COMPARATIVE ANALYSIS OF GROWTH PATTERNS WHO 2007 AND NATIONAL REFERENCES IN THE ASSESSMENT OF CHILD NUTRITIONAL STATUS IN ECUADOR

This study examined the degree of agreement between the growth patterns established by the WHO in 2007 and national references used to assess the nutritional status of children aged 6 to 12 in Ecuador. Materials and Methods: This observational, retrospective, descriptive, cross-sectional study used a sample obtained from an open database of the National Institute of Statistics and Census (INEC). The database contained information on 2,540 schoolchildren between the ages of six and 12 from different cities in Ecuador. Age, city of birth, weight, and height data were collected to establish anthropometric indicators, such as weight-for-age (WFA), height-for-age (HFA), and body mass index (BMI), for each model to be compared. The mean and standard deviation were calculated for the anthropometric measurements. For the comparison between groups of women and men, the t-test for independent samples was carried out. Additionally, percentage frequency tables were generated for the nutritional status and height variables according to the WHO 2007 and national references. These were compared using the Pearson chi-square independence test, considering p < 0.05 as significant. Additionally, 95% confidence intervals were calculated for both proportions and means. To compare nutritional status according to the two national classification criteria and the WHO 2007 criteria, concordance was analyzed using the Kappa index. Results: An analysis of the anthropometric characteristics of the sample population revealed no significant differences between the sexes with respect to weight and height values according to age. A comparison of the nutritional diagnosis according to the World Health Organization's reference with the national reference indicated a decrease in the prevalence of overweight individuals by 3%.The prevalence of obesity was found to be 5%, and in individuals with normal nutritional status, it was 12.9%. In comparison, the prevalence of morbid obesity increased by 7.1%. The prevalence of obesity was 0.7%, that of thinness was 6.7%, and that of severe thinness was 1.9%. Finally, when comparing the two evaluation models, a Kappa index of 0.53 was obtained, equivalent to moderate agreement. Conclusion: The analysis indicated that, when employing national benchmarks, the prevalence of obesity and morbid obesity is significantly higher than when utilizing WHO benchmarks. A particularly salient finding was the marked increase in diagnoses among 10-year-old boys and 12-year-old girls. The observed discrepancy indicates that national references are more suitable for the population under study, thereby facilitating a more precise evaluation of the nutritional status of children in this region.