Regular measuring of height and weight for children and adolescents
Systematic review
|Updated
Key message
Background Overweight and obesity are major global public health problems affecting both adults and children. The World Health Organization estimates that at least 20 million children under the age of 5 years are overweight globally. Identifying children and adolescents at risk for over or underweight gives the possibility for prevention and early treatment. The Norwegian Knowledge Centre for Health Services was asked to summarise relevant research on the effect of growth monitoring related to the problem of obesity. The report will be considered in the production of new guidelines for height and weight measuring in primary health care for children from 0-20 years. Objectives What effect does growth monitoring have on overweight, underweight and eating disorders? What are the benefits, harms and costs associated with the different measuring programs? Is there a connection between being overweight as a child and overweight as an adult? Methods We searched systematically in ten databases last in January 2005 to identify studies of height and weight measuring of children and adolescents from 0-20 years. The outcome measures were overweight, underweight and eating disorders, as well as costs and resource use of measuring. Results The literature search gave 6 280 hits. Three systematic reviews and 15 studies met the inclusion criteria for types of studies, participants, interventions and outcome measures. A summary of the systematic reviews and studies is presented below: • From current research we can not determine if growth monitoring has an effect on overweight, underweight or eating disorders, only that it can identify abnormal growth on the growth chart and monitor growth development. • Height and weight for the children were similar with and without monitoring. It is uncertain if these results are transferable to Norwegian children. • Normal measuring of height (in centimetres) and weight (in kilograms) is the best method to classify overweight and underweight, compared to other methods. • Self-reported height and weight gives inaccurate information. This was indicated by five of six studies. Adolescents overestimate their height and underestimate their weight. • Overweight in childhood increases the risk for overweight in adulthood. This was indicated by two systematic reviews and four studies that assessed the association 36 between size and growth during infancy and early childhood subsequent obesity later in childhood, adolescence and adulthood. - The older a child is when they are overweight, the greater risk for being overweight later in life. We found no research that could answer the following: • If measuring programs can cause harm by triggering the development of overweight, underweight or eating disorders. • Benefits and harms of the different measuring programs. • How often and at what ages children and adolescence ought to be measured. Conclusion There is little research that has been done on the benefits and harms of regular measuring of height and weight for children and adolescents. The research can not answer if growth monitoring is worthwhile, other than to identify abnormal growth and monitor growth development.