Growth charts — WHO standards versus India crafted.

General Studies Paper – 2

Context:

• Persistent child undernutrition in India prompts debate on WHO Growth Standards’ suitability.
• Concerns include potential overestimation, genetic factors, misdiagnosis risks, and the need for improved interventions and overall development.

Background:

• Child undernutrition persists as a significant issue in India.
• Determinants of undernutrition include food intake, dietary diversity, health, sanitation, women’s status, and poverty.
• Common measures includeheight-for-age (stunting) and weight-for-height (wasting).

Favorable Environment in Child Growth:

• Definition:Refers to conditions supporting healthy child growth, encompassing nutrition, healthcare, sanitation, and socio-economic factors.
• MGRS Approach:Multicentre Growth Reference Study (MGRS) aimed to establish growth standards based on children in favorable environments.

Sampling Concerns:

• Misleading Comparisons:Some argue that comparisons with other datasets may be misleading due to sampling issues.
• Representation in Surveys:Large-scale surveys in India might lack samples reflecting a truly favorable environment for growth.

Genetic and Environmental Factors:

• Influence on Growth:Genetic growth potential and maternal height are considered non-modifiable factors influencing child growth.
• Maternal Height as an Indicator:Maternal height is seen as a reflection of the intergenerational transmission of poverty and a measure of deprivation.

Concerns about Misdiagnosis:

• Potential Overestimation:High growth standards may lead to misdiagnosis and potential overfeeding, contributing to overweight and obesity concerns.
• Balancing Interventions:Despite concerns, the article suggests the need for improved quality in government programs addressing undernutrition. 

Recommendations and Interventions:

• Urgent Action:Implementation of recommendations like including eggs in meals and incorporating pulses in the Public Distribution System.
• Dietary Gaps:Emphasis on improving the quality of meals to ensure they are nutrient-rich and contribute to dietary diversity.

ICMR Recommendation:

• Committee Formation:Indian Council of Medical Research (ICMR) forms a committee to revise growth references, suggesting a detailed nationwide study.

Conclusion:

• While acquiring newer information is welcomed, sticking to WHO-MGRS standards is logical for international comparisons and intra-country trends.