discussions, stats, and author profiles for this publication at: http://www.researchgate.net/publication/225288167
CITATIONS
15
8 AUTHORS, INCLUDING:
Raman Marwaha
SEE PROFILE
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Ratnesh Kanwar
Kuntal Bhadra
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269
ABSTRACT
Background. The assessment of growth is crucial for
child care and reference data are central to growth monitoring.
We aimed to assess the height, weight and body mass index
(BMI) of Indian schoolchildren in order to develop genderappropriate growth charts for children 518 years of age.
Methods. Cross-sectional evaluation of anthropometric
parameters (height, weight and BMI) was done in Indian schoolchildren (318 years) randomly selected from both fee-paying
(upper socioeconomic strata) and non-fee paying (lower socioeconomic strata) schools from 4 regions (north, south, east and
west) of India. A total of 106 843 children were evaluated, of
which 42 214 children (19 303 boys, 22 911 girls) were from
the lower socioeconomic strata and 64 629 children (34 411
boys, 30 218 girls) were from the upper socioeconomic strata.
Normative charts, using the lambdamusigma (LMS) method
to smoothen the curves, were drawn from children belonging to
the upper socioeconomic strata, in view of the gross discrepancy
between the two socioeconomic strata.
Results. Height, weight and BMI percentile (3rd, 5th, 10th,
25th, 50th, 75th, 90th, 95th and 97th) data were calculated
and charts generated. The height of boys and girls was consistently
higher at all ages when compared with earlier India data, but the
final height was 24 cm lower than that reported in the WHO
multicentre study of 2007. Weight centiles showed a rising
trend both in boys and girls compared not only to earlier Indian
data published in 1992, but also to that reported by the WHO
multicentre study. The median weight at all ages in both boys
and girls was approximately 4 kg more than that reported in
affluent Indian children two decades earlier.
Institute of Nuclear Medicine and Allied Sciences, Timarpur,
Delhi 110007, India
RAMAN KUMAR MARWAHA, RATNESH KANWAR, AMIT
SABHARWAL, KUNTAL BHADRA Department of Endocrinology
and Thyroid Research Centre
All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029,
India
NIKHIL TANDON, SHIVAPRASAD C. Department of Endocrinology
and Metabolism
Sher-i-Kashmir Institute of Medical Sciences Srinagar, Jammu and
Kashmir
MOHD ASHRAF GANIE Department of Endocrinology
B.R. Sur Homeopathic Medical College, New Delhi, India
ARCHNA NARANG Department of Medicine
Correspondence to RAMAN KUMAR MARWAHA;
marwaha_ramank@hotmail.com
The National Medical Journal of India 2011
270
TABLE I. Comparison of height, weight and BMI centiles (3rd, 50th and 97th) of lower socioeconomic strata (LSES) v. upper
socioeconomic strata (USES) schoolgirls and schoolboys at ages 3, 10 and 18 years
Age (years)
LSES boys
USES boys
3rd
50th
97th
3rd
3
10
18
88.4
117.8
155.2
97.2
132.9
169.1
109.0
148.6
181.5
91.2
125.4
160.4
3
10
18
11.0
19.1
40.7
13.5
