Is the World Health Organization’s multicentre child growth standard an appropriate growth reference for assessing optimal growth of South African mixed-ancestry children?

Main Article Content

L M Arendse
D Brits
E V Lambert
V E Gibbon

Abstract


In South Africa (SA), it has been estimated that one-third of boys and 25% of girls under the age of 5 years are stunted, according to the World Health Organization (WHO) Multicentre Growth Reference Study. During the past decade, research in developed and developing countries has shown that the international growth standard overestimates stunting and/or wasting when compared with population-specific growth references. Population-specific growth references typically incorporate genetic and environmental factors and can therefore better inform public health by identifying children who may be at risk for malnutrition, or who may be ill. Using the universal growth standard in SA may not be accurately assessing growth. In this article, environmental and genetic factors, and their influence on growth, are reviewed. These points are illustrated through a brief history of the peopling of SA, with an understanding of the socioeconomic and political climate – past and present. We discuss the uniqueness of certain population groups in SA, with contributions regarding some of the shortest peoples in the world and a history of sociopolitical inequities, which may mean that children from certain population groups who are perfectly healthy would underperform using the universal growth standard. Therefore, we suggest that a local population-specific growth reference would serve to better inform public health policies, and address childhood health equity and physical developmental pathways to adult health risk status.

 

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Is the World Health Organization’s multicentre child growth standard an appropriate growth reference for assessing optimal growth of South African mixed-ancestry children?. (2022). South African Journal of Child Health, 16(2), 117-121. https://doi.org/10.7196/SAJCH.2022.v16i2.1805
Section
Review Articles

How to Cite

Is the World Health Organization’s multicentre child growth standard an appropriate growth reference for assessing optimal growth of South African mixed-ancestry children?. (2022). South African Journal of Child Health, 16(2), 117-121. https://doi.org/10.7196/SAJCH.2022.v16i2.1805

References

De Onis M, Onyango A, Borghi E, et al. WHO Child Growth Standards: Length/ height-for-age, Weight-for-age, Weight-for-length, Weight-for-height, and Body Mass Index-for-age. Methods and Development. Geneva: WHO, 2006.

De Onis M, Garza C, Victora CG, et al. WHO Multicentre Growth Reference Study (MGRS): Rationale, planning and implementation. Food Nutr Bull 2004;25(Suppl 1):S1-S89.

Norris SA, Griffiths P, Pettifor JM, Dunger DB, Cameron N. Implications of adopting the WHO 2006 child growth standards: Case study from urban South Africa, the birth to twenty cohort. Ann Hum Biol 2009;36(1):21-27. https://doi.org/10.1080/03014460802620694

Schoeman S, Faber M, Adams V, et al. Adverse social, nutrition and health conditions in rural districts of the KwaZulu-Natal and Eastern Cape provinces, South Africa. S Afr J Clin Nutr 2010;23(3):140-147. https://doi.org/10.1080/1 6070658.2010.11734328

Cole TJ. The development of growth references and growth charts. Ann Hum Biol 2012;39(5):382-394. https://doi.org/10.3109/03014460.2012.694475

National Department of Health. Strategic Plan for Maternal, Newborn, Child and Women’s Health (MNCWH) and Nutrition in South Africa 2012 - 2016. Pretoria: NDoH, 2011.

Millennium Development Goals (MDG) Africa Steering Group. Achieving the Millennium Development Goals in Africa: Recommendations of the MDG Africa Steering Group. New York: United Nations, 2008.

Fenn B, Penny ME. Using the new World Health Organization growth standards: Differences from 3 countries. J Pediatr Gastroenterol Nutr 2008;46(3):316-321. https://doi.org/10.1097/mpg.0b013e31815d6968

Vignerová J, Shriver L, Paulová M, et al. Growth of Czech breastfed infants in comparison with the World Health Organization standards. Cent Eur J Public Health 2015;23(1):32-38. https://doi.org/10.21101/cejph.a4204

Christesen HT, Pedersen BT, Pournara E, Petit IO, Júlíusson PB. Short stature: Comparison of WHO and national growth standards/references for height. PLoS ONE 2016;11(6):e0157277. https://doi.org/10.1371/journal.pone.0157277

Ya-Qin Z, Hui L, Hua-Hong W, et al. The 5th national survey on the physical growth and development of children in the nine cities of China: Anthropometric measurements of Chinese children under 7 years in 2015. Am J Phys Anthropol 2017;163:497-509. https://doi.org/10.1002/ajpa.23224

Natale V, Rajagopalan A. Worldwide variation in human growth and the World Health Organization growth standards: A systematic review. BMJ Open 2014;4:e003735. https://doi.org/10.1136/bmjopen-2013-003735

Singhal A. Long-term adverse effects of early growth acceleration or catch-up growth. Ann Nutr Metab 2017;70:236-240. https://doi.org/10.1159/000464302

Bogin B. The evolution of human growth. In: Cameron N, Bogin B, eds. Human Growth and Development. 2nd ed. Amsterdam: Elsevier, 2012:287-324.

