To celebrate the 21st anniversary of the National Study of Health and Growth, a scientific meeting was held at Guy’s Hospital, London, on 12 October 1992. The programme of the anniversary meeting included papers on the origin and aims of the study by Professor W Holland; the historical background by Professor J M Tanner; social factors, health and growth by Dr R Rona; obesity in Britain by Professor J Garrow; secular trends in growth and obesity by Dr S Chinn; the assessment of trends in asthma in English children by Dr P Burney; and the contribution of the national study to new reference values for growth by Dr S Chinn.
The development and continuation of this study has been a remarkable achievement. Early in the 1960s a survey of schoolchildren was initiated by the then Department of Clinical Epidemiology at St Thomas’ Hospital to investigate the effects of pollution, social and family factors on children aged 5-14, and four areas of Kent were chosen to represent different socio-economic levels - eg Romney Marsh for rural and the Medway towns for industrial urban. Information was collected on height and weight by age, sex and social background and this showed that in the late 1960s the principal factors influencing height were family size, social class and whether the mother was employed. The results on maternal employment were similar to those from surveys carried out in World War II, where the effect was attributed to greater food availability, since the mothers on war work could eat in the factory canteen so that more food was available at home.
In view of the proposed changes in social policy envisaged in 1971, which included the withdrawal of provision of free school milk to children aged 7 and over, the then Ministry of Health decided that these changes should be monitored, and a working group was set up under the chairmanship of Professor Angus Thompson. That working group recommended a nutritional surveillance system and this started in 1972. Its main objective was to assess changes in the nutritional status of children over time, from the measurements of height, weight and triceps skin fold thickness. The design was a mixed longitudinal study. Information on socio-economic factors, food provided in the school, and respiratory illnesses, has been collected via a questionnaire completed by parents; measurements have been obtained for at least 95% of the children in the study and the questionnaire response rate maintained throughout the study is over 80%. Approximately 70 papers incorporating the new data have been published in scientific journals.
Between 8,000 and 10,000 children participate in the study each year. All children in primary schools in 56 areas of England and Scotland are measured in alternate years. This design allows the study of:
The information provided is comparable from area to area and from one year to another. In 1992 new measurements were incorporated to assess cardiovascular risk factors, to be applied in the 9 year old age group only.
The study has contributed to knowledge in the following areas:
This is indeed a remarkable and well worthwhile study.