26.3
54.7
17.9
39.8
78.4
10.8
22.6
45.7
50th
LSES girls
97th
USES girls
3rd
50th
97th
3rd
50th
97th
Height (cm)
101.2 111.6
138.6 152.2
174.4 185.5
87.1
118.8
146.7
96.0
133.3
154.6
112.3
146.9
164.6
90.4
126.3
149.1
99.5
139.5
158.5
111.0
151.9
168.0
Weight (kg)
14.0
21.0
33.0
53.3
66.2
98.5
10.4
19.1
37.1
13.0
26.5
46.5
19.0
39.4
62.8
10.3
22.9
40.8
13.8
33.8
55.6
20.8
52.7
80.1
200
120
190
110
180
100
170
90
160
80
Weight in kg
Height in cm
MARWAHA et al. : REFERENCE DATA FOR HEIGHT , WEIGHT AND BODY MASS INDEX OF INDIAN SCHOOLCHILDREN
150
140
130
271
70
60
50
120
40
110
30
100
20
90
10
0
80
4
10
11
12
13
14
15
16
17
18
19 20
10
11
12
13
14
15
16
Age (years)
Height percentiles
3
10
25
50
75
90
95
97
91.19
96.38
101.51
106.44
111.22
115.95
120.66
125.44
130.40
135.61
140.94
146.02
150.47
154.17
157.34
160.39
92.42
97.67
102.85
107.83
112.66
117.45
122.22
127.07
132.13
137.46
142.90
148.06
152.56
156.24
159.38
162.37
94.34
99.67
104.93
109.98
114.89
119.76
124.63
129.60
134.80
140.30
145.88
151.15
155.67
159.33
162.39
165.27
97.57
103.04
108.44
113.63
118.66
123.68
128.70
133.86
139.28
144.99
150.77
156.14
160.66
164.21
167.11
169.79
101.20
106.84
112.40
117.74
122.93
128.10
133.30
138.64
144.25
150.15
156.07
161.47
165.91
169.29
171.96
174.39
104.88
110.70
116.42
121.92
127.26
132.60
137.96
143.47
149.24
155.26
161.23
166.59
170.88
174.04
176.46
178.62
106.87
112.79
118.60
124.19
129.62
135.04
140.49
146.08
151.92
157.98
163.95
169.26
173.46
176.48
178.75
180.77
110.25
116.33
122.32
128.06
133.64
139.20
144.79
150.50
156.42
162.52
168.45
173.64
177.64
180.42
182.44
184.20
111.57
117.72
123.77
129.57
135.21
140.83
146.48
152.23
158.17
164.27
170.17
175.31
179.22
181.90
183.81
185.48
TABLE III. Weight (kg) centiles of 318-year-old Indian schoolboys belonging to the upper socioeconomic
strata
Age (years)
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
18
TABLE II. Height (cm) centiles of 318-year-old Indian schoolboys belonging to the upper socioeconomic
strata
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
17
Age in years
Age in years
Weight percentiles
3
10
25
50
75
90
95
97
10.77
12.53
14.16
15.61
17.07
18.72
20.57
22.63
24.91
27.45
30.27
33.32
36.46
39.58
42.64
45.70
11.09
12.92
14.62
16.15
17.70
19.46
21.43
23.63
26.07
28.78
31.78
34.99
38.27
41.51
44.67
47.82
11.61
13.57
15.40
17.06
18.76
20.69
22.87
25.32
28.02
31.02
34.29
37.77
41.27
44.70
48.01
51.31
12.63
14.83
16.91
18.84
20.83
23.10
25.68
28.58
31.78
35.29
39.09
43.03
46.94
50.69
54.29
57.83
14.03
16.57
19.01
21.30
23.69
26.43
29.54
33.03
36.86
41.03
45.45
49.98
54.37
58.51
62.42
66.25
15.85
18.84
21.74
24.50
27.40
30.72
34.48
38.66
43.20
48.08
53.19
58.33
63.25
67.80
72.04
76.14
17.08
20.36
23.58
26.65
29.88
33.57
37.73
42.31
47.27
52.54
58.03
63.52
68.72
73.50
77.92
82.17
19.73
23.66
27.53
31.25
35.16
39.58
44.49
49.81
55.45
61.38
67.50
73.57
79.25
84.41
89.12
93.60
21.04
25.28
29.47
33.50
37.71
42.46
47.68
53.28
59.18
65.35
71.70
77.98
83.85
89.16
93.97
98.53
19 20
272
36
200
190
33
180
30
170
Height in cm
BMI in kg/m 2
27
24
21
18
160
150
