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Relative Growth Modeling of Anthropometric Outcomes
John M. Williamson ORCID icon link to view author John M. Williamson details   Hung-Mo Lin ORCID icon link to view author Hung-Mo Lin details   Molin Wang  

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https://doi.org/10.6339/26-JDS1224
Pub. online: 3 April 2026      Type: Data Science In Action      Open accessOpen Access

Received
2 June 2025
Accepted
22 February 2026
Published
3 April 2026

Abstract

Traditionally z-scores specified from the WHO population growth curves have been used to describe a child’s growth in relation to his age- and sex-matched population distribution. We propose a new regression approach that offers a straightforward interpretation of the relative growth in terms of the original anthropometric variable. We create a hybrid data set consisting of the observations from the study of interest and counterpart pseudo-population observations imputed from the WHO population growth curves matched to each study participant. We then fit linear and quantile regression models to the hybrid data incorporating demographic variables (usually age and biological sex) corresponding to the growth curves of demographically-similar individuals, a study versus population indicator, and its interactions with demographic variables. We further control for confounding variables from the study by adding their interactions with the study indicator variable. The interaction terms between the study indicator and the demographic variables age and biologic sex can be interpreted as relative growth parameters that depict the differences in means (or quantiles) between the study participants and their pseudo-population counterparts of the original anthropometric variables, rather than the associated z-scores. We use anthropometric growth data from a prospective birth cohort study conducted in Uganda for illustration.

Supplementary material

 Supplementary Material
The data set, WHO growth curves, and the SAS IML programs can be downloaded from https://github.com/Hungmolin/Relative-growth-modeling-of-anthropometric-outcomes.git. A complete list of the files is described in README.txt.

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Copyright
2026 The Author(s). Published by the School of Statistics and the Center for Applied Statistics, Renmin University of China.
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Open access article under the CC BY license.

Keywords
linear regression population life tables quantile regression

Funding
HML was partially supported by the National Health Institute under CTSA Grant UL1 TR001863.

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