Malnutrition in India: WHO Standards


Malnutrition in India: WHO Standards
Malnutrition in India: WHO Standards

Child Malnutrition in India is like that annoying pop-up ad that just won’t go away in India. We’ve got a challenge on our hands, and one of the measuring tapes we’re using is the World Health Organization (WHO) Growth Standards. But hold on, is it the right measuring tape for our diverse Indian playground?

WHO Growth Standards and MGRS

The WHO standards are like the global fashion trends, but in this case, it’s all about height-for-age and weight-for-height. The Multicentre Growth Reference Study (MGRS) is the catwalk where these standards strutted their stuff between 1997 and 2003. They went to six countries, including India, to set the stage for what’s considered “normal growth.”

Importance of India-Specific Standards

The existing standards used in India, derived from the WHO-Multicentre Growth Reference Study (WHO-MGRS), are under scrutiny for their applicability to the Indian context. Recognizing the diverse nature of India, the ICMR acknowledges the need for growth references that account for regional variations in growth potential.

Why a New Study?

The ICMR formed a panel last year to create growth standards tailored specifically to India. Concerns were raised about the limitations of the current WHO-MGRS standards, which were based on data from six countries, including India. The call for expressions of interest by the ICMR emphasizes the necessity of growth references that include urban and rural children from diverse regions of the country.

Sampling Concerns

Now, critics are side-eyeing this MGRS sample, which was a South Delhi elite club. It’s like trying to understand the taste of biryani by only asking people at the Taj Hotel. We’ve got diversity, folks – it’s time our measuring tape did too.

Genetic Growth and Maternal Heights

Let’s talk genetics – not the kind that determines if you can roll your tongue, but the one that decides your height potential. Maternal height, a non-negotiable part of the genetic package, is throwing a curveball. It’s like trying to grow a skyscraper when the foundation is a bit, well, short.

Regional Disparities

But hold on, countries in South Asia with similar economic conditions are saying, “Hey, we’re rocking these WHO-MGRS standards!” It’s like neighbors throwing a better party using the same recipe. So, what gives, India?

Other Concerns and Misdiagnosis

Are we overfeeding our kids? That’s the question on everyone’s mind. Using high standards could be like trying to fit into skinny jeans after Diwali – uncomfortable and potentially unhealthy. We might end up with a bunch of kids classified as ‘overweight’ and, spoiler alert, that’s not helping anyone.

Programmatic Improvements

But hey, it’s not all gloom and doom. We can spice up our government programs like a boring curry. The suggestion here is to level up the meal game – think diversifying diets, throwing in some eggs, and making pulses the rockstars of the Public Distribution System. It’s time for a culinary revolution!

Global vs. Local Perspectives

Genetic factors, ethnicity, and socio-economic disparities significantly influence child growth. Pediatricians argue that applying global standards may lead to inaccurate assessments and interventions. Customizing references to local contexts becomes essential for precise child health monitoring and interventions.

Recommendations and ICMR’s Role

Enter the Indian Council of Medical Research (ICMR). They’ve formed a committee – the superheroes of the growth chart saga. This committee is suggesting a deep dive into child growth across the country. If needed, they might even craft a growth chart that screams “Made in India.”

Balancing Aspirations

Sure, we need updated information, but we can’t ditch the WHO-MGRS standards like last year’s smartphone. The trick is to balance the international catwalk with our local trends. It’s like rocking a traditional saree with a touch of global glam – best of both worlds.

What Does the ICMR Study Entail?

The ICMR’s study is a comprehensive multi-centric research initiative comprising two observational studies conducted in both rural and urban areas across six regions in India.

Longitudinal Study

The first part involves a longitudinal study, tracking individuals from early pregnancy until delivery, with periodic follow-ups of the newborn up to 2-3 years of age. Pregnant women meeting predefined criteria will be enrolled to ensure a conducive environment for growth.

Cross-Sectional Study

The second part is a cross-sectional study covering all age brackets from 2-3 years up to 19 years. Participants will be selected based on predefined criteria to ensure unhindered growth and development without identifiable constraints.


In the end, this growth chart debate is like choosing between chai and coffee – we want the best of both. The WHO standards, despite their critics, are like a reliable GPS guiding us through the labyrinth of child undernutrition. As we dream of a developed India by 2047, let’s make sure our growth charts grow with us.

Frequently Asked Questions (FAQ)

Why is ICMR developing India-specific growth standards?

ICMR recognizes the need for growth references that accurately represent the diversity of India, considering regional variations in growth potential. Existing global standards may not be entirely applicable to the Indian context.

What are the limitations of the current WHO-MGRS standards?

The WHO-MGRS standards, used in India since 2006, were based on data from six countries, including India. Concerns have been raised about their accuracy in the Indian context, prompting the need for country-specific standards.

How do existing references differ in their assessment of child malnutrition in India?

Studies show variations in the prevalence of stunting and wasting when using the WHO-MGRS reference compared to a country-specific growth chart called Indian Urban Middle Class (IUMC).

How long will the ICMR project take, and what happens in the interim?

The project to devise new standards is expected to take at least four years. In the meantime, some panel members propose using growth standards similar to the WHO reference until the prospective study results become available.

Why are there concerns about using WHO-MGRS standards in India?

Critics are side-eyeing the MGRS sample, which was basically a VIP club in South Delhi. It’s like trying to understand the pulse of the nation by only asking the elite – not the best strategy.

How does maternal height impact child growth, and why is it a concern?

Maternal height is like the secret sauce in the growth recipe. The concern is that trying to boost the height game in one generation is like expecting instant noodles to grow into biryani.

What is the role of ICMR in the growth chart debate?

ICMR is like the captain of the growth chart ship. They’ve formed a committee to explore child growth across the country. If needed, they might craft an Indian growth chart that fits our unique flavors.

How can overfeeding be addressed in government programs addressing undernutrition?

It’s time to upgrade our meal plans. Diversify diets, throw in some eggs, and let pulses shine in the Public Distribution System – because a balanced diet is the key to a nation’s heart.
Malnutrition in India: WHO Standards

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