Table 3.

Summary of recommendations for establishing Saudi guidelines of anthropometric measurements for children/adolescents and directions for future work in line with the Saudi 2030 Vision.

Recommendations—Children/Adolescents	Directions for Future Work
1. Use preterm infants’ growth standards for preterm infants if preterm infants are well-nourished and free from environmental and socioeconomic constraints on growth until 64 weeks postmenstrual age [202]	Develop a protocol to be used in all hospitals and to be endorsed by the Saudi MOH
2. Update the Saudi growth charts (SGC) using the WHO and the United Nations Children’s Fund (UNICEF) guideline for children under 5 years old, Arabic version [15] (see Table S3)	▪Use the WHO protocol for anthropometric measurement [15] to ensure standardization and provide a guideline for pediatricians, dietitians, general practitioners and family doctors on how to use the SGC and interpret them. ▪Integrate SGC into electronic health records [216] Develop a protocol on anthropometric data documentation in hospital systems and to be reported to the Saudi MOH ▪More studies on the assessment of growth status (growth charts used) of Saudi children and the reasons of why Saudi growth charts are not used by some clinicians are needed [200,201]
3. Explore non-traditional anthropometrics to define obesity in Saudi children and develop specific cutoffs [206]	Non-traditional anthropometrics, such as chest and wrist circumference, body mass abdominal index etc. [206] can be used in the case of limited equipment available and may help prevent childhood obesity by early detection
4. Update the SGC for children/adolescents ages 5–19 years [209] (see Table S3)	▪Collaboration between Saudi MOH and Saudi Ministry of Education to develop a protocol for annual screening of anthropometrics in schools [209] ▪Provide a guideline for paediatricians, dietitians, general practitioners and family doctors on how to measure anthropometrics to ensure standardization and how to use the Saudi growth charts and interpret them [199] ▪More studies on the assessment of growth status (growth charts used) of Saudi adolescents and the reasons of why Saudi growth charts are not used are needed [199] ▪Develop a protocol on anthropometric data documentation in hospital systems and to be reported to the Saudi MOH
Recommendations for Individuals with Health Conditions and Disabilities	Directions for Future Work
5. Update SGC for Down syndrome [213]	Update, publish the Saudi cutoffs and endorse them to be used by the Saudi MOH
6. Create simplified equations to calculate body surface area in Saudi children and adults from large representative Saudi samples [43,47].	Equations to calculate body surface area are created from anthropometrics (e.g., weight, height). Body surface area is a major factor in the determination of the course of treatment and drug dosage and can be used by physicians in different medical conditions (e.g., transplantation, predict chances of survival in burn patients, nephrotic syndrome) [214]
	▪Provide a guideline for health practitioners on when and how to use body surface equations to ensure standardization and how to interpret the results. ▪Generalize and endorse the use of body surface equations by the Saudi MOH
7. Create a national birth defect registry [211]	The data from the registry will help in identifying the prevalence, trends, the causes of birth defects and conducting preventive measures.

Legend: MOH: Ministry of Health, SGC: Saudi growth charts, WHO: World Health Organization.