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      Perspectives in Human Growth, Development and Maturation 

      A New International Growth Reference for Young Children

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          Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee.

          The World Health Organization (WHO) convened an Expert Committee to reevaluate the use of anthropometry at different ages for assessing health, nutrition, and social wellbeing. The Committee's task included identifying reference data for anthropometric indexes when appropriate, and providing guidelines on how the data should be used. For fetal growth, the Committee recommended an existing sex-specific multiracial reference. In view of the significant technical drawbacks of the current National Center for Health Statistics (NCHS)/WHO reference and its inadequacy for assessing the growth of breast-fed infants, the Committee recommended the development of a new reference concerning weight and length/height for infants and children, which will be a complex and costly undertaking. Proper interpretation of midupper arm circumference for preschoolers requires age-specific reference data. To evaluate adolescent height-for-age, the Committee recommended the current NCHS/WHO reference. Use of the NCHS body mass index (BMI) data, with their upper percentile elevations and skewness, is undesirable for setting health goals; however, these data were provisionally recommended for defining obesity based on a combination of elevated BMI and high subcutaneous fat. The NCHS values were provisionally recommended as reference data for subscapular and triceps skinfold thicknesses. Guidelines were also provided for adjusting adolescent anthropometric comparisons for maturational status. Currently, there is no need for adult reference data for BMI; interpretation should be based on pragmatic BMI cutoffs. Finally, the Committee noted that few normative anthropometric data exist for the elderly, especially for those > 80 y of age. Proper definitions of health status, function, and biologic age remain to be developed for this group.
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            Smoking during pregnancy and lactation and its effects on breast-milk volume.

            The influence of cigarette smoking on daily breast-milk volume was measured by the dose-to-mother deuterium-dilution method in 10 smoking and 10 nonsmoking mothers. After administration of deuterium to the mother, breast milk and infant saliva were sampled over 14 d and analyzed by mass spectrometry. Nonsmoking mothers had a significantly greater breast-milk volume than did smokers [961 +/- 120 vs 693 +/- 110 g/d, mean +/- SD; t = 5.21, P less than 0.0001). Growth rates of the infants were also measured. Weight increase of infants of non-smoking mothers was 550 +/- 130 g whereas of infants of smoking mothers it was only 340 +/- 170 g (t = 3.11, P less than 0.01). These results indicate that cigarette smoking has a negative influence on breast-milk volume whereas the lower infant-growth rates of the smoking mothers suggest also that their breast-milk output was insufficient to support the energy requirements of their infants.
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              Physical status: The use and interpretation of anthropometry. Report of a WHO Experts Committee

              N Listed (1995)
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                Book Chapter
                2001
                : 45-53
                10.1007/978-94-015-9801-9_4
                5ebcdfba-6ecd-4bf6-a434-65d0e8b07e6f
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