Assessment of Agreement between the National (Indian Academy of Pediatrics) and International (Centers for Disease Control and World Health Organization) growth references among tibetan adolescent girls of Kangra District, Himachal Pradesh

• Main Authors: Shweta Singh, Neelam Singh, Gautam Kumar Kshatriya
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Medical Journal of Dr. D.Y. Patil Vidyapeeth
• Subjects: adolescent girls; body mass index; growth references; stunting
• Online Access: http://www.mjdrdypv.org/article.asp?issn=2589-8302;year=2020;volume=13;issue=6;spage=624;epage=629;aulast=Singh
• ISSN: 2589-8302; 2589-8310

Context: Various growth assessment references are available to assess nutritional status. The use of body mass index (BMI) in adolescents is well established for clinical and public health applications. It is required to compare national references with the international, to avoid over/underestimation of BMI categories. Aims: The aim of the present study was to quantify differences in the assessment of height/age and BMI/age ratios using national (Indian Academy of Pediatrics [IAP]) and international (Centers for Disease Control and Prevention [CDC], and World Health Organization [WHO]) references. Subjects and Methods: Anthropometric measurements of 276 Tibetan adolescent girls (13–18 years old) were taken. BMI-for-age and height-for-age were measured and compared using three references – IAP 2015, WHO 2007, and CDC 2000. Statistical Analysis Used: Kappa coefficient was done between different references using SPSS version 20 and MS-excel. Results: The prevalence of overweight/obesity was reported highest (23.55%) by IAP references, while stunting was highest (17.26%) with CDC references. A substantial agreement (k = 0.623) was observed in stunting and almost perfect agreement (k = 0.868) was observed for BMI categories between WHO and CDC. The disagreement level was highest in IAP and CDC for stunting and IAP and WHO for BMI categories. Conclusions: Prevalence of malnutrition differs with the application of different references. National references producing higher estimates of obesity than international definition indicates that decisions regarding whether or not to use national BMI references, should always be undertaken with caution.