Moore DD, Walker MD, Diamond DJ, Conkling MA, Goodman HM. Structure, expression, and evolution of growth hormone genes. Recent Progr Hormone Res 1982;38:197-225.

Weedon MN, Frayling TM. Reaching new heights: Insights into the genetics of human stature. Trends Genet 2008;24(12):595-603. https://doi.org/10.1016/j.tig.2008.09.006

Cowgill LW, Eleazer CD, Auerbach BM, Temple DH, Okazaki K. Developmental variation in ecogeographic body proportions. Am J Phys Anthropol 2012;148:557-570. https://doi.org/10.1002/ajpa.22072

Wells JCK. Ecogeographical associations between climate and human body compositions: Analyses based on anthropometry and skinfolds. Am J Phys Anthropol 2012;147:169-186. https://doi.org/10.1002/ajpa.21591

Giuliani C, Bacalini MG, Sazzini M, et al. The epigenetic side of human adaptation: Hypotheses, evidences and theories. Ann Hum Biol 2015;42(1):1-9. https://doi.org/10.3109/03014460.2014.961960

Lomolino MV, Sax DF, Riddle BR, Brown, JH. The island rule and a research agenda for studying ecogeographical patterns. J Biogeography 2006;33:1503-1510. https://doi.org/10.1111/j.1365-2699.2006.01593.x

Wells JCK. Ecogeographical associations between climate and human body compositions: Analyses based on anthropometry and skinfolds. Am J Phys Anthropol 2012;147:169-186. https://doi.org/10.1002/ajpa.21591

Galvin KA, Thornton PK, Boone RB, Sunderland J. Climate variability and impacts on east African livestock herders: The Maasai of Ngorongoro

conservation area, Tanzania. Afr J Range Forage Sci 2004;21(3):183-189.

Jarvis JP, Scheinfeldt LB, Soi S, et al. Patterns of ancestry, signatures of natural selection, and genetic association with stature in Western African pygmies. PLoS Genet 2012;8(4):e1002641. https://doi.org/10.1371/journal.pgen.1002641

Patin E, Laval G, Barreiro LB, et al. Inferring the demographic history of African farmers and pygmy hunter-gatherers using a multilocus resequencing data set. PLoS Genet 2009;5(4):e1000448. https://doi.org/10.1371/journal.pgen.1000448

Galvin KA, Beeton TA, Boone RB, BurnSilver SB. Nutritional status of Maasai pastoralists under change. Hum Ecol 2015;43:411-424. https://doi.

org/10.1007%2Fs10745-015-9749-x

O’Dea JD. Possible contribution of low ultraviolet light under the rainforest canopy to the small stature of pygmies and negritos. Homo 1994;44(3):284-287.

Dickens TE, Rahman Q. The extended evolutionary synthesis and the role of soft inheritance in evolution. Proc Royal Soc B 2012;279:2913-2921. https://doi.org/10.1098/rspb.2012.0273

Steckel RH. Biological measures of the standard of living. J Econ Perspect 2008;22(1):129-152. https://doi.org/10.1257/jep.22.1.129

Stulp G, Barrett L. Evolutionary perspectives on human height variation. Biol Rev 2016;91:206-234. https://doi.org/10.1111/brv.12165

Walker ARP. Nutrition-related diseases in southern Africa: With special reference to urban African populations in transition. Nutr Res 1995;15(7):1053-1094.

Akachi Y, Canning D. The height of women in sub-Saharan Africa: The role of health, nutrition, and income in childhood. Ann Hum Biol 2007;34(4):397-410. https://doi.org/10.1080/03014460701452868

Hochberg Z. Evo-devo of child growth II: Human life history and transition between its phases. Eur J Endocrinol 2009;160:135-141. https://doi.org/10.1530/eje-08-0445

Steckel RH. Biological measures of the standard of living. J Econ Perspect 2008;22(1):129-152. https://doi.org/10.1257/jep.22.1.129

Hochberg Z. Evolutionary perspective in child growth. Rambam Maimonides Med J 2011;2(3):e0057. https://doi.org/10.5041%2FRMMJ.10057

German A, Livshits G, Peter I, et al. Environmental rather than genetic factors determine the variation in the age of the infancy to childhood transition: A twins study. J Pediatr 2015;166:731-735. https://doi.org/10.1016/j.jpeds.2014.11.047

Bogin B. Background to the study of human growth. In: Bogin B, ed. Patterns of Human Growth. 2nd ed. Cambridge. Cambridge University Press, 1999:18-19.

