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Fit to WHO weight standard of European infants over time

Research output: Contribution to journalArticle

  • Daniel Levin
  • Louise Marryat
  • Tim J Cole
  • John McColl
  • Ulla Harjunmaa
  • Per Ashorn
  • Charlotte Wright

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    Rights statement: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

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    Licence: Creative Commons: Attribution (CC-BY)

Original languageEnglish
Pages (from-to)455-60
Number of pages6
JournalArchives of Disease in Childhood
Issue number5
Early online date16 Feb 2016
Publication statusPublished - May 2016


OBJECTIVES: The 2006 WHO growth charts were created to provide an international standard for optimal growth, based on healthy, breastfed populations, but it has been suggested that Northern European children fit them poorly. This study uses infant weight data spanning 50 years to determine how well-nourished preschool children from different eras fit the WHO standard, and discuss the implications of deviations.

DESIGN: Four longitudinal datasets from the UK and one from Finland were used comprising over 8000 children born between 1959 and 2003. Weights from birth to 2 years were converted to age-sex-adjusted Z scores using the WHO standard and summarised using Generalized Additive Models for Location, Scale and Shape.

RESULTS: Weights showed a variable fit to the WHO standard. Mean weights for all cohorts were above the WHO median at birth, but dipped by up to 0.5 SD to a nadir at 8 weeks before rising again. Birth weights increased in successive cohorts and the initial dip became slightly shallower. By age 1 year, cohorts were up to 0.75 SD above the WHO median, but there was no consistent pattern by era.

CONCLUSIONS: The WHO standard shows an acceptable, but variable fit for Northern European infants. While birth weights increased over time, there was, unexpectedly, no consistent variation by cohort beyond this initial period. Discrepancies in weight from the standard may reflect differences in measurement protocol and trends in infant feeding practice.

    Research areas

  • Body Weight, Child, Preschool, Ethnic Groups, European Continental Ancestry Group, Female, Finland, Great Britain, Growth Charts, Humans, Infant, Male, Weight Gain, World Health Organization

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