Growth charts: A diagnostic tool

CONTEXT: Assessment of growth by objective anthropometric methods is crucial in child care. India is in a phase of nutrition transition and thus it is vital to update growth references regularly. OBJECTIVE: To review growth standards and references for assessment of physical growth of Indian children for clinical use and research purposes. MATERIALS AND METHODS: Basics of growth charts and importance of anthropometric measurements are described. A comparison between growth standards and references is provided. Further, Indian growth reference curves based on the data collected by Agarwal et al. and adopted by the Indian Academy of Pediatrics, World Health Organization growth standards for children under the age of 5 years (2006) and contemporary Indian growth references published on apparently healthy affluent Indian children (data collected in 2007-08) are discussed. The article also discusses the use of adult equivalent body mass index (BMI) cut-offs for screening for overweight and obesity in Indian children. RESULTS AND CONCLUSIONS: For the assessment of height, weight and BMI, WHO growth standards (for children < 5 years) and contemporary cross sectional reference percentile curves (for children from 5-18 years) are available for clinical use and for research purposes. BMI percentiles (adjusted for the Asian adult BMI equivalent cut-offs) for the assessment of physical growth of present day Indian children are also available. LMS values and Microsoft excel macro for calculating SD scores can be obtained from the author (email: vamankhadilkar@gmail.com). Contemporary growth charts can be obtained by sending a message to 08861201183 or email: gntd@novonordisk.com.