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Open AccessArticle

Child Growth Curves in High-Altitude Ladakh: Results from a Cohort Study

1
Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 30059, Taiwan
2
Department of Family Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan
3
Department of Dietetics, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 30059, Taiwan
4
Department of Family Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei 108206, Taiwan
*
Author to whom correspondence should be addressed.
These authors contribution is equally to this work.
Int. J. Environ. Res. Public Health 2020, 17(10), 3652; https://doi.org/10.3390/ijerph17103652
Received: 13 April 2020 / Revised: 14 May 2020 / Accepted: 18 May 2020 / Published: 22 May 2020
(This article belongs to the Special Issue The Environment and Children’s Health)
High prevalence of child underweight and stunting in high-altitude areas has often been reported. However, most previous studies on this topic were cross-sectional. Another critical concern is that using the World Health Organization (WHO) Child Growth Standards to evaluate child growth in high-altitude areas may lead to overestimations of underweight and stunting. Our study aimed to evaluate the long-term growth pattern of children (3 to 18 years) above the altitude of 3500 m in Ladakh, India. The participants’ body weight (BW), body height (BH), and body mass index (BMI) were measured annually according to the WHO Child Growth Standards for children under 5 years old and the WHO reference data for children aged 5 to 19 years. The generalized estimating equation (GEE) was used to estimate the means and z-scores of BW, BH, and BMI at different ages. A total of 401 children were enrolled from 2012 to 2018. Their mean z-scores of BW, BH, and BMI were −1.47, −1.44, and −0.85 in 2012 and increased to −0.74, −0.92, and −0.63 in 2018. This population’s specific growth curve was also depicted, which generally fell below the 85th percentile of the WHO standards. This is the first cohort study about long-term child growth patterns in a high-altitude area. The detailed underlying mechanisms of our findings need future research on more representative data of high-altitude populations. View Full-Text
Keywords: child growth; growth curve; high altitude; body weight; body height child growth; growth curve; high altitude; body weight; body height
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Yang, W.-C.; Fu, C.-M.; Su, B.-W.; Ouyang, C.-M.; Yang, K.-C. Child Growth Curves in High-Altitude Ladakh: Results from a Cohort Study. Int. J. Environ. Res. Public Health 2020, 17, 3652.

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