Publications

Anthropometric Growth Reference for Indian Children and Adolescents.

Majumder, Rajesh; Kurpad, Anura V.; Sachdev, Harshpal Singh; Thomas, Tinku; Ghosh, Santu

OBJECTIVE: We aimed to develop anthropometric growth references for Indian children and adolescents, based on available 'healthy' child data from multiple  national surveys. METHODOLOGY: Data on 'healthy' children, defined by comparable  WHO's Multicentre Growth Reference Study (MGRS) selection criteria, were  extracted from four Indian surveys over the last 2 decades, viz, NFHS-3, 4, and 5  and Comprehensive National Nutrition Survey (CNNS). Reference distributions of  height-for-age for children up to 19 years, weight-for-age for children up to 9y,  weight-for-height for children less than 5 years and BMI for age for children  between 5-19 y were estimated by GAMLSS with Box-Cox Power Exponential (BCPE)  family. The national prevalence of growth faltering was also estimated by the  NFHS-5 and CNNS data. RESULTS: The distributions of the new proposed Indian  growth references are consistently lower than the WHO global standard, except in  the first 6 months of age. Based on these references, growth faltering in Indian  children and adolescents reduced > 50% in comparison with the WHO standard.  CONCLUSION: The study findings revealed that the WHO one-standard-fits-all  approach may lead to inflated estimates of under nutrition in India and could be  a driver of misdirected policy and public health expenditure in the Indian  context. However, these findings need validation through prospective and focussed  studies for more robust evidence base.