National anthropometric reference values and growth curves for Japanese children: history and critical review

Context: Child health statistics are a critical component of child health assessment. However, the importance of nationally representative data on growth is not well recognised for Japanese children. Objective: The aim of this paper is to review the national growth surveys for Japanese children and to discuss the clinical use of the national growth reference values and growth curves. Methods: There are five governmental organisations surveying health and growth in Japanese children. Based on these studies, several aspects of the current governmental policy on child growth assessment have been examined. This review focussed on national anthropometric studies reported by Japanese investigators in English for international readers to understand Japanese issues. Results: A variety of growth reference curves have been developed since the early 1980s in Japan. However, these references have several limitations: incomplete data for both infants and young adults, limited description of socio-economic factors and continued governmental use of weight-for-height rather than BMI. Conclusion: Japanese child health statistics use measures that are applicable only to Japanese children.