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Rethinking 'normal': are pubertal milestones and growth charts obsolete?

Balaji Chinnasami1, Kanimozhi Sadasivam2, Aamina Hussain3

  • 1Paediatric Endocrinology Unit, Department of Paediatrics, SRM Medical College, Hospital and Research Centre, SRM Institute of Science and Technology, Potheri, Kattankulathur, Chengalpattu, Tamilnadu 603203, India.

Trends in Endocrinology and Metabolism: TEM
|September 27, 2025
PubMed

Insights

Pediatric growth monitoring needs updating due to rising obesity and precocious puberty. We propose using metabolic health benchmarks instead of traditional anthropometry for better long-term health insights.

Area of Science:

  • Pediatric Endocrinology
  • Growth Monitoring
  • Metabolic Health

Background:

  • Childhood development and pubertal milestones are key to pediatric growth monitoring.
  • Increasing trends in childhood obesity and precocious puberty challenge current growth standards.
  • Existing anthropometry-based criteria may not accurately reflect long-term health outcomes.

Purpose of the Study:

  • To propose a paradigm shift in pediatric growth monitoring.
  • To advocate for metabolically informed benchmarks over traditional anthropometry.
  • To improve the assessment of long-term health in children.

Main Methods:

  • Review of current pediatric growth monitoring guidelines.
  • Analysis of trends in childhood obesity and precocious puberty.
  • Conceptual framework for metabolically informed growth benchmarks.

Main Results:

  • Current anthropometric standards may be misleading.
  • Metabolic health indicators offer a more accurate reflection of long-term health.
  • A shift towards metabolic benchmarks is warranted for improved pediatric care.

Conclusions:

  • Traditional growth references require re-evaluation.
  • Metabolically informed benchmarks are essential for accurate pediatric health assessment.
  • Adopting new benchmarks will enhance long-term health outcomes in children.

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