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Comparative Study
. 2015 Mar 11;10(3):e0120806.
doi: 10.1371/journal.pone.0120806. eCollection 2015.

Should the WHO Growth Charts Be Used in France?

Free PMC article
Comparative Study

Should the WHO Growth Charts Be Used in France?

Pauline Scherdel et al. PLoS One. .
Free PMC article


Background: Growth charts are an essential clinical tool for evaluating a child's health and development. The current French reference curves, published in 1979, have recently been challenged by the 2006 World Health Organization (WHO) growth charts.

Objective: To evaluate and compare the growth of French children who were born between 1981 and 2007, with the WHO growth charts and the French reference curves currently used.

Design: Anthropometric measurements from French children, who participated in 12 studies, were analyzed: 82,151 measurements were available for 27,257 children in different age groups, from birth to 18 years. We calculated and graphically compared mean z-scores based on the WHO and French curves, for height, weight and Body Mass Index (BMI) according to age and sex. The prevalence of overweight using the WHO, the French and International Obesity Task Force definitions were compared.

Results: Our population of children was on average 0.5 standard deviations taller than the French reference population, from the first month of life until puberty age. Mean z-scores for height, weight and BMI were closer to zero based on the WHO growth charts than on the French references from infancy until late adolescence, except during the first six months. These differences not related to breastfeeding rates. As expected, the prevalence of overweight depended on the reference used, and differences varied according to age.

Conclusion: The WHO growth charts may be appropriate for monitoring growth of French children, as the growth patterns in our large population of French children were closer to the WHO growth charts than to the French reference curves, from 6 months onwards. However, there were some limitations in the use of these WHO growth charts, and further investigation is needed.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.


Fig 1
Fig 1. Mean z-scores of our French population (birth—5 years) according to both growth charts.
Fig 2
Fig 2. Mean z-scores of our French population (5–18 years) according to both growth charts.
Fig 3
Fig 3. Mean z-scores of exclusively/never breastfed children according to both growth charts.

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Grant support

The funding source for this study: Ministry of Health (Direction Générale de la Santé) and all the funding sources for the different cohorts and surveys (EDEN, FLVS, ELFE, PELAGIE, EPIPAGE, ELANCE, ICAPS, ENNS, INVS/DGESCO, IRSA, PNNS en Aquitaine and INCA2 study; if required details can be provided in supplementary material). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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