The CDC Growth Chart Reference Population
RACE/ETHNICITY OF THE REFERENCE POPULATION
The racial and ethnic distribution in the reference population is
representative of the U.S. population at the time each of the NHES and
NHANES surveys were conducted.
CDC promotes one set of growth charts for all racial and ethnic
groups. Racial- and ethnic-specific charts are not recommended because
studies support the premise that differences in growth among various
racial and ethnic groups are the result of environmental rather than
genetic influences (Garza and de Onis, 2004;
Mei, Yip, Trowbridge, 1998; Kuczmarski et al 2002) .
For example, this graph shows data from the Pediatric Nutrition
Surveillance System on the prevalence of low height-for-age or
stunting of recently immigrated refugee children from Southeast
Asia in the early 1980s (yellow line) compared to white children
(red line). By the 1990s, the prevalence of low height-for-age
had declined among Asian children and heights for age were
almost identical to that of white children in the United States.
This study illustrates the effect of environmental factors on
growth. Improved socioeconomic status often is associated with
improved growth (Mei, Yip, Trowbridge, 1998).