Tanner JM. Catch-up growth in man. Br Med Bull 1981;37(3):233-238.

Petersen DC, Libiger O, Tindall EA, et al. Complex patterns of genomic admixture within southern Africa. PLoS Genet 2013;9(3):e1003309. https://doi.org/10.1371/journal.pgen.1003309

Busby GBJ, Band G, Si Le Q, et al. Admixture into and within sub-Saharan Africa. eLife 2016;5:e15266. https://doi.org/10.7554/elife.15266

Montinaro F, Busby GBJ, Gonzalez-Santos M, et al. Complex ancient genetic structure and cultural transitions in southern African populations. Genetics 2017;205:303-316. https://doi.org/10.1534/genetics.116.189209

National Department of Health (NDoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC), ICF. South Africa Demographic and Health Survey 2016: Key Indicator Report. Pretoria: NDoH, 2017.

Statistics South Africa. Living Conditions Survey: Living Conditions of Households in South Africa – an Analysis of Household Expenditure and

Income Data using the LCS 2014/2015. Pretoria: Stats SA, 2017.

Rutstein SO, Johnson K. The DHS Wealth Index. DHS Comparative Reports No. 6. Maryland: ORC Macro, 2004. http://www.dhsprogram.com/topics/wealthquintiles (accessed 22 July 2020).

Steyn NP, Labadarios D, Maunder E, Nel J, Lombard C. Secondary anthropometric data analysis of the National Food Consumption Survey in South Africa: The double burden. Nutrition 2005;21(1):4-13. https://doi.org/10.1016/j.nut.2004.09.003

Statistics South Africa. Poverty Trends in South Africa: An Examination of Absolute Poverty between 2006 and 2015. Pretoria: Stats SA, 2017.

Morris AG, Heinze A, Chan EKF, Smith AB, Hayes VM. First ancient mitochondrial human genome from a prepastoralist southern African. Genome Biol Evol 2014;6(10):2647-2653. https://doi.org/10.1093%2Fgbe%2Fevu202

Liebenberg L, L’Abbè EN, Stull KE. Population differences in the postcrania of modern South Africans and the implications for ancestry estimation. Forens Sci Int 2015;257:522-529. https://doi.org/10.1016/j.forsciint.2015.10.015

Quintana-Murci L, Harmant C, Quach H, et al. Strong maternal Khoisan contribution to the South African coloured population: A case of gender-biased admixture. Am J Hum Genet 2010;86:611-620. https://doi.org/10.1016%2Fj.ajhg.2010.02.014

Petrus T, Isaacs-Martin W. The multiple meanings of coloured identity in South Africa. Africa Insight 2012;42(1):87-102.

Inwood K, Masakure O. Poverty and physical well-being among the coloured population in South Africa. Econ Hist Dev Regions 2013;28:2:56-82. https://doi.org/10.1080/20780389.2013.866382

Eideh H, Jonsson B, Hochberg Z. Growth of the Kalahari desert’s bushman ‒ the Ju/’hoansi San. Acta Pædiatr 2012;101:528-532. https://doi.org/10.1111/j.1651-2227.2011.02573.x

Rosa A, Brehm A. African human mtDNA phylogeography at-a-glance. J Anthropol Sci 2011;89:25-58. https://doi.org/10.4436/jass.89006

Uren C, Kim M, Martin AR, et al. Fine-scale human population structure in southern Africa reflects ecogeographic boundaries. Genetics 2016;204(1):303-314. https://doi.org/10.1534/genetics.116.187369

Walker RS, Gurven M, Hill K, et al. Growth rates and life histories in twentytwo small-scale societies. Am J Hum Biol 2006;8:295-311. https://doi.org/10.1002/ajhb.20510

Temple NJ, Steyn NP, Fourie J, de Villiers A. Price and availability of healthy food: A study in rural South Africa. Nutrition 2011;27:55-58. https://doi.org/10.1016/j.nut.2009.12.004

Statistics South Africa. Mortality and Causes of Death in South Africa, 2015: Findings from Death Notifications. Pretoria: Stats SA, 2017.

South Africa. National Health Act No. 61 of 2003.

Cole TJ. The secular trend in human physical growth: A biological view. Econ Hum Biol 2003;1:161-168. https://doi.org/10.1016/s1570-677x(02)00033-3

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