A Study on New IAP 2015 Growth References in Rural South Indian Children

Time to Shun Diversity in Growth Charts: A Case for Using Only IAP 2015 Growth Charts for Identification of Growth Abnormalities in 5–18-Year-Old Indian Children

“…In the IAP 2015 charts, 23rd adult equivalent centile corresponds to approximately 0.55 SD (71st centile) for males and 0.67 SD (75th centile) for females; while the 27th adult equivalent centile corresponds to 1.33 SD (90th centile) and 1.63 SD (95th centile), respectively, in males and females. This revised approach has helped in early identification of children with overweight/ obesity, as noted in previous studies [6,7], and corroborated by the present study as well [1].…”

“…Regarding wasting, or rather thinness, which is a more appropriate term for children above 5 y of age, the 2015 charts define it as BMI below the 3rd centile, while the older IAP charts defined it as BMI below the 5th centile. In the study by Chalil et al, a major discrepancy has been observed in the prevalence of thinness by the 2015 vs. older IAP charts (11% vs. 1.5%) [1]. This is somewhat disconcerting, as it conveys the impression that in the newer charts there may have been an upward shift in the weight and BMI centiles, leading to erroneous labeling of some children with normal BMI as thin.…”

“…These are useful at local as well as country level for planning and resource allocation for various nutritional problems. In this issue of the Journal, a study among rural adolescents from Erode and Vellore districts of Tamil Nadu by Chalil VK et al, with the objective of assessing the utility of IAP 2015 growth references in identifying growth abnormalities in this population in comparison to other charts, has been published [1].…”

“…One of the key aspects highlighted in this paper is that the use of appropriate growth charts that are population-specific and contemporary, is of utmost importance in the correct identification of growth abnormalities. For example, the use of World Health Organization (WHO) or Center for Disease Control (CDC) charts in place of the IAP 2015 charts can lead to an erroneous diagnosis of short stature and unnecessary investigations in 7 to 28% more adolescents (prevalence of short stature 11.3, 32.5, and 4.2% by WHO, CDC and IAP 2015 charts, respectively) [1]. At the same time, the percentage of children classified as short by the 2015 charts is slightly higher than that classified using the older IAP charts (based on the 1992 paper by Agarwal et al, and also recommended in the IAP 2007 guidelines) [2,3], reflecting the slight secular trend in height.…”