140
130
120
110
15
100
12
90
80
9
4
10
11
12
13
14
15
16
17
18
19 20
10
Age in years
11
12
13
14
15
16
FIG 3. Body mass index (BMI) percentiles of upper socioeconomic strata boys aged 518 years
Age (years)
BMI percentiles
3
10
25
50
75
90
95
97
12.66
12.66
12.69
12.68
12.70
12.82
13.00
13.23
13.46
13.69
13.96
14.29
14.66
15.06
15.44
15.80
12.86
12.90
12.93
12.94
12.99
13.13
13.34
13.60
13.86
14.12
14.41
14.76
15.16
15.58
15.98
16.36
13.19
13.27
13.33
13.37
13.46
13.65
13.91
14.22
14.53
14.83
15.17
15.56
15.99
16.44
16.87
17.29
13.82
13.97
14.10
14.21
14.38
14.65
15.01
15.42
15.82
16.21
16.62
17.09
17.59
18.10
18.59
19.07
14.66
14.91
15.15
15.37
15.65
16.05
16.54
17.08
17.61
18.10
18.61
19.16
19.75
20.34
20.91
21.46
15.72
16.12
16.50
16.87
17.31
17.88
18.54
19.24
19.91
20.53
21.14
21.80
22.47
23.15
23.79
24.42
16.41
16.92
17.41
17.89
18.44
19.13
19.90
20.71
21.46
22.15
22.82
23.52
24.25
24.97
25.65
26.31
17.87
18.63
19.38
20.12
20.94
21.89
22.90
23.89
24.78
25.57
26.32
27.10
27.90
28.69
29.43
30.14
18.58
19.48
20.37
21.26
22.21
23.29
24.40
25.47
26.41
27.22
27.98
28.78
29.60
30.42
31.17
31.89
TABLE V. Height (cm) centiles of 318-year-old Indian schoolgirls belonging to the upper socioeconomic
strata
Age (years)
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
18
19 20
TABLE IV. Body mass index (BMI; kg/m2) centiles of 318-year-old Indian schoolboys belonging to the
upper socioeconomic strata
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
17
Age in years
Height percentiles
3
10
25
50
75
90
95
97
90.42
95.52
100.57
105.53
110.46
115.50
120.77
126.25
131.68
136.60
140.54
143.46
145.53
146.98
148.11
149.12
91.45
96.64
101.79
106.84
111.87
117.01
122.39
127.95
133.43
138.33
142.20
145.02
146.98
148.34
149.37
150.30
93.09
98.42
103.69
108.88
114.05
119.35
124.86
130.54
136.08
140.95
144.72
147.40
149.21
150.42
151.32
152.11
96.00
101.52
107.00
112.39
117.77
123.27
128.97
134.81
140.41
145.23
148.85
151.31
152.89
153.88
154.56
155.15
99.49
105.20
110.86
116.43
121.98
127.65
133.51
139.45
145.08
149.84
153.30
155.57
156.92
157.68
158.15
158.53
103.28
109.13
114.93
120.63
126.29
132.06
138.00
144.00
149.63
154.32
157.64
159.73
160.89
161.46
161.74
161.92
105.46
111.36
117.21
122.94
128.63
134.43
140.40
146.41
152.03
156.67
159.92
161.92
163.00
163.47
163.66
163.74
109.38
115.31
121.18
126.93
132.64
138.45
144.41
150.40
155.97
160.55
163.69
165.56
166.50
166.84
166.88
166.80
110.99
116.92
122.78
128.52
134.22
140.01
145.96
151.93
157.48
162.03
165.13
166.96
167.85
168.14
168.12
168.00
MARWAHA et al. : REFERENCE DATA FOR HEIGHT , WEIGHT AND BODY MASS INDEX OF INDIAN SCHOOLCHILDREN
110
273
36
100
33
90
30
BMI in kg/m 2
Weight in kg
80
70
60
50
27
24
21
40
18
30
15
20
12
10
0
9
4
10
11
12
13
14
15
16
17
18
19 20
10
Age in years
11
12
13
14
15
Age (years)
Weight percentiles
3
10
25
50
75
90
95
97
10.31
11.96
13.51
14.99
16.56
18.34
20.43
22.86
25.57
28.39
31.10
33.56
35.70
37.55
39.21
40.81
10.64
12.37
14.01
15.57
17.24
19.14
21.36
23.95
26.80
29.75
32.55
35.07
37.23
39.08
40.73
42.33
11.20
13.06
14.83
16.55
18.38
20.47
