Examination of Healthy Growth among Children of the U.S. Affiliated Pacific Region

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2020

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Child growth, from birth to adolescence, has profound implications on adult health (1). Healthy growth is measured in many countries as an expected linear growth relative to a growth reference, depicting how children grow (2). Measuring how a child grows has many challenges when comparing children from different countries and ethnic backgrounds. Multiple growth references with varying recommendations, including a widely accepted growth standard describing how a child should grow, are available but lead to inconsistencies in growth classifications, which is a limitation in global trends for children. The dual burden of malnutrition, which is the coexistence of undernutrition and overnutrition, frequently assessed by growth, has also been a health concern in child growth (3). A shift in diet and activity level in the last century, caused by environmental changes and increase in wealth, known widely as nutrition transition, has led to behavior changes and adverse health outcomes (4). Child overweight and obesity (COWOB) is a growing epidemic influenced by nutrition transition, especially in the US affiliated Pacific (USAP) region, with the likelihood of these children developing diabetes and cardiovascular disease early in life and in adult years. Limited data on child growth in USAP region are available. The findings in this dissertation will expand the limited growth data for USAP children and explore appropriate anthropometric classifications by: 1) comparing two growth references and growth standard charts; 2) examining waist circumference among children with acanthosis nigricans, an indicator for insulin resistance; and 3) assessing height among children with acanthosis nigricans or obesity.

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Epidemiology

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96 pages

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