Differences in body height between the contemporary Western Balkan children and the WHO growth references core sample

  • Gregor Starc
  • Stevo Popović
  • Višnja Đordić
  • Sergej Ostojić
  • Sanja Musić Milanović
  • Enisa Kujundžić
  • Igor Spiroski
  • Saša Đurić
  • Bojan Mašanović
  • Vedrana Sember
  • Bojan Leskošek
Keywords: stature, children, Balkans, growth references, misclassification


Body height is the most commonly used anthropometric measure for the assessment and classification of somatic status and growth. The World Health Organization constructed various growth references intended for global use that are directly derived or indirectly affected by body height, but the WHO core sample is based on country-specific, relatively small, and temporally distant reference samples from the Health Examination Survey Cycle II (1963-65) and the Health and Nutrition Examination Survey Cycle I (1971-75). This paper aimed to assess whether the body height of the contemporary 7- to 8-year-olds from the Western Balkans is similar to the body height of their peers from the reference core sample. We utilised the 2017 data from the Western Balkans for comparison, and the analysis showed that contemporary children from this region are more than 4 cm taller from their peers from the core reference sample. The 50th percentile of body height in the Western Balkan sample exceeds the 75th percentile of the core reference sample, which shows that the two populations are quite distinct. The WHO references should, therefore, be used with caution for growth assessment in children from the Western Balkans.