Development of Updated Growth References for Indian Children and Adolescents (0–18 Years): A Multicenter Cross-Sectional Study

Growth monitoring is a vital component of child health assessment, serving as an early indicator of nutritional status and growth-related disorders. While international growth references, such as the WHO Child Growth Standards (for children under five), WHO Growth References (for ages 5–19) and the 2015 IAP growth charts are commonly used in India, they may not accurately reflect the growth of present day Indian children. Several studies have highlighted the limitations of applying global/ dated standards to Indian populations, including the risk of overestimating undernutrition.

Existing Indian growth references, such as those developed by Agarwal et al. (1992), Khadilkar et al. (2009, 2012), and the IAP Growth Charts (2015), have contributed significantly to pediatric growth assessment in India. However, these data were primarily derived from older cohorts and urban, affluent populations. They may not adequately capture recent secular trends in growth patterns, especially in the context of India’s ongoing nutrition transition and the rising prevalence of overweight and obesity in children and adolescents.

The absence of up-to-date, comprehensive, and nationally representative growth references limits the accuracy of nutritional assessments and hinders effective public health planning. Therefore, there is a clear and urgent need to develop updated growth reference data for Indian children and adolescents aged 0–18 years, based on contemporary anthropometric measurements. Such data will enhance clinical decision-making and provide a robust foundation for nutrition policies, school health programs, and research.