Field Testing of IAP2015 Charts

Area of Science:

• Pediatric Nutrition
• Growth Monitoring
• Anthropometry

Background:

• Accurate growth charts are essential for monitoring child development and nutritional status.
• Existing growth references, such as World Health Organization (WHO) and Indian Academy of Pediatrics 2007 (IAP2007) charts, may not reflect the current generation of children accurately.
• Variations in socioeconomic status can influence anthropometric measurements and growth patterns.

Purpose of the Study:

• To evaluate the performance of the Indian Academy of Pediatrics 2015 (IAP2015) growth charts across diverse socioeconomic strata.
• To compare Z-scores for height, weight, and Body Mass Index (BMI) for age derived from IAP2015 charts against those from IAP2007 and WHO charts.
• To assess the representativeness of IAP2015 charts for contemporary Indian children.

Main Methods:

• A cross-sectional observational study was conducted in Pune, India.
• Anthropometric measurements (height, weight) were collected from apparently healthy children aged 5-18 years from urban affluent, urban underprivileged, and rural populations.
• Standard deviation scores (Z-scores) for height-for-age, weight-for-age, BMI-for-age were calculated using IAP2015, IAP2007, and WHO growth charts.

Main Results:

• Significant differences in anthropometric parameters were observed across socioeconomic groups, with urban affluent children being tallest and heaviest, and urban underprivileged children being shortest.
• Children exhibited shorter stature on WHO references and taller stature on IAP2007 references.
• BMI Z-scores were higher on IAP2007 charts and lower on WHO references. The IAP2015 charts classified the highest proportion of urban affluent children within the reference range.
• WHO references led to overestimation of stunting and wasting, while IAP2007 charts underestimated these conditions. Both WHO and IAP2007 charts classified fewer children as obese/overweight compared to IAP2015.

Conclusions:

• The IAP2015 growth charts serve as a better representation of healthy children in the current generation.
• Utilizing IAP2015 charts can help prevent inappropriate classification of children's growth and nutritional status.
• These updated charts are recommended for use in clinical practice and public health initiatives for accurate child growth monitoring.