Assessment of Japanese healthy children’s nutritional status using Waterlow classification

Malnutrition is associated with an increased risk of morbidity and mortality, and may case an undesirable effect on the growth and development in children. There have been several reports about the prevalence of malnutrition in hospitalized children, but reports about malnutrition in a large number of healthy children are quite limited. The aim of this study was to evaluate the prevalence of likelihood of malnutrition in Japanese healthy children. We retrospectively reviewed data of height and weight at a regular health check in 7517 healthy children (age 3 - 17;3747 boys, 3770 girls) during 2008 and 2010 in Nara city, Japan. The data were evaluated using Waterlow classification, i.e., weight-for-height (W/H) and height-for-age (H/A). The prevalence of under-nutrition, as estimated by the values of W/H less than 90% and H/A less than 95%, were 20.1% and 8.3%, respectively, and this prevalence of malnutrition risk tended to vary substantially with age. The peak levels of the prevalence were found to be at around 12 years old for both sexes in W/H, and at around 11 years old for boys and at around 10 years old for girls in H/A. We have clearly demonstrated the existence of certain percentages of the likelihood of malnutrition at different ages in healthy children. These findings suggest that when we want to evaluate the nutritional status using Waterlow classification in hospitalized children, we should be careful by taking such reference values into account.