Prevalence of High Weight-for-recumbent Length Among Infants and Toddlers From Birth to 24 Months of Age: United States, 1971–1974 Through 2015–2016

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by Cheryl D. Fryar, M.S.P.H., Margaret D. Carroll, M.S.P.H., and Cynthia L. Ogden, Ph.D., Division of Health and Nutrition Examination Surveys

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Excess weight in infants is often defined using weight-for-recumbent length. The Centers for Disease Control and Prevention (CDC) recommends using the World Health Organization (WHO) growth standards to monitor growth in children under age 2 years in the United States. The recommended definition of excess weight in infants is +2 z scores (corresponding to the 97.7th percentile) on the WHO sex-specific weight-for-recumbent length growth standards. Some analyses have used the 95th percentile on the CDC sex-specific weight-for-recumbent length growth charts as a cut point for excess weight in infants. Consequently, this report presents estimates of excess weight using both definitions.

Based on the WHO growth standards, results from the 2015–2016 National Health and Nutrition Examination Survey (NHANES), using measured recumbent lengths and weights, indicate that an estimated 8.9% of infants and children under age 24 months have high weight-for-recumbent length. Based on the CDC growth charts, an estimated 9.9% of infants and children under 24 months have high weight-for-recumbent length.

Table 1 shows the unweighted sample sizes for infants and toddlers with measured recumbent length and weight by age for each survey cycle. Because data collection began at different ages in different surveys, Table 2 shows the prevalence of high weight-for-recumbent length from birth to 24 months, from 6 to 24 months, and from 12 to 24 months by survey years. The 1976–1980 NHANES included individuals starting at 6 months, while the 1988–1994 NHANES included individuals aged 2 months and over. Beginning with 1999–2000, NHANES included individuals from birth. Therefore, trends from 1976–1980 to the present can be reported only for the 6- to 24-month age group.

NHANES, conducted by the National Center for Health Statistics, uses a stratified, multistage probability sample of the civilian noninstitutionalized U.S. population. A household interview and a physical examination are conducted for each survey participant. During the physical examination, conducted in a mobile examination center, recumbent length and weight are measured as part of a more comprehensive set of body measurements. These measurements are taken by trained health technicians, using standardized measuring procedures and equipment. Observations for persons missing a valid recumbent length or weight measurement are not included in the data analysis.

For additional information on NHANES methods, visit the Survey Methods and Analytic Guidelines page.

 

References

Grummer-Strawn LM, Reinold C, Krebs NF, Centers for Disease Control and Prevention (CDC). Use of World Health Organization and CDC growth charts for children aged 0–59 months in the United States. MMWR Recomm Rep 59(RR–9):1–15. 2010.

Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. 2000 CDC growth charts for the United States: Methods and development [PDF – 5 MB]. National Center for Health Statistics. Vital Health Stat 11(246). 2002.

World Health Organization. WHO child growth standards. Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. 2006.

 

This Health E-Stat supersedes the earlier version below:

 

Tables

Table 1. Unweighted sample size for infants and toddlers from birth to 24 months with measured weight and recumbent length, by age: United States, 1971–1974 through 2015–2016
Survey period Age (months)
Birth to under 24 6–24 12–24
1971–1974 — — 553
1976–1980 — 1,014 719
1988–1994 — 2,442 1,287
1999–2000 671 466 256
2001–2002 667 488 256
2003–2004 766 574 332
2005–2006 822 602 345
2007–2008 719 524 295
2009–2010 703 521 317
2011–2012 584 403 219
2013–2014 609 450 240
2015–2016 630 465 272

— Data not available.
SOURCE: NCHS, National Health and Nutrition Examination Survey.

 

Table 2. High weight-for-recumbent length among infants and toddlers from birth to 24 months, by age: United States, 1971–1974 through 2015–2016
Survey period Percent (standard error)
WHO growth standards1 CDC growth charts2
Birth to under 24 months 6–24 months 12–24 months Birth to under 24 months 6–24 months 12–24 months
1971–1974 — — 6.5 (1.2) — — 6.7 (1.3)
1976–1980 — 6.3 (1.0) 6.8 (1.1) — 7.1 (1.0) 7.2 (1.2)
1988–1994 — 7.8 (0.7) 8.0 (1.0) — 8.8 (0.7) 8.5 (1.1)
1999–2000 9.2 (1.3) 9.8 (1.7) 7.9 (2.1) 10.4 (1.6) 10.5 (1.6) 7.8 (2.1)
2001–2002 7.8 (1.1) 7.7 (1.3) 6.3 (1.3) 7.9 (1.1) 7.8 (1.3) 6.4 (1.3)
2003–2004 8.5 (1.2) 9.0 (1.7) 9.0 (2.1) 9.5 (1.3) 10.1 (1.6) 9.8 (2.1)
2005–2006 7.1 (1.0) 7.1 (1.4) 6.7 (1.7) 8.2 (1.1) 8.1 (1.5) 6.9 (1.7)
2007–2008 8.8 (0.9) 9.7 (1.1) 9.7 (1.8) 9.5 (1.1) 10.4 (1.2) 10.1 (1.2)
2009–2010 8.6 (1.3) 9.6 (1.7) 9.4 (2.1) 9.7 (1.1) 10.7 (1.6) 9.6 (2.0)
2011–2012 7.1 (1.3) 8.2 (1.6) 7.1 (2.2) 8.1 (1.2) 8.2 (1.6) 6.3 (2.0)
2013–2014 8.1 (1.2) 8.4 (1.5) 7.9 (1.8) 9.1 (1.4) 9.5 (1.7) 8.3 (1.7)
2015–2016 8.9 (0.9) 9.0 (1.1) 8.4 (1.3) 9.9 (1.2) 10.2 (1.3) 8.1 (1.5)

— Data not available.
* Estimate has a confidence interval width between 5 and 30 and a relative confidence interval width greater than 130% and does not meet standards of reliability or precision; see “National Center for Health Statistics Data Presentation Standards for Proportions [PDF – 2.9 MB]“.
1High weight-for-recumbent length is greater than or equal to the 97.7th percentile (+2 standard deviations) of the sex-specific weight-for-recumbent length WHO growth standards.
2High weight-for-recumbent length is greater than or equal to the 95th percentile of the sex-specific weight-for-recumbent length 2000 CDC growth charts.
NOTE: WHO is World Health Organization; CDC is Centers for Disease Control and Prevention.
SOURCE: NCHS, National Health and Nutrition Examination Survey.