Perspective: Can growth monitoring and promotion accurately diagnose or screen for inadequate growth of individual children? A critical review of the epidemiological foundations

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cg.authorship.typesCGIAR and advanced research instituteen
cg.contributor.affiliationInternational Food Policy Research Instituteen
cg.contributor.affiliationUniversity of South Carolinaen
cg.contributor.donorBill & Melinda Gates Foundationen
cg.creator.identifierJef L Leroy: 0000-0001-9371-3832
cg.creator.identifierRebecca Brander: 0000-0002-6156-0373
cg.creator.identifierMarie Ruel: 0000-0002-9506-348X
cg.creator.identifierRasmi Avula: 0000-0003-0066-6964
cg.howPublishedFormally Publisheden
cg.identifier.doihttps://doi.org/10.1016/j.advnut.2025.100367en
cg.identifier.projectIFPRI - Nutrition, Diets, and Health Unit
cg.identifier.publicationRankA Plus
cg.isijournalISI Journalen
cg.issn2161-8313en
cg.issue3en
cg.journalAdvances in Nutritionen
cg.reviewStatusPeer Reviewen
cg.subject.impactAreaNutrition, health and food security
cg.volume16en
dc.contributor.authorLeroy, Jef L.en
dc.contributor.authorBrander, Rebecca L.en
dc.contributor.authorFrongillo, Edward A.en
dc.contributor.authorLarson, Leila M.en
dc.contributor.authorRuel, Marie T.en
dc.contributor.authorAvula, Rasmien
dc.date.accessioned2025-01-21T17:39:26Zen
dc.date.available2025-01-21T17:39:26Zen
dc.identifier.urihttps://hdl.handle.net/10568/169581
dc.titlePerspective: Can growth monitoring and promotion accurately diagnose or screen for inadequate growth of individual children? A critical review of the epidemiological foundationsen
dcterms.abstractGrowth monitoring and promotion (GMP), the process of periodic anthropometric measurements to assess the adequacy of individual child growth, is implemented across low- and middle-income countries (LMICs). The epidemiological foundations of GMP (i.e., that GMP can accurately diagnose or screen for inadequate growth) have never been critically reviewed. We first assessed growth patterns of individual healthy children. Using longitudinal data from low-, middle-, and high-income countries, we evaluated whether commonly used GMP criteria can be used for diagnosis and screening; i.e., if they accurately identify current, or predict subsequent, inadequate growth in individual children. The growth of individual healthy children does not track along a specific growth curve which challenges the notion that growth measurements alone can be used to distinguish between healthy and inadequate growth. We demonstrate that GMP criteria do not provide meaningful diagnostic information and that GMP is not a meaningful screening activity: commonly used GMP criteria are inaccurate predictors of (inadequate) growth later in childhood; and collecting individual children’s weight and height does not help to identify who needs support or who will benefit. Our results do not undermine the importance of dedicated programs to diagnose wasting in individual children nor do they challenge the need for well-child care to support parents and to ensure children’s optimal nutrition, health, and development. Our findings, however, highlight the need to carefully reconsider the current design of GMP in LMICs.en
dcterms.accessRightsOpen Access
dcterms.audienceScientistsen
dcterms.bibliographicCitationLeroy, Jef L.; Brander, Rebecca L.; Frongillo, Edward A.; Larson, Leila M.; Ruel, Marie T.; and Avula, Rasmi. 2025. Perspective: Can growth monitoring and promotion accurately diagnose or screen for inadequate growth of individual children? A critical review of the epidemiological foundations. Advances in Nutrition 16(3): 100367. https://doi.org/10.1016/j.advnut.2025.100367en
dcterms.issued2025-03
dcterms.languageen
dcterms.licenseCC-BY-4.0
dcterms.publisherElsevieren
dcterms.subjectchild growthen
dcterms.subjectdiagnosisen
dcterms.subjectepidemiologyen
dcterms.subjectscreeningen
dcterms.subjectstuntingen
dcterms.subjectundernutritionen
dcterms.subjectwastingen
dcterms.typeJournal Article

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