22.92
25.75
28.85
32.02
34.97
37.56
39.77
41.62
43.25
44.83
12.29
14.39
16.43
18.42
20.57
23.03
25.90
29.19
32.75
36.30
39.52
42.27
44.54
46.39
47.99
49.52
13.77
16.22
18.61
20.97
23.54
26.48
29.89
33.77
37.89
41.92
45.48
48.43
50.78
52.63
54.18
55.64
15.67
18.54
21.37
24.20
27.26
30.76
34.79
39.34
44.10
48.67
52.61
55.79
58.23
60.08
61.57
62.94
16.93
20.07
23.18
26.29
29.66
33.50
37.90
42.83
47.97
52.85
57.02
60.33
62.83
64.68
66.14
67.46
19.58
23.27
26.93
30.59
34.54
39.00
44.07
49.69
55.49
60.94
65.52
69.09
71.72
73.59
74.99
76.21
20.84
24.79
28.70
32.60
36.79
41.51
46.84
52.74
58.80
64.48
69.24
72.93
75.62
77.50
78.88
80.06
TABLE VII. Body mass index (BMI; kg/m2) centiles of 318-year-old Indian schoolgirls belonging to the
upper socioeconomic strata
Age (years)
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
17
18
FIG 6. Body mass index (BMI) percentiles of upper socioeconomic strata girls aged 518 years
TABLE VI. Weight (kg) centiles of 318-year-old Indian schoolgirls belonging to the upper socioeconomic
strata
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
16
Age in years
BMI percentiles
3
10
25
50
75
90
95
97
12.14
12.26
12.35
12.41
12.51
12.66
12.87
13.14
13.48
13.90
14.35
14.81
15.23
15.60
15.91
16.20
12.37
12.51
12.62
12.71
12.83
13.02
13.25
13.55
13.93
14.38
14.86
15.34
15.78
16.15
16.47
16.77
12.76
12.94
13.08
13.21
13.37
13.60
13.89
14.24
14.67
15.17
15.70
16.21
16.68
17.08
17.41
17.73
13.48
13.73
13.95
14.15
14.41
14.72
15.10
15.56
16.09
16.68
17.29
17.87
18.39
18.82
19.18
19.52
14.44
14.79
15.12
15.43
15.79
16.23
16.74
17.33
17.98
18.69
19.40
20.06
20.64
21.11
21.50
21.86
15.63
16.11
16.57
17.02
17.53
18.12
18.78
19.52
20.32
21.16
21.97
22.72
23.37
23.88
24.30
24.68
16.39
16.96
17.51
18.05
18.66
19.35
20.10
20.94
21.82
22.73
23.60
24.40
25.07
25.62
26.05
26.44
17.94
18.71
19.46
20.19
21.00
21.88
22.82
23.81
24.83
25.86
26.83
27.70
28.43
29.01
29.47
29.88
18.66
19.53
20.37
21.20
22.10
23.07
24.08
25.14
26.22
27.29
28.29
29.18
29.93
30.53
30.99
31.41
19 20
274
175.0
165.0
Height (cm)
155.0
145.0
135.0
125.0
115.0
Agarwal et al.10
WHO4
Khadilkar et al.11
Our study
10
11
12
13
14
15
16
17
18
106.3
110.3
108.1
112.4
114.2
116.0
114.9
117.7
119.7
121.7
120.9
122.9
123.6
127.3
126.9
128.1
128.2
132.6
132.4
133.3
133.6
137.8
137.2
138.6
139.6
143.1
142.4
144.2
145.8
149.1
148.3
150.1
152.0
156.0
154.8
156.0
157.6
163.2
161.4
161.4
162.5
169.0
166.1
165.9
166.3
172.9
168.5
169.2
168.7
175.2
169.7
171.9
169.8
176.1
170.4
174.3
Age (years)
FIG 7. Comparison of median height percentiles of boys from our study with WHO (2006) and other Indian studies
MARWAHA et al. : REFERENCE DATA FOR HEIGHT , WEIGHT AND BODY MASS INDEX OF INDIAN SCHOOLCHILDREN
275
75.0
Weight (kg)
60.0
45.0
30.0
15.0
Agarwal et al.10
WHO4
Khadilkar et al.11
Our study
10
11
12
13
14
15
16
17
18
17.1
18.5
17.1
19.0
19.0
20.5
19.8
21.3
21.0
22.5
22.5
23.7
22.6
25.4
25.4
26.4
24.4
28.1
28.6
29.5
27.0
31.2
31.7
33.0
30.6
35.6
36.9
34.8
40.5
41.0
39.4
45.6
45.4
44.1
50.6
49.9
48.5
54.7
54.3
52.4
57.7
58.5
55.5
59.8
62.4
58.6
61.5
66.2
