A comparison of the 2015 Indian Academy of Pediatrics, International Obesity Task Force and World Health Organization growth references among 5–18-year-old children

Abstract

Background and Rationale: The Indian Academy of Pediatrics (IAP) Growth Charts Committee has constructed revised IAP growth references for 5–18-year-old Indian children. This study was conducted with the objective of comparing these growth references with those prescribed by the International Obesity Task Force (IOTF) for Asian population and by the World Health Organization (WHO). Methods: Information about age, weight, and height was obtained from school-age children and adolescents between 5 and 18 years of age attending a health center as patients or accompanying persons. Three reference systems - the new IAP, “Asian” IOTF, and WHO-based on age- and gender-specific body mass index cutoffs were used to classify children as obese, overweight, or nonobese nonoverweight. The three reference systems were compared using weighted kappa. Results: The prevalence of overweight using new IAP, “Asian” IOTF, and WHO reference systems was 6.6%, 6.6%, and 4.0%, respectively. The prevalence of obesity using new IAP, “Asian” IOTF, and WHO reference systems was 5.0%, 5.0%, and 4.3%, respectively. The prevalence of overweight and obesity was lower when the WHO reference was used, especially for adolescents. There was an excellent agreement between new IAP and “Asian” IOTF references (weighted kappa = 0.9558, 95% confidence interval 0.9134–0.9982). Conclusions: The WHO reference may be less suitable for use in the Indian context, especially in adolescents.