After the first year of life, children usually follow very predictable gains in weight and height over time. Growth as gain in weight and height remains, with activity, the aspect of energy consumption that the body can reduce if energy intakes are inadequate for all needs. The wide range of normal weights for age in a population means that a single weight in an individual child is not a good indicator of over or under nutrition. Nevertheless, weight change over time is the most widely used parameter for judging nutritional status. Failure to gain weight at the expected rate is often the first evidence of declining nutritional status. Where inadequate nutrition is prolonged, linear growth faltering also occurs. Growth curves showing weights and heights plotted against age with trajectories for mean and standard deviation or centile distributions of a population are the basis of growth assessment in childhood. In infancy, crossing the centiles upwards or downwards is quite common as infants express their genetic potential for growth in a postnatal environment of different constraints from those in utero. In adolescence, growth may diverge from population patterns because of the timing of the pubertal growth spurt in relation to the reference population. Between these two periods of apparent growth instability, the majority of children follow very stable growth trajectories in relation to population distribution for age. This is particularly so for height. The obesogenic environment enveloping so many children in westernized societies today may be causing children's weights to move up across the centiles much more frequently than in the past.
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