Child growth standards

Growth performance of affluent Indian children is similar to that in developed countries

Bhandari N, Bahl R, Taneja S, de Onis M, Bhan MK

Bulletin of the World Health Organization 2002;80:189-95.


A cross-sectional survey was conducted in order to determine whether an affluent population in south Delhi had a growth performance similar to that in developed countries and to identify socioeconomic factors that militated against optimal growth in this group.


The weights and lengths of 395 children aged 12–23 months and the heights of 331 mothers and 153 grandmothers were measured and information was obtained on family socioeconomic status and child-feeding practices. Children born prematurely, i.e. before 37 weeks of gestation, and those with illness adversely affecting growth, were excluded from the analysis, as with the NCHS/ WHO reference population.


In 341 children included in the analysis, the mean Z-scores for weight-for-age, length-for-age and weight-for-length were –0.45, –0.28 and –0.32 respectively. About 6% of the children were underweight (weight-for-age Z-score4–2), 3% were stunted (length-for-age Z-score4–2), and 4% were wasted (weight-for-length Z-score4–2). The factors that were significantly associated with higher length-for-age were one or both parents having 17 years or more of education (mean length-for-age Z-score –0.17) and non-vegetarian diet (mean length-for-age Z-score –0.18). No socioeconomic factors were associated with mean weight-for-length.


The children in this affluent population were close to the NCHS/WHO reference population with regard to anthropometric indicators. The subpopulation with higher parental education had even better growth. It is intended to include this subpopulation in the WHO Multicentre Growth Reference Study.