Comparison Using U.S., International, and Ethnic-Specific Growth Charts

Chinese American children have the lowest overweight prevalence in the U.S. compared to other groups. However, the method used to determine overweight status is based on a reference population that under-sampled Asian Americans. Because Asians experience weight-related medical conditions at a lower Body Mass Index (BMI) than other populations, alternative growth charts may more accurately identify at-risk Chinese American children.

To investigate this further, the Charles B. Wang Community Health Center performed a chart review to compare U.S. CDC growth chart estimations of overweight prevalence amongst Chinese pediatrics patients to estimations made using other international and ethnic Chinese growth charts.

table chart of growth chart comparisons

U.S. CDC growth chart estimations of overweight prevalence were compared to four other standardized growth chart estimations which used different reference populations.

image showing growth chart type and overweight prevalence

Five to seven percent of the sampled Chinese pediatric patients may be misclassified as normal weight using the CDC growth chart.

Overall a higher overweight prevalence for Chinese American children was found using international and ethnic Chinese growth charts than the U.S. CDC growth chart. Findings suggest the U.S.CDC growth chart potentially underestimates overweight prevalence in Chinese American children.  Either ethnic-specific or international growth charts should be considered for Chinese Americans or lower BMI percentile cut-off points for weight related screenings should be used.

As a health center dedicated to providing care to the medically underserved with an emphasis on Asian Americans, the Charles B. Wang Community Health Center’s Pediatric Department has integrated U.S., international, and ethnic Chinese growth charts into its electronic medical records system. Physicians will be able to reference each chart’s weight status projection when offering obesity counseling to pediatric patients.

This research project was conducted by Jennifer Lau, Cindy Huang, Loretta Au, Ina Elbaar, Eda Chao, and Raymond Tse. Their research project, “Measuring Overweight In Chinese American Children: Comparison Using US, International, and Ethnic-Specific Growth Charts” was presented at the 2017 CAMS Annual Scientific Conference as an oral presentation.

Written by Matthew Chin

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Posted by Charles B. Wang Community Health Center

The Charles B. Wang Community Health Center is a nonprofit and federally qualified health center, established in 1971. Our mission is to provide high quality and affordable health care to the undeserved, with a focus on Asian Americans. Our vision is to ensure that everyone has full and equal access to the highest level of health care. Learn more at www.cbwchc.org.

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