Cross-sectional study of child and adolescent growth in Ecuador

Child growth is internationally recognized as an important indicator for monitoring health in populations. There exists a wide controversy regarding the use of international growth standards versus local references. This study seeks to construct reference growth curves for school-age Ecuadorian children and adolescents, and to compare them with World Health Organization (WHO) standards, in order to identify the differences and their public health implications. The study authors enrolled 2891 children (1644 girls and 1247 boys) aged 5 to 18 years, from a variety of climatic zones and ethnic groups. LMS method was used to construct Ecuadorian curves for height, weight and Body Mass Index. Comparisons of Ecuadorian and WHO curves were graphically illustrated. U.S children were taller than Ecuadorian children across all age ranges, with larger differences between the two populations in children over 13 years. Consequently, estimates of low height and extremely low height, as well as overweight, obese and undernourished, were significantly different between WHO standards and the Ecuadorian references. Population-specific growth curves may be more adequate for growth monitoring of Ecuadorian children than WHO growth curves. We advocate for the construction of an Ecuadorian growth reference for clinical use based on national population, from conception to maturity, as an accurate instrument for monitoring growth.