Open seminar on “Assessing Child Nutritional Status”

An open seminar entitled, ‘Assessing child nutritional status – international standards vs. national references?’ was held at Centre for International Health (CIH) Wednesday August 19, 2015. In all, 25 persons affiliated with CIH were present, plus one PhD candidate from South Africa, who joined via Skype.

The seminar was hosted by Anne Hatløy, Associate Professor, Centre for International Health and Catherine Schwinger, PhD Candidate at the Department of Global Public Health and Primary Care.

Hatløy began the seminar by giving an introduction to the development of the WHO Child Growth Standards. This was followed by a presentation by Schwinger of arguments for the use of national references based on scientific literature. Two articles in particular were considered:

• ‘Growth of Belgian and Norwegian children compared to the WHO growth standards: prevalence below −2 SD and above  +2 SD and the effect of breastfeeding’.
  Arch Dis Child 2011;96:916–921.
  P B Júlíusson, M Roelants, K Hoppenbrouwers, R Hauspie, R Bjerknes 
• ‘WHO Child Growth Standards in action’.
  Arch Dis Child July 2008 Vol 93 No 7.
  Stef van Buuren, Jacobus P van Wouwe

Interactive discussions

The presentations were followed by a lively debate touching upon different aspects of this issue. The main points of discussion were the quality of the WHO Child Growth Standards, the problem of defining overweight and the need for including clinical indicators, as well as the purpose of using either references or a standard.

The up-to-date methodology and the rigorous execution of the WHO Multicentre Growth Reference Study (MGRS) was emphasized, based on published documentation, but also on personal communication with researchers and organizations involved in the implementation of the MGRS. A former professor at CIH was closely involved in the training and quality control of the anthropometric measurements in the MGRS.

Irrespective of the discussion on the conceptual correctness, there was consensus that it is crucial to agree on one reference to enable valid comparisons both over time and between groups. One of the problems identified was that the concept of what is abnormal, e.g. what is overweight, might have changed over time. Clinical indicators, such as physical and mental impairments need to be taken into consideration in order to establish meaningful definitions.

Proactive learning for all

The open seminar initiative provided students and faculty alike with a valuable opportunity to share experiences and knowledge. These can be taken with them in their research, involving field work in many different developing and developed countries.