Reference growth curves to identify weight status (underweight, overweight or oebesity) in children and adolescents: systematic review

Abstract

The identification of somatic growth, through reference curves, can be used to create strategies and public policies to reduce public health problems such as malnutrition and obesity and to identify underweight, overweight and obesity, taking into account the variability of physical and of human development characterized by intra and interpopulation heterogeneity. The purpose of this systematic review was to identify studies providing reference growth curves for weight status (underweight, overweight or obesity) in children and adolescents. A systematic search was conducted in CINAHL; LILACS; PubMed ScienceDirect; Scopus; SPORTDiscus; SciELO; Web of Science. Manual searches were also carried out in gray literature (Google scholar) in order to find possible studies that were not retrieved by the search strategy. Data were extracted by two independent reviewers, and consensus was verified between them. To assess the risk of bias/methodological quality of studies, the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-sectional Studies (NHLBI) was used. Overall, 86 studies that met the inclusion criteria were included (cross-sectional and longitudinal). Through the values of reference growth curves for the identification of underweight, overweight and obesity, it was possible to verify that there is great variability among percentiles for the identification of underweight, overweight and obesity. The most prevalent percentiles for underweight were P3 and P5; for overweight, the most prevalent was P85 and the most prevalent percentiles for obesity were P95 and P97. The most prevalent anthropometric indicators were Body Mass Index (BMI), Waist Circumference (WC), Body Mass (BM) for age and height for age. Conclusion: The optimal growth must be reached, through the standard growth curves, but that the reference curves demonstrate a cut of the population growth, raising possible variables that can influence the optimal growth, such as an increase in the practice of physical activities and an awareness of proper nutrition.