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Every child born in the UK receives a set of growth charts with their Personal Child Health Record. These charts have been developed and designed by Professor Charlotte Wright, University of Glasgow. Growth monitoring is fundamental for the assessment of health and the identification of growth abnormalities in children, and growth charts are used to interpret these measurements. The design of child growth charts and the instructions for their use influences perceptions of normality and drives screening activity for conditions such as failure to thrive or obesity. The newly developed UK child growth charts more accurately reflect healthy growth patterns than previous versions, and feature a range of design improvements and evidence-based, straightforward instructions for use. They have been endorsed by the key professional societies for child health and nutrition in the UK, and are being used by health professionals and parents throughout the UK, Ireland and New Zealand.
The methodology for growth curve estimation developed by Rigby and Stasinopoulos (2004,2006) has been used worldwide. The World Health Organisation used the methodology and the related software exclusively for developing child growth standards, WHO (2006, 2007, 2009). The Global Lung Function Initiative (GLFI), (www.lungfunction.org, Stanojevic et al. 2008, Cole et al. 2009, ) use it for providing a unified worldwide approach to lung function in growth and ageing. The methodology is now the gold standard for developing growth curves.
With childhood obesity now of global public health and clinical importance, attention had to be directed toward how best to identify the condition and more importantly those who are at further risk of serious obesity-related conditions. This case study illustrates how assessment has moved beyond the simple crude measure, challenging the accepted approach and developed more sensitive and specific assessment tools. Described is a new range of clinical assessment charts which allow practitioners and epidemiologists to evaluate a range of body characteristics known to be linked to morbidity, make a fuller assessment of individual risk and target better and specific intervention.
Childhood obesity is a national problem but it is a problem even more keenly felt in the West Midlands where statistics show the percentage of children classified as obese is higher than the national average. Research demonstrating that simple measures such as waist circumference and body mass index (BMI) are every bit as effective as complex and expensive measuring processes such as magnetic resonance imaging (MRI) scans in identifying high risk obese children has fed into the evaluation and subsequent improvement of child weight management programmes in the region and more widely in the UK. It also informed the development of an obesity strategy and action plan for Worcestershire for the period 2008-11.
Clinical research conducted at the UCL Institute of Child Health between 1998 and 2011 under the direction of Professors Alan Lucas and Atul Singhal showed that a slower rate of infant weight gain had long-term benefits to reduce the risk of obesity and cardiovascular disease. This contradicted the accepted view, which favoured the promotion of rapid weight gain in infancy. This work has had a significant influence on public health policies and initiatives in the UK and elsewhere. It has changed the way infant formulas are made and used. Two new interventions for overweight children have been developed and are helping families around the world.
The University of Southampton's lifecourse cohort studies have led to a paradigm shift in the medical approach to obesity and non-communicable diseases. Research linking maternal pre-conception and early years nutrition with health outcomes for later life has directly influenced public healthcare policy at international (United Nations), national (Scientific Advisory Committee on Nutrition) and local (Southampton City) levels. Dissemination through medical practice and Southampton-designed public education programmes such as LifeLab means this research has already led to health benefits for tens of thousands of people, providing them with the information and tools to help prevent themselves and their children from succumbing to a non-communicable disease.