Age (years)
FIG 8. Comparison of median weight percentiles of boys from our study with WHO (2006) and other Indian studies
175.0
165.0
Height (cm)
155.0
145.0
135.0
125.0
115.0
Agarwal et al.10
WHO4
Khadilkar et al.11
Our study
10
11
12
13
14
15
16
17
18
106.0
109.6
107.0
110.9
112.5
115.1
113.1
116.4
117.4
120.8
119.0
121.9
123.2
126.6
125.4
127.6
129.2
132.5
131.2
133.5
135.2
138.6
137.1
139.4
140.9
145.0
143.1
145.0
146.0
151.2
149.1
149.8
150.4
156.4
153.0
153.3
153.8
159.8
155.2
155.5
156.0
161.7
156.3
156.9
156.8
162.5
156.8
157.6
157.0
162.9
156.9
158.1
163.1
157.3
158.5
Age (years)
FIG 9. Comparison of median height percentiles of girls from our study with WHO (2006) and other Indian studies
276
Weight (kg)
60.0
45.0
30.0
15.0
Agarwal et al.10
WHO4
Khadilkar et al.11
Our study
10
11
12
13
14
15
16
17
18
16.8
18.3
16.3
18.6
17.5
20.2
18.5
20.9
19.0
22.4
21.3
23.5
20.8
25.0
24.4
26.4
23.5
28.2
27.8
29.8
26.9
31.9
31.7
33.7
30.9
36.3
37.8
35.0
41.1
41.9
39.1
44.9
45.4
42.7
47.7
48.4
45.7
49.4
50.7
47.7
50.3
52.6
48.4
51.1
54.1
51.7
55.6
Age (years)
FIG 10. Comparison of median weight percentiles of girls from our study with WHO (2006) and other Indian studies
comparing the median BMI of boys between the two studies, this
difference was not observed between the ages of 12 and 15 years.
Even the 3rd centiles of BMI across all ages and both sexes were
higher than that reported by Khadilkar et al.11 This comparison
of weight and BMI between the present and earlier Indian
studies811,22 clearly indicates secular trends in childhood obesity,
which are more prominent in girls than boys.
The above data are in consonance with reports of increasing
prevalence of overweight and obesity in children and adolescents
from across the world, including studies from India.811,2226 The
International Obesity Task Force (IOTF) has recommended cutoffs of 25 kg/m2 and 30 kg/m2 for overweight and obesity in adults,
while there is a suggestion that lower cut-offs of 23 kg/m2 and
27 kg/m2 should be used to define these conditions in South
Asians.26 The National Task Force for Childhood Prevention of
Adult Diseases of the Indian Academy of Pediatrics has
recommended that Indian children >10 years of age are to be
considered overweight if their BMI is >85th percentile for age or
if their weight is >120% of the 50th percentile of weight for height
by national standards.24 After reviewing datasets from several
populations, WHO found that the NCHS dataset was the most
suitable for a smooth transition to the 2006 WHO child growth
standard curves at 5 years, and also aligned well with the IOTF
cut-off values at the age of 18 years. Accordingly, WHO
reconstructed the 1977 NCHS/WHO reference using state-of-theart statistical analysis, resulting in the development of the 2006
WHO growth reference standards, which is recommended for
international use.4 In our study, 85th and 95th percentile values for
MARWAHA et al. : REFERENCE DATA FOR HEIGHT , WEIGHT AND BODY MASS INDEX OF INDIAN SCHOOLCHILDREN
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