elk Grove Village, Ill: American Academy of Pediatrics; 2003 3. Growth and Pubertal Development in Children and Adolescents: Effects of Diet and Physical Activity. Rogol AP, Clark PA, Roemmich JN. Am J Clin Nutr. 2000;72(suppl) :521S– 528S [OpenUrl][1][Abstract/FREE Full Text][2] 4. Evaluation of Methodology for Nutritional Assessment in Children: Anthropometry, Body Composition, and Energy Expenditure. Zemel BS, Riley EM, Stallings VA. Ann Rev Nutr. 1997;17 :211– 235 [OpenUrl][3][CrossRef][4][PubMed][5][Web of Science][6] Growth in children is usually steady and predictable, and good references are available for assessment and comparison. Growth reflects changes in the mass of body tissues (muscle, fat, and bone), with differences in maturation and body composition between boys and girls. Growth is a key component of nutritional status and indicator of health and well-being for the individual and in populations, with every aspect of a child’s health being affected by his or her nutritional status. Growth can be measured objectively by using various anthropometric measurements and is universally part of any pediatric care. Typically, weight is measured by using scales, infantometer (length board), stadiometer (stature) for linear growth, calipers for skinfold measurements, and nonstretchable tape for head and arm or other circumferences. Recumbent length is referenced through age 3 years, stature from 2 to 20 years, and head circumference from birth to age 3 years. Although infancy and adolescence are characterized by rapid growth, growth occurs in spurts, with rapid growth followed by slower growth. Stunting or faltering of linear growth reflects both a decrease in the number of spurts and the height of these spurts and can begin in utero. Growth generally is divided into four periods: 1) infancy to 2 years of age, 2) preschool years (2 to 6 years), 3) middle childhood years (7 to 10 years), and 4) adolescence (11 to 20 years). These growth periods encompass changes in body composition as well as maturational milestones. During infancy, childhood, and adolescence, both cell number and cell size increase. Body composition changes significantly from infancy to adolescence in terms of absolute and relative changes in the amount of lipid, protein, water, and minerals. Skinfold measurements provide information on body composition that reflects nutritional stores, including lean body mass (muscle and water), lipid (energy stores), and bone … [1]: {openurl}?query=rft.jtitle%253DThe%2BAmerican%2BJournal%2Bof%2BClinical%2BNutrition%26rft.stitle%253DAm%2BJ%2BClin%2BNutr%26rft.aulast%253DRogol%26rft.auinit1%253DA.%2BD%26rft.volume%253D72%26rft.issue%253D2%26rft.spage%253D521S%26rft.epage%253D528%26rft.atitle%253DGrowth%2Band%2Bpubertal%2Bdevelopment%2Bin%2Bchildren%2Band%2Badolescents%253A%2Beffects%2Bof%2Bdiet%2Band%2Bphysical%2Bactivity%26rft_id%253Dinfo%253Apmid%252F10919954%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=ajcn&resid=72/2/521S&atom=%2Fpedsinreview%2F27%2F5%2F196.atom [3]: {openurl}?query=rft.jtitle%253DAnnual%2Breview%2Bof%2Bnutrition%26rft.stitle%253DAnnu%2BRev%2BNutr%26rft.aulast%253DZemel%26rft.auinit1%253DB.%2BS.%26rft.volume%253D17%26rft.issue%253D1%26rft.spage%253D211%26rft.epage%253D235%26rft.atitle%253DEVALUATION%2BOF%2BMETHODOLOGY%2BFOR%2BNUTRITIONAL%2BASSESSMENT%2BIN%2BCHILDREN%253A%2BAnthropometry%252C%2BBody%2BComposition%252C%2Band%2BEnergy%2BExpenditure%26rft_id%253Dinfo%253Adoi%252F10.1146%252Fannurev.nutr.17.1.211%26rft_id%253Dinfo%253Apmid%252F9240926%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/external-ref?access_num=10.1146/annurev.nutr.17.1.211&link_type=DOI [5]: /lookup/external-ref?access_num=9240926&link_type=MED&atom=%2Fpedsinreview%2F27%2F5%2F196.atom [6]: /lookup/external-ref?access_num=A1997XM78600012&link